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Erschienen in: The journal of nutrition, health & aging 9/2016

05.02.2016

Nutritional and functional status in geriatric day hospital patients–MNA short form versus full MNA

verfasst von: E. Schrader, E. Grosch, T. Bertsch, C. C. Sieber, Dorothee Volkert

Erschienen in: The journal of nutrition, health & aging | Ausgabe 9/2016

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Abstract

Objectives

The aims of this study were to determine the prevalence of malnutrition in patients of a geriatric day hospital using the Mini Nutritional Assessment short form (MNA-SF) and the full MNA, to compare both tools, and to examine the relationship between nutritional and functional status.

Design

Cross-sectional study.

Setting

Geriatric day hospital.

Participants

190 patients (72.1% female, median 80 years) aged 65 years or older.

Measurements

In consecutively admitted geriatric day hospital patients nutritional status was assessed by MNA-SF and full MNA, and agreement between both tools calculated by Cohen’s kappa. Basic activities of daily living (ADL), instrumental activities of daily living (IADL) and short physical performance battery (SPPB) were determined and related to MNA categories (Chi2-test, Mann-Whitney-U-test).

Results

36.3 % and 44.7% of the patients were at risk of malnutrition, 8.9 % and 5.8 % were malnourished according to MNA-SF and full MNA, respectively. Agreement between both MNA forms was moderate (?=0.531). No significant associations between MNA-SF and ADL, IADL and SPPB, and between full MNA and SPPB were observed. According to full MNA, the proportion of patients with limitations in ADL and IADL significantly increased with declining nutritional status (ADL: 2.1 vs. 8.2 vs. 18.2 %, p=0.044; IADL: 25.5 vs. 47.1 vs. 54.5 %, p=0.005) with a simultaneous decrease of the proportion of patients without limitations. Well-nourished patients reached significantly higher ADL scores than patients at risk of malnutrition (95 (-100) vs. 95 (85- 100), p=0.005) and significantly higher IADL scores than patients at risk or malnourished (8 (6-8) vs. 7 (5-8) vs. 6 (4-8), p=0.004).

