8.2 Mini Nutritional Assessment (MNA)

The Mini Nutritional Assessment (MNA) is a crucial tool for identifying malnutrition risk in older adults. It's designed for those 65 and up, helping catch nutritional issues early before they lead to serious health problems. This quick, non-invasive assessment can be used in various settings, from hospitals to nursing homes.

The MNA covers four key areas: anthropometric measurements, general health, diet, and self-perception. Scores range from 0-30, categorizing individuals as normal, at risk, or malnourished. This comprehensive approach helps healthcare providers tailor interventions and monitor progress, making it a valuable asset in geriatric nutrition care.

Target Population and Setting for MNA

Older Adults at Risk for Malnutrition

Top images from around the web for Older Adults at Risk for Malnutrition

• 

  Frontiers | Mini Nutritional Assessment Scores Indicate Higher Risk for Prospective Mortality ... View original

  Is this image relevant?

• 

  Frontiers | Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF ... View original

  Is this image relevant?

• 

  高齢者の栄養評価表 [MNAR (Mini Nutritional Assessment)] | 受賞対象一覧 | Good Design Award View original

  Is this image relevant?

• 

  Frontiers | Mini Nutritional Assessment Scores Indicate Higher Risk for Prospective Mortality ... View original

  Is this image relevant?

• 

  Frontiers | Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF ... View original

  Is this image relevant?

1 of 3

Top images from around the web for Older Adults at Risk for Malnutrition

• 

  Frontiers | Mini Nutritional Assessment Scores Indicate Higher Risk for Prospective Mortality ... View original

  Is this image relevant?

• 

  Frontiers | Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF ... View original

  Is this image relevant?

• 

  高齢者の栄養評価表 [MNAR (Mini Nutritional Assessment)] | 受賞対象一覧 | Good Design Award View original

  Is this image relevant?

• 

  Frontiers | Mini Nutritional Assessment Scores Indicate Higher Risk for Prospective Mortality ... View original

  Is this image relevant?

• 

  Frontiers | Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF ... View original

  Is this image relevant?

1 of 3

• The MNA is designed for use in older adults aged 65 years and older who are at risk for malnutrition
• The assessment is particularly useful for identifying older adults who are at risk for malnutrition before significant weight loss or clinical signs of malnutrition occur
• Early identification of nutritional risk allows for timely intervention to prevent the development of more severe malnutrition and its associated negative health outcomes (increased risk of infections, delayed wound healing, functional decline)

Versatile Use in Various Clinical Settings

• The MNA is intended for use in both community-dwelling older adults and those living in long-term care facilities (nursing homes, assisted living facilities)
• The assessment can be administered by healthcare professionals (nurses, dietitians, physicians) in various clinical settings
  • Hospitals
  • Outpatient clinics
  • Long-term care facilities
• The MNA is a non-invasive, easy-to-use tool that can be completed in approximately 10-15 minutes, making it practical for use in busy clinical settings

Components and Scoring System of MNA

Comprehensive Assessment of Nutritional Status

• The MNA consists of 18 items divided into four sections
  1. Anthropometric measurements
     • Body mass index (BMI)
     • Mid-arm circumference
     • Calf circumference
     • These measurements provide information about body composition and muscle mass
  2. General assessment
     • Questions about lifestyle, medication use, mobility, presence of psychological stress or acute disease, and neuropsychological problems (dementia, depression)
  3. Dietary assessment
     • Evaluates the number of meals consumed, food and fluid intake, and self-perceived nutritional status and health status
  4. Subjective assessment
     • Includes questions about the participant's self-view of nutritional status and comparisons to others of the same age

Scoring System and Nutritional Status Categories

• Each item in the MNA is scored, and the total score ranges from 0 to 30 points
  • Higher scores indicate better nutritional status
• Scores are categorized into three groups
  1. 24-30 points: Normal nutritional status
  2. 17-23.5 points: At risk of malnutrition
  3. Less than 17 points: Malnourished
• The scoring system allows for a quick and objective assessment of an older adult's nutritional status, which can guide further interventions and treatment plans

Interpreting MNA Results

Guiding Interventions Based on MNA Scores

• MNA scores provide valuable information about an older adult's nutritional status and can help guide interventions to prevent or treat malnutrition
• Older adults with normal nutritional status (MNA score 24-30) should be monitored regularly to ensure they maintain their nutritional health
• Those identified as being at risk for malnutrition (MNA score 17-23.5) require further assessment to determine the underlying causes of their nutritional risk
  • May benefit from interventions (dietary counseling, meal programs, oral nutritional supplements)
• Older adults who are malnourished (MNA score <17) require immediate intervention
  • Referral to a registered dietitian
  • Initiation of oral nutritional supplements or enteral feeding
  • Treatment of any underlying medical conditions contributing to malnutrition

Interpreting Results in Context and Monitoring Progress

• MNA results should be interpreted in the context of the individual's overall health status
  • Presence of chronic diseases
  • Medications
  • Social factors that may impact nutritional status
• Regular reassessment using the MNA can help track changes in nutritional status over time and evaluate the effectiveness of interventions
• Monitoring progress allows for adjustments to be made to the individual's care plan as needed to optimize their nutritional status and overall health outcomes

Reliability and Validity of MNA

Extensive Validation Across Different Settings

• The MNA has been extensively validated in numerous studies across different countries and clinical settings, demonstrating its reliability and validity as a nutritional screening tool for older adults
• Test-retest reliability of the MNA has been shown to be high
  • Intraclass correlation coefficients ranging from 0.89 to 0.97
  • Indicates that the tool produces consistent results when administered by the same or different assessors
• The MNA has demonstrated good concurrent validity when compared to other nutritional assessment methods
  • Subjective Global Assessment (SGA)
  • Malnutrition Universal Screening Tool (MUST)
• Predictive validity of the MNA has been established
  • Studies show that low MNA scores are associated with increased risk of mortality, functional decline, and hospital readmission in older adults

Applicability and Limitations

• The MNA has been validated in various clinical settings
  • Community-dwelling older adults
  • Hospitalized patients
  • Those living in long-term care facilities
  • Demonstrates its versatility and applicability across different populations
• While the MNA has been shown to be a reliable and valid tool, it is important to recognize its limitations
  • Reliance on self-reported information
  • Potential for observer bias in some of the subjective assessment items
• Despite these limitations, the MNA remains a widely used and accepted tool for assessing nutritional status in older adults, providing valuable insights for guiding interventions and improving health outcomes