To review the literature on the MNA® to Spring 2006, we searched MEDLINE, Web of Science & Scopus, and did a manual search in J Nutr Health Aging, Clin Nutr, Eur J Clin Nutr and free online available publications. Validation and validity: The MNA® was validated against two principal criteria, clinical status and comprehensive nutrition assessment using principal component and discriminant analysis. The MNA® short- form (MNA®-SF) was developed and validated to allow a 2-step screening process. The MNA® and MNA®-SF are sensitive, specific, and accurate in identifying nutrition risk. Nutritional Screening: The prevalence of malnutrition in community-dwelling elderly (21 studies, n = 14149 elderly) is 2 ± 0.1% (mean ± SE, range 0- 8%) and risk of malnutrition is 24 ± 0.4% (range 8-76%). A similar pattern is seen in out-patient and home care elderly (25 studies, n = 3119 elderly) with prevalence of undernutrition 9 ± 0.5% (mean ± SE, range 0-30%) and risk of malnutrition 45 ± 0.9% (range 8-65%). A high prevalence of undernutrition has been reported in hospitalized and institutionalized elderly patients: prevalence of malnutrition is 23 ± 0.5% (mean ± SE, range 1- 74%) in hospitals (35 studies, n = 8596) and 21 ± 0.5% (mean ± SE, range 5-71%) in institutions (32 studies, n = 6821 elderly). An even higher prevalence of risk of malnutrition was observed in the same populations, with 46 ± 0.5% (range 8-63%) and 51 ± 0.6% (range 27-70%), respectively. In cognitively impaired elderly subjects (10 studies, n = 2051 elderly subjects), detection using the MNA®, prevalence of malnutrition was 15 ± 0.8% (mean ± SE, range 0-62%), and 44 ± 1.1% (range 19-87%) of risk of malnutrition. Characteristics: The large variability is due to differences in level of dependence and health status among the elderly. In hospital settings, a low MNA® score is associated with an increase in mortality, prolonged length of stay and greater likelihood of discharge to nursing homes. Malnutrition is associated with functional and cognitive impairment and difficulties eating. The MNA® detects risk of malnutrition before severe change in weight or serum proteins occurs. Nutritional Intervention: Intervention studies demonstrate that timely intervention can stop weight loss in elderly at risk of malnutrition or undernourished and is associated with improvements in MNA® scores. The MNA® can also be used as a follow up assessment tool. Conclusion: The MNA® is a screening and assessment tool with a reliable scale and clearly defined thresholds, usable by health care professionals. It should be included in the geriatric assessment and is proposed in the minimum data set for nutritional interventions.

https://www.mna-elderly.org/publications/341.pdf

The Mini Nutritional Assessment (MNA) review of the literature--What does it tell us?

Purpose During the last decade, oncologists and geriatricians have begun to work together to integrate the principles of geriatrics into oncology care. The increasing use of a comprehensive geriatric assessment (CGA) is one example of this effort. A CGA includes an evaluation of an older individual's functional status, comorbid medical conditions, cognition, nutritional status, psychological state, and social support; and a review of the patient's medications. This article discusses recent advances on the use of a CGA in older patients with cancer. Methods In this article, we provide an update on the studies that address the domains of a geriatric assessment applied to the oncology patient, review the results of the first studies evaluating the use of a CGA in developing interventions to improve the care of older adults with cancer, and discuss future research directions. Results The evidence from recent studies demonstrates that a CGA can predict morbidity and mortality in older patients with cancer. Acc...

Comprehensive Geriatric Assessment for Older Patients With Cancer

The Mini Nutritional Assessment (MNA) is a simple tool, useful in clinical practice to measure nutritional status in elderly persons. From its validation in 1994, the MNA has been used in hundreds of studies and translated into more then 20 languages. It is a well-validated tool, with high sensitivity, specificity, and reliability. An MNA score > or = 24 identifies patients with a good nutritional status. Scores between 17 and 23.5 identify patients at risk for malnutrition. These patients have not yet started to lose weight and do not show low plasma albumin levels but have lower protein-calorie intakes than recommended. For them, a multidisciplinary geriatric intervention is needed, which takes into account all aspects that might interfere with proper alimentation and, when necessary, proposes therapeutic interventions for diet or supplementation. If the MNA score is less than 17, the patient has protein-calorie malnutrition. It is important at this stage to quantify the severity of the malnutrition (by measuring biochemical parameters like plasma albumin or prealbumin levels, establishing a 3- day record of food intake, and measuring anthropometric features like weight, BMI, arm circumference and skin folds). Nutritional intervention is clearly needed and should be based on achievable objectives established after a detailed comprehensive geriatric assessment. The MNA has been shown to be useful for nutritional intervention follow-up as well. The MNA can help clinicians design an intervention by noting where the patient loses points when performing the MNA. Moreover, when a nutritional intervention is successful, the MNA score increases. The MNA is recommended by many national and international clinical and scientific organizations. It can be used by a variety of professionals, including physicians, dietitians, nurses or research assistants. A short screening version (MNA-SF) has been developed, which, if positive, indicates the need to complete the full MNA. It takes less than 4 minutes to administer the MNA-SF and between 10 and 15 minutes for the full MNA.

Overview of the MNA--Its history and challenges.

This study aimed to investigate the prevalence of and factors associated with non-adherence to medication amongst a sample of breast cancer patients. 131 women with stable disease were interviewed and completed standardised psychological measures. 55% of women reported non-adherence to medication frequently or occasionally, with younger women and those who disliked taking their medication being significantly less adherent (P = 0.015, P = 0.001). Women who deliberately omitted taking their tablets occasionally or frequently had significantly lower scores, indicative of a weaker influence, on 'internal' and 'powerful others' dimensions of health locus of control (P = 0.032, P = 0.009). Despite a life-threatening diagnosis, patients may not adhere to medication representing a potential missed opportunity for health gain and waste of resources. Furthermore, interpretation of clinical trial data may be misleading without adherence information. More research is needed to identify those at risk for non-adherence. If other routes of administration are available these options should be discussed with patients to maximise efficacy of therapy.

Intentional and non-intentional non-adherence to medication amongst breast cancer patients

Malnutrition and depression among community-dwelling elderly people.

Purpose
The aim of this study was to explore the nursing role in education and follow-up of patients who were taking oral chemotherapy (CT) and to identify the worldwide gap in patient education about oral CT.

Role of the nurse in patient education and follow-up of people receiving oral chemotherapy treatment: an International survey

Aim
Our aim was to study the nutritional status of older men receiving treatment for advanced prostate cancer (PC).

Jolanta Toliusiene

Papers

Role of the nurse in patient education and follow-up of people receiving oral chemotherapy treatment: an International survey

The nutritional status of older men with advanced prostate cancer and factors affecting it