Conclusion

The high prevalence of risk of malnutrition and the observed association between functional status and nutritional status according to full MNA call for routine nutritional screening using this tool in geriatric day hospital patients.
Literatur
1.
Zurück zum Zitat Glaesmer H, Künstler J, Reuter W. [Improvement of functional deficits, physical mobility and cognitive function by treatment in a geriatric day hospital.] (Article in German). Z Gerontol Geriatr 2003;36:475–483CrossRefPubMed Glaesmer H, Künstler J, Reuter W. [Improvement of functional deficits, physical mobility and cognitive function by treatment in a geriatric day hospital.] (Article in German). Z Gerontol Geriatr 2003;36:475–483CrossRefPubMed
2.
Zurück zum Zitat Forster A, Young J. Community rehabilitation for older people: day hospital or home-based services? Age Ageing 2011;40:2–4CrossRefPubMed Forster A, Young J. Community rehabilitation for older people: day hospital or home-based services? Age Ageing 2011;40:2–4CrossRefPubMed
3.
4.
Zurück zum Zitat Chevalier S, Saoud F, Gray-Donald K et al. The physical functional capacity of frail elderly persons undergoing ambulatory rehabilitation is related to their nutritional status. J Nutr Health Aging 2008;12:721–726PubMed Chevalier S, Saoud F, Gray-Donald K et al. The physical functional capacity of frail elderly persons undergoing ambulatory rehabilitation is related to their nutritional status. J Nutr Health Aging 2008;12:721–726PubMed
5.
Zurück zum Zitat Tavassoli N, Guyonnet S, van Abellan Kan G et al. Description of 1,108 older patients referred by their physician to the «Geriatric Frailty Clinic (G.F.C) for Assessment of Frailty and Prevention of Disability» at the gerontopole. J Nutr Health Aging 2014;18:457–464CrossRefPubMed Tavassoli N, Guyonnet S, van Abellan Kan G et al. Description of 1,108 older patients referred by their physician to the «Geriatric Frailty Clinic (G.F.C) for Assessment of Frailty and Prevention of Disability» at the gerontopole. J Nutr Health Aging 2014;18:457–464CrossRefPubMed
6.
Zurück zum Zitat Smoliner C, Fischedick A, Sieber CC et al. Olfactory function and malnutrition in geriatric patients. J Gerontol A Biol Sci Med Sci 2013;68:1582–1588CrossRefPubMed Smoliner C, Fischedick A, Sieber CC et al. Olfactory function and malnutrition in geriatric patients. J Gerontol A Biol Sci Med Sci 2013;68:1582–1588CrossRefPubMed
7.
Zurück zum Zitat Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med 2002;18:737–757CrossRefPubMed Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med 2002;18:737–757CrossRefPubMed
8.
Zurück zum Zitat Rubenstein LZ, Harker JO, Salvà A et al. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci. 2001;56:M366–72CrossRefPubMed Rubenstein LZ, Harker JO, Salvà A et al. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci. 2001;56:M366–72CrossRefPubMed
9.
Zurück zum Zitat Kaiser MJ, Bauer JM, Ramsch C et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 2009;13:782–788CrossRefPubMed Kaiser MJ, Bauer JM, Ramsch C et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 2009;13:782–788CrossRefPubMed
10.
Zurück zum Zitat Kaiser MJ, Bauer JM, Rämsch C et al. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 2010;58:1734–1738CrossRefPubMed Kaiser MJ, Bauer JM, Rämsch C et al. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 2010;58:1734–1738CrossRefPubMed
11.
Zurück zum Zitat Kaiser MJ, Bauer JM, Uter W et al. Prospective validation of the modified mini nutritional assessment short-forms in the community, nursing home, and rehabilitation setting. J Am Geriatr Soc 2011;59:2124–2128CrossRefPubMed Kaiser MJ, Bauer JM, Uter W et al. Prospective validation of the modified mini nutritional assessment short-forms in the community, nursing home, and rehabilitation setting. J Am Geriatr Soc 2011;59:2124–2128CrossRefPubMed
12.
Zurück zum Zitat Lilamand M, Kelaiditi E, Cesari M et al. Validation of the Mini Nutritional Assessment-Short Form in a Population of Frail Elders without Disability. Analysis of the Toulouse Frailty Platform Population in 2013. J Nutr Health Aging 2015;19:570–574PubMed Lilamand M, Kelaiditi E, Cesari M et al. Validation of the Mini Nutritional Assessment-Short Form in a Population of Frail Elders without Disability. Analysis of the Toulouse Frailty Platform Population in 2013. J Nutr Health Aging 2015;19:570–574PubMed
13.
Zurück zum Zitat Inzitari M, Doets E, Bartali B et al. Nutrition in the age-related disablement process. J Nutr Health Aging 2011;15:599–604CrossRefPubMed Inzitari M, Doets E, Bartali B et al. Nutrition in the age-related disablement process. J Nutr Health Aging 2011;15:599–604CrossRefPubMed
14.
