Pinar Soysal1, Ahmet Turan Isik2, Ferhat Arik3, Ugur Kalan3, Abdullah Eyvaz3, Nicola Veronese4. 1. Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey; Geriatric Center, Kayseri Education and Research Hospital, Kayseri, Turkey. Electronic address: dr.pinarsoysal@hotmail.com. 2. Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey. 3. Kayseri Education and Research Hospital, Geriatric Center, Department of Internal Medicine, Kayseri, Turkey. 4. National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy; Geriatrics Unit, Department of Geriatric Care, Ortho Geriatrics and Rehabilitation, E.O. Galliera Hospital, National Relevance and High Specialization Hospital, Genova, Italy.
Abstract
OBJECTIVES: Comprehensive Geriatric Assessment (CGA) may not be performed in clinical practice as it takes too much time and requires special training. The Mini-Nutritional Assessment (MNA) is widely used to assess nutritional status in older adults. We aimed to determine whether or not the MNA can estimate frailty status defined by the Fried criteria. SETTING AND PARTICIPANTS: Six hundred two outpatients aged 65 years or older who underwent the CGA were included the study. MEASURES: Frailty status was defined by 5 dimensions including shrinking, exhaustion, low levels of activity, weakness, and slowness: 0 for robust, 1-2 for prefrail, and 3-5 for frail. MNA was performed in all participants even if their MNA-Short Form scores were ≥12. RESULTS: Of the 602 outpatients, of whom the mean age was 74.2 ± 8.2 years, 190 participants (31.6%) were considered frail and 218 (36.2%) prefrail. Internal consistency of the MNA had a Cronbach-alpha of 0.701. Interclass correlation coefficient for the test-retest reliability was found as 0.697. MNA with a cut-off point of 22.5 had a sensitivity of 72.1% and a specificity of 91.2% to detect frail participants. MNA with a cut-off point of 25.5 had a sensitivity of 66.9% and a specificity of 85.4% to detect prefrailty. For the estimation of frailty and prefrailty, the area under the receiver operating characteristics curve of MNA was 0.903 and 0.834, respectively. CONCLUSIONS: MNA can be a useful tool for frailty screening indicating that 2 common geriatric syndromes, malnutrition and frailty, can be identified by MNA simultaneously in clinical practice.
OBJECTIVES: Comprehensive Geriatric Assessment (CGA) may not be performed in clinical practice as it takes too much time and requires special training. The Mini-Nutritional Assessment (MNA) is widely used to assess nutritional status in older adults. We aimed to determine whether or not the MNA can estimate frailty status defined by the Fried criteria. SETTING AND PARTICIPANTS: Six hundred two outpatients aged 65 years or older who underwent the CGA were included the study. MEASURES: Frailty status was defined by 5 dimensions including shrinking, exhaustion, low levels of activity, weakness, and slowness: 0 for robust, 1-2 for prefrail, and 3-5 for frail. MNA was performed in all participants even if their MNA-Short Form scores were ≥12. RESULTS: Of the 602 outpatients, of whom the mean age was 74.2 ± 8.2 years, 190 participants (31.6%) were considered frail and 218 (36.2%) prefrail. Internal consistency of the MNA had a Cronbach-alpha of 0.701. Interclass correlation coefficient for the test-retest reliability was found as 0.697. MNA with a cut-off point of 22.5 had a sensitivity of 72.1% and a specificity of 91.2% to detect frail participants. MNA with a cut-off point of 25.5 had a sensitivity of 66.9% and a specificity of 85.4% to detect prefrailty. For the estimation of frailty and prefrailty, the area under the receiver operating characteristics curve of MNA was 0.903 and 0.834, respectively. CONCLUSIONS: MNA can be a useful tool for frailty screening indicating that 2 common geriatric syndromes, malnutrition and frailty, can be identified by MNA simultaneously in clinical practice.
Authors: Alessandro Federico; Giuseppe Gerardo Caprio; Anna Maria Dalise; Michelangela Barbieri; Marcello Dallio; Carmelina Loguercio; Giuseppe Paolisso; Maria Rosaria Rizzo Journal: Medicine (Baltimore) Date: 2020-01 Impact factor: 1.817