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Mini Nutritional Assessment (short form) and functional decline in older patients admitted to an acute medical ward

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Abstract

Background and aims: Protein and/or energy malnutrition is common in hospitalized older patients and is associated with poor outcomes. Among recommended nutritional screening tools, contrasting data exist about the usefulness of the Mini Nutritional Assessment Short-Form (MNA-SF). We evaluated whether the MNA-SF, alone or integrated with serum albumin levels, is a reliable predictor of functional decline in older patients. Methods: We studied 275 elderly patients (mean age 76.5, 60.7% males) admitted to an acute medical ward of a tertiary-care teaching hospital over a 12-month period. In this observational study, we evaluated nutritional status, with the MNA-SF alone or integrated with albumin. Data were collected at admission and related to laboratory and geriatric assessment features, and length of stay (LOS). Functional decline (defined as a loss ≥10% in terms of Barthel Index score at discharge compared with 2 weeks before admission) was considered as outcome. Results: The MNA-SF estimated 46% patients at risk of malnutrition. These subjects had worse clinical features (lower total cholesterol and albumin levels), longer LOS (13.3 vs 11.2 days, p=0.014) and considerable functional decline (OR 4.25, 95% CI 1.83–9.9, p=0.001). Integrating the MNA-SF with albumin values, we obtained an effective instrument to detect older inpatients with protein-energy malnutrition, at higher risk of undergoing functional decline (OR 16.19, 95% CI 4.68–56.03, p<0.0001). Conclusions: The MNA-SF is a useful screening tool for hospitalized elders at risk of malnutrition. It is associated with poor clinical outcomes and is able to predict functional decline. Together with hypoalbuminemia, it better identifies patients with true protein-energy malnutrition.

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Authors and Affiliations

  1. Department of Internal Medicine, University “Politecnica delle Marche”, Ancona, Italy

    Fabio Salvi MD, U.O., Raffaella Giorgi, Annalisa Grilli, Valeria Morichi, Emma Espinosa, Maria Laura Marinozzi & Paolo Dessì-Fulgheri

  2. Statistic and Biometry Centre, Department of Gerontological Research, Italian National Institute for Research and Care of Aging (INRCA), Ancona, Italy

    Liana Spazzafumo

Authors
  1. Fabio Salvi MD, U.O.
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  2. Raffaella Giorgi
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  3. Annalisa Grilli
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  4. Valeria Morichi
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  5. Emma Espinosa
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  6. Liana Spazzafumo
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  7. Maria Laura Marinozzi
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  8. Paolo Dessì-Fulgheri
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Correspondence to Fabio Salvi MD, U.O..

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Salvi, F., Giorgi, R., Grilli, A. et al. Mini Nutritional Assessment (short form) and functional decline in older patients admitted to an acute medical ward. Aging Clin Exp Res 20, 322–328 (2008). https://doi.org/10.1007/BF03324863

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  • DOI: https://doi.org/10.1007/BF03324863

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