Date: 19 May 2014

The diagnostic accuracy of the revised mini nutritional assessment short form for older people living in the community and in nursing homes

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Abstract

Objective

The aim of this study was to determine the diagnostic accuracy of the CC-SF, which was developed to use calf circumference (CC) instead of BMI in the MNA-SF, for elderly people living in the community and in nursing homes. It also aimed separately to determine the correlation of CC-SF and BMI-SF with the full MNA.

Study Design and Methods

The study included 640 elderly people living in their community and 243 elderly people living in nursing homes. Accuracy was assessed by determining the sensitivity and selectivity of the nutritional assessments. The correlations between the MNA-SFs and the full MNA were analyzed.

Results

The correlation between MNA-SFs and full MNAs was strong, significant and almost identical both in the community and in nursing homes (r=0.86–0.88; p<0.001). The observed agreement between the BMISF and the full MNA was 82.2% in the community and 77.8% in the nursing homes. There was a substantial agreement by kappa values in the comparison of community and nursing homes (the Kappa value of the BMI-SF was 0.63 in the community and 0.62 in the nursing homes, and the kappa value of the CC-SF was 0.62 in the community and 0.63 in the nursing homes). When compared to the full MNA the MNA-SFs tended to underestimate nutritional status. Both MNA-SFs had similarly high sensitivity and selectivity, both in the community and nursing homes. (when dichotomized as “malnourished-at risk of malnutrition” versus “well nourished” and “malnourished” versus “at risk of malnutrition-well nourished”) (over 80%).

Conclusion

In cases where BMI cannot be determined, the CC-SF is a good substitute for the BMI-SF.