LESS HEALTHY ELDERLY EATING LESS FOOD ARE IDENTIFIED BY A MODIFIED MNA TOOL
D. Nitzan Kaluski, F. Stern, J. Kachal, R. Goldsmith, T. Shimony, R. Dichtiar, L. Keinan-Boker
J Aging Res Clin Practice 2013;2(1):71-77
Background: The MABAT ZAHAV survey is part of several National Health and Nutrition surveys conducted in Israel over the past decade in different population groups. Objectives: To ascertain whether a modified form of the Mini Nutritional Assessment (MNA) tool identifies community-dwelling elderly Jews at risk of malnutrition by evaluating their food groups and nutrient intakes. Design: A Cross-sectional study. Participants and setting: A total of 1,499 free-living Jewish elderly sampled from two major Health Insurance Funds in Israel were interviewed at their homes. This study analyses were restricted to 1,016 and 1,067 elderly with modified full MNA and modified MNA-SF, respectively. Measurements: Nutritional status was assessed using a modified full MNA and a modified short form MNA (MNA-SF). To evaluate food intake, a 24-hour dietary recall was carried out. Results: Based on the modified full MNA score, about 64% of the elderly had normal nutritional status, 34% were at risk of malnutrition and 2% were malnourished. The corresponding proportions based on the modified MNA-SF score were 66%, 28% and 6%, respectively. According to the modified full MNA, elderly 'at risk of malnutrition' compared to those with 'normal nutritional status', consumed significantly less portions of some food groups. Their energy, macronutrient and selected micronutrient intakes were also significantly lower. According to the MNA-SF, the only significant differences were found for energy, macronutrients and selected micronutrients, with a lower consumption in the elderly at risk of malnutrition. With the modified full MNA being utilized as a gold-standard, the modified MNA-SF sensitivity (for 'risk of malnutrition' vs. 'normal nutritional status') was 85% and its specificity, 96%. Conclusions: The modified full MNA accurately captures elderly at risk of malnutrition, and its scores are highly correlated to those of the modified MNA-SF. Thus MNA-SF can be used by the community health care services to screen for malnutrition risk.