Zurück zum Zitat Mithal A, Bonjour J, Boonen S et al. Impact of nutrition on muscle mass, strength, and performance in older adults. Osteoporos Int 2013;24:1555–1566CrossRefPubMed Mithal A, Bonjour J, Boonen S et al. Impact of nutrition on muscle mass, strength, and performance in older adults. Osteoporos Int 2013;24:1555–1566CrossRefPubMed
15.
Zurück zum Zitat 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 2008;20:322–328CrossRefPubMed 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 2008;20:322–328CrossRefPubMed
16.
Zurück zum Zitat Schrader E, Baumgärtel C, Gueldenzoph H et al. Nutritional status according to Mini Nutritional Assessment is related to functional status in geriatric patients—independent of health status. J Nutr Health Aging 2014;18:257–263CrossRefPubMed Schrader E, Baumgärtel C, Gueldenzoph H et al. Nutritional status according to Mini Nutritional Assessment is related to functional status in geriatric patients—independent of health status. J Nutr Health Aging 2014;18:257–263CrossRefPubMed
17.
Zurück zum Zitat Cereda E, Valzolgher L, Pedrolli C. Mini nutritional assessment is a good predictor of functional status in institutionalised elderly at risk of malnutrition. Clin Nutr 2008;27:700–705CrossRefPubMed Cereda E, Valzolgher L, Pedrolli C. Mini nutritional assessment is a good predictor of functional status in institutionalised elderly at risk of malnutrition. Clin Nutr 2008;27:700–705CrossRefPubMed
18.
Zurück zum Zitat Kiesswetter E, Pohlhausen S, Uhlig K et al. Malnutrition is related to functional impairment in older adults receiving home care. J Nutr Health Aging 2013;17:345–350CrossRefPubMed Kiesswetter E, Pohlhausen S, Uhlig K et al. Malnutrition is related to functional impairment in older adults receiving home care. J Nutr Health Aging 2013;17:345–350CrossRefPubMed
19.
Zurück zum Zitat Bollwein J, Volkert D, Diekmann R et al. Nutritional status according to the mini nutritional assessment (MNA®) and frailty in community dwelling older persons: a close relationship. J Nutr Health Aging 2013;17:351–356CrossRefPubMed Bollwein J, Volkert D, Diekmann R et al. Nutritional status according to the mini nutritional assessment (MNA®) and frailty in community dwelling older persons: a close relationship. J Nutr Health Aging 2013;17:351–356CrossRefPubMed
20.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR. «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198PubMed Folstein MF, Folstein SE, McHugh PR. «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198PubMed
21.
Zurück zum Zitat Sheikh JI, Yesavage JA. A knowledge assessment test for geriatric psychiatry. Hosp Community Psychiatry 1985;36:1160–1166PubMed Sheikh JI, Yesavage JA. A knowledge assessment test for geriatric psychiatry. Hosp Community Psychiatry 1985;36:1160–1166PubMed
22.
Zurück zum Zitat Eveleth PB, Andres R, Chumlea WC, et al. Uses and interpretation of anthropometry in the elderly for the assessment of physical status. Report to the Nutrition Unit of the World Health Organization: the Expert Subcommittee on the Use and Interpretation of Anthropometry in the Elderly. J Nutr Health Aging 1998;2: 5–17.PubMed Eveleth PB, Andres R, Chumlea WC, et al. Uses and interpretation of anthropometry in the elderly for the assessment of physical status. Report to the Nutrition Unit of the World Health Organization: the Expert Subcommittee on the Use and Interpretation of Anthropometry in the Elderly. J Nutr Health Aging 1998;2: 5–17.PubMed
23.
Zurück zum Zitat Guigoz Y, Vellas B, Garry PJ. Mini Nutritional Assessment: A practical assessment tool for grading nutritional state of elderly patients. Facts Res Gerontol 1994;15–59 Guigoz Y, Vellas B, Garry PJ. Mini Nutritional Assessment: A practical assessment tool for grading nutritional state of elderly patients. Facts Res Gerontol 1994;15–59
24.
Zurück zum Zitat Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J 1965;14:61–65PubMed Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J 1965;14:61–65PubMed
25.
Zurück zum Zitat Volkert D, Saeglitz C, Gueldenzoph H et al. Undiagnosed malnutrition and nutritionrelated problems in geriatric patients. J Nutr Health Aging 2010;14:387–392CrossRefPubMed Volkert D, Saeglitz C, Gueldenzoph H et al. Undiagnosed malnutrition and nutritionrelated problems in geriatric patients. J Nutr Health Aging 2010;14:387–392CrossRefPubMed
26.
Zurück zum Zitat Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179–186CrossRefPubMed Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179–186CrossRefPubMed
27.
Zurück zum Zitat Covinsky KE, Palmer RM, Fortinsky RH et al. Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. J Am Geriatr Soc 2003;51:451–458CrossRefPubMed Covinsky KE, Palmer RM, Fortinsky RH et al. Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. J Am Geriatr Soc 2003;51:451–458CrossRefPubMed
28.
