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J Am Geriatr Soc. 2014 Mar;62(3):512-7. doi: 10.1111/jgs.12683. Epub 2014 Mar 10.

Prognostic differences of the Mini Nutritional Assessment short form and long form in relation to 1-year functional decline and mortality in community-dwelling older adults receiving home care.

Author information

1
Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany.

Abstract

OBJECTIVES:

To compare the prognostic value of the revised Mini Nutritional Assessment short form (MNA-SF) classification with that of the long form (MNA-LF) in relation to mortality and functional change in community-dwelling older adults receiving home care in Germany.

DESIGN:

Multicenter, 1-year prospective observational study.

SETTING:

Community.

PARTICIPANTS:

Older adults (≥ 65) receiving home care (n = 309).

MEASUREMENTS:

Nutritional status (well nourished, at risk of malnutrition, malnourished) was classified using the MNA-SF and MNA-LF at baseline. Functional status was determined according to the Barthel Index of activities of daily living (ADLs) at baseline and after 1 year. Hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality were calculated for MNA-SF and MNA-LF categories using stepwise Cox regression analyses. Repeated-measurements analysis of covariance was used to examine changes in ADL scores over time for MNA-SF and MNA-LF categories.

RESULTS:

MNA-SF classified 15% of the sample as malnourished and 41% as being at risk of malnutrition, whereas the MNA-LF classified 14% and 58%, respectively. During the follow-up year, 15% of participants died. The estimated hazard ratios (HR) for 1-year mortality were lower for MNA-SF than for MNA-LF categories (at risk of malnutrition: HR = 2.21, 95% confidence interval (CI) = 1.02-4.75 vs HR = 5.05, 95% CI = 1.53-16.58; malnourished: HR = 3.27, 95% CI = 1.34-8.02 vs HR = 8.75, 95% CI = 2.45-31.18). For MNA-SF categories, no differences in functional change were found. According to the MNA-LF, ADL decline tended to be greater in those at risk of malnutrition (7.1 ± 10.1 points) than in those who were well nourished (3.7 ± 10.1 points) and malnourished (4.9 ± 10.1 points).

CONCLUSION:

In this sample of older adults receiving home care, the MNA-LF was superior to the MNA-SF in predicting mortality and differentiating functional decline during 1 year of follow-up.

KEYWORDS:

Mini Nutritional Assessment; functional decline; home care; mortality; physical function

PMID:
24611678
DOI:
10.1111/jgs.12683
[Indexed for MEDLINE]

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