Literature DB >> 24611678

Prognostic differences of the Mini Nutritional Assessment short form and long form in relation to 1-year functional decline and mortality in community-dwelling older adults receiving home care.

Eva Kiesswetter1, Stefanie Pohlhausen, Katrin Uhlig, Rebecca Diekmann, Stephanie Lesser, Wolfgang Uter, Helmut Heseker, Peter Stehle, Cornel C Sieber, Dorothee Volkert.   

Abstract

OBJECTIVES: To compare the prognostic value of the revised Mini Nutritional Assessment short form (MNA-SF) classification with that of the long form (MNA-LF) in relation to mortality and functional change in community-dwelling older adults receiving home care in Germany.
DESIGN: Multicenter, 1-year prospective observational study.
SETTING: Community. PARTICIPANTS: Older adults (≥ 65) receiving home care (n = 309). MEASUREMENTS: Nutritional status (well nourished, at risk of malnutrition, malnourished) was classified using the MNA-SF and MNA-LF at baseline. Functional status was determined according to the Barthel Index of activities of daily living (ADLs) at baseline and after 1 year. Hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality were calculated for MNA-SF and MNA-LF categories using stepwise Cox regression analyses. Repeated-measurements analysis of covariance was used to examine changes in ADL scores over time for MNA-SF and MNA-LF categories.
RESULTS: MNA-SF classified 15% of the sample as malnourished and 41% as being at risk of malnutrition, whereas the MNA-LF classified 14% and 58%, respectively. During the follow-up year, 15% of participants died. The estimated hazard ratios (HR) for 1-year mortality were lower for MNA-SF than for MNA-LF categories (at risk of malnutrition: HR = 2.21, 95% confidence interval (CI) = 1.02-4.75 vs HR = 5.05, 95% CI = 1.53-16.58; malnourished: HR = 3.27, 95% CI = 1.34-8.02 vs HR = 8.75, 95% CI = 2.45-31.18). For MNA-SF categories, no differences in functional change were found. According to the MNA-LF, ADL decline tended to be greater in those at risk of malnutrition (7.1 ± 10.1 points) than in those who were well nourished (3.7 ± 10.1 points) and malnourished (4.9 ± 10.1 points).
CONCLUSION: In this sample of older adults receiving home care, the MNA-LF was superior to the MNA-SF in predicting mortality and differentiating functional decline during 1 year of follow-up.
© 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Entities:  

Keywords:  Mini Nutritional Assessment; functional decline; home care; mortality; physical function

Mesh:

Year:  2014        PMID: 24611678     DOI: 10.1111/jgs.12683

Source DB:  PubMed          Journal:  J Am Geriatr Soc        ISSN: 0002-8614            Impact factor:   5.562


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