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J Nutr Health Aging. 2015 Apr;19(4):461-7. doi: 10.1007/s12603-015-0443-x.

Body mass index, Mini Nutritional Assessment, and their association with five-year mortality in very old people.

Author information

1
M. Burman, Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umea Universitet, Umea, Sweden SE-90187, maria.burman@umu.se.

Abstract

OBJECTIVES:

to investigate the prevalence of malnutrition and the association between Body Mass Index (BMI), Mini Nutritional Assessment (MNA) and five-year mortality in a representative population of very old (>85 years) people.

DESIGN:

A prospective cohort study.

SETTING:

A population-based study of very old people in northern Sweden and western Finland, living in institutional care or in the community.

PARTICIPANTS:

Out of 1195 potential participants, 832 were included (mean age 90.2±4.6 years).

MEASUREMENTS:

Nutritional status was assessed using BMI and MNA and the association of those two variables with five-year mortality was analyzed.

RESULTS:

The mean BMI value for the whole population was 25.1±4.5 kg/m2, with no difference between genders (P=0.938). The mean MNA score was 22.5±4.6 for the whole sample, and it was lower for women than for men (P<0.001). Thirteen percent were malnourished (MNA<17) and 40.3% at risk of malnutrition (MNA 17-23.5) according to MNA. Also, 34.8% of those with a MNA score <17 still had a BMI value ≥22.2 kg/m2. A BMI value <22.2 kg/m2 and a MNA score<17 were associated with lower survival. The association with mortality seemed to be J-shaped for BMI, and linear for MNA.

CONCLUSIONS:

Malnutrition according to MNA was common, but a substantial portion of those with a low MNA score still had a high BMI value, and vice versa. The association with mortality appeared to be J-shaped for BMI, and linear for MNA. The MNA seems to be a good measurement of malnutrition in very old people, and BMI might be misleading and could underestimate the prevalence of malnutrition, especially in women.

PMID:
25809811
DOI:
10.1007/s12603-015-0443-x
[Indexed for MEDLINE]

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