Zurück zum Zitat Guralnik JM, Simonsick EM, Ferrucci L et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994;49:M85–94CrossRefPubMed Guralnik JM, Simonsick EM, Ferrucci L et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994;49:M85–94CrossRefPubMed
29.
Zurück zum Zitat Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–174CrossRefPubMed Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–174CrossRefPubMed
30.
Zurück zum Zitat Pereira SR M, Chiu W, Turner A et al. How can we improve targeting of frail elderly patients to a geriatric day-hospital rehabilitation program? BMC Geriatr 2010;10:82CrossRefPubMedPubMedCentral Pereira SR M, Chiu W, Turner A et al. How can we improve targeting of frail elderly patients to a geriatric day-hospital rehabilitation program? BMC Geriatr 2010;10:82CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Malone M, Hill A, Smith G. Three-month follow up of patients discharged from a geriatric day hospital. Age Ageing 2002;31:471–475CrossRefPubMed Malone M, Hill A, Smith G. Three-month follow up of patients discharged from a geriatric day hospital. Age Ageing 2002;31:471–475CrossRefPubMed
32.
Zurück zum Zitat Winter J, Flanagan D, McNaughton SA et al. Nutrition screening of older people in a community general practice, using the MNA-SF. J Nutr Health Aging 2013;17:322–325CrossRefPubMed Winter J, Flanagan D, McNaughton SA et al. Nutrition screening of older people in a community general practice, using the MNA-SF. J Nutr Health Aging 2013;17:322–325CrossRefPubMed
33.
Zurück zum Zitat Bahat G, Muratli S, Ilhan B et al. Body mass index and functional status in community dwelling older Turkish males. Aging Male, 2015;18;228–232CrossRefPubMed Bahat G, Muratli S, Ilhan B et al. Body mass index and functional status in community dwelling older Turkish males. Aging Male, 2015;18;228–232CrossRefPubMed
34.
Zurück zum Zitat Bales CW, Ritchie CS. Sarcopenia, weight loss, and nutritional frailty in the elderly. Annu Rev Nutr 2002;22:309–323CrossRefPubMed Bales CW, Ritchie CS. Sarcopenia, weight loss, and nutritional frailty in the elderly. Annu Rev Nutr 2002;22:309–323CrossRefPubMed
35.
Zurück zum Zitat Cederholm T, Bosaeus I, Barazzoni R et al. Diagnostic criteria for malnutrition -An ESPEN Consensus Statement. Clin Nutr 2015;34:335–340CrossRefPubMed Cederholm T, Bosaeus I, Barazzoni R et al. Diagnostic criteria for malnutrition -An ESPEN Consensus Statement. Clin Nutr 2015;34:335–340CrossRefPubMed
36.
Zurück zum Zitat Houston DK, Nicklas BJ, Ding J et al. Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 2008;87:150–155PubMed Houston DK, Nicklas BJ, Ding J et al. Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 2008;87:150–155PubMed
37.
Zurück zum Zitat Wolfe RR. The underappreciated role of muscle in health and disease. Am J Clin Nutr 2006;84:475–482PubMed Wolfe RR. The underappreciated role of muscle in health and disease. Am J Clin Nutr 2006;84:475–482PubMed
38.
Zurück zum Zitat Tsai AC, Wang J, Chang T et al. A comparison of the full Mini Nutritional Assessment, short-form Mini Nutritional Assessment, and Subjective Global Assessment to predict the risk of protein-energy malnutrition in patients on peritoneal dialysis: a cross-sectional study. Int J Nurs Stud 2013;50:83–89CrossRefPubMed Tsai AC, Wang J, Chang T et al. A comparison of the full Mini Nutritional Assessment, short-form Mini Nutritional Assessment, and Subjective Global Assessment to predict the risk of protein-energy malnutrition in patients on peritoneal dialysis: a cross-sectional study. Int J Nurs Stud 2013;50:83–89CrossRefPubMed
39.
Zurück zum Zitat Flabeau O, Laurendeau G, Laksir H et al. Characteristics of patients who stop falling after a risk-based multidisciplinary intervention initiated in a geriatric day hospital. J Nutr Health Aging 2013;17:199–204CrossRefPubMed Flabeau O, Laurendeau G, Laksir H et al. Characteristics of patients who stop falling after a risk-based multidisciplinary intervention initiated in a geriatric day hospital. J Nutr Health Aging 2013;17:199–204CrossRefPubMed
40.
Zurück zum Zitat Feldblum I, German L, Castel H et al. Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status. Nutr J 2007;6:37CrossRefPubMedPubMedCentral Feldblum I, German L, Castel H et al. Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status. Nutr J 2007;6:37CrossRefPubMedPubMedCentral
Metadaten
Titel
Nutritional and functional status in geriatric day hospital patients–MNA short form versus full MNA
verfasst von
E. Schrader
E. Grosch
T. Bertsch
C. C. Sieber
Dorothee Volkert
Publikationsdatum
05.02.2016
Verlag
Springer Paris
Erschienen in
The journal of nutrition, health & aging / Ausgabe 9/2016
Print ISSN: 1279-7707
Elektronische ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-016-0691-4

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