THE MINI NUTRITIONAL ASSESSMENT AS AN INDICATOR OF FRAILTY IN OLDER FINNISH PEOPLE
I. Nykänen, T.H Rissanen, S. Hartikainen
J Aging Res Clin Practice 2013;2(1):61-64
Objective: To evaluate how well the Mini Nutritional Assessment (MNA) screening test is able to identify frailty in community-dwelling older people. Design: Cross-sectional study. Setting: Population-based. Participants: 584 persons aged 75 and older (mean 81.2 SD 4.6), 70% female. Measurements: Nutritional status was assessed using the MNA and frailty was defined according to the modified Fried´s frailty criteria (FCC). Results: According to the mini-nutritional assessment classification, 65% (n=380), 34% (n=199), and 1% (n=5) of the participants were assessed as well-nourished, at risk of malnutrition, and malnourished, respectively. Using the FFC, 38% (n=219) were not-frail, 47% (n=276) were pre-frail and 15% (n=89) were frail. Of all 199 participants identified as being the risk of malnutrition by MNA, 15% (n=30) were not-frail, 52% (n=104) were pre-frail and 33% (n=65) were frail, by FFC. Furthermore 50% (n=189) were not-frail, 45% (n=170) were pre-frail and 5% (n=21) were frail among well-nourished participants. The sensitivity of the MNA in identifying frailty was 0.50, specificity 0.86, positive predictive value 0.85, negative predictive value 0.52 and the Youden Index 0.36. Conclusion: Mini Nutritional Assessment screening test is not sufficiently sensitive for screening frailty status in older population. Frailty is a comprehensive syndrome and may require a more extensive screening tool including all components of frailty.