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The journal of nutrition, health & aging

, Volume 17, Issue 4, pp 351–356 | Cite as

Nutritional status according to the Mini Nutritional Assessment (MNA®) and frailty in community dwelling older persons: A close relationship

  • Julia Bollwein
  • D. Volkert
  • R. Diekmann
  • M. J. Kaiser
  • W. Uter
  • K. Vidal
  • C. C. Sieber
  • J. M. Bauer
Article

Abstract

Objective

This study investigates the association between MNA results and frailty status in community-dwelling older adults. In addition the relevance of singular MNA items and subscores in this regard was tested.

Design

Cross-sectional study.

Setting

Community-dwelling older adults were recruited in the region of Nürnberg, Germany.

Participants

206 volunteers aged 75 years or older without cognitive impairment (Mini Mental State Examination >24 points), 66.0% female.

Measurements

Frailty was defined according to Fried et al. as presence of three, pre-frailty as presence of one or two of the following criteria: weight loss, exhaustion, low physical activity, low handgrip strength and slow walking speed. Malnutrition (<17 points) and the risk of malnutrition (17–23.5 points) were determined by MNA®.

Results

15.1% of the participants were at risk of malnutrition, no participant was malnourished. 15.5 % were frail, 39.8% pre-frail and 44.7% non-frail. 46.9% of the frail, 12.2% of the pre-frail and 2.2% of the non-frail participants were at risk of malnutrition (p<0.001). Hence, 90% of those at risk of malnutrition were either pre-frail or frail. For the anthropometric, dietary, subjective and functional, but not for the general MNA subscore, frail participants scored significantly lower than pre-frail (p<0.01), and non-frail participants (p<0.01). Twelve of the 18 MNA items were also significantly associated with frailty (p<0.05).

Conclusions

These results underline the close association between frailty syndrome and nutritional status in older persons. A profound understanding of the interdependency of these two geriatric concepts will represent the basis for successful treatment strategies.

Key words

Mini Nutritional Assessment MNA subscores frailty risk of malnutrition community-dwelling older adults 

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References

  1. 1.
    Guigoz Y, Vellas BJ, Garry PJ, Guigoz Y and Garry PJ. Mini nutritional assessment. A practical assessment tool for grading the nutritional status of elderly patients. Facts Res Gerontol 1994;4:15–59.Google Scholar
  2. 2.
    van Abellan Kan G, Rolland Y, Bergman H, Morley JE, Kritchevsky SB, Vellas B. The I.A.N.A Task Force on frailty assessment of older people in clinical practice. J Nutr Health Aging 2008;12:29–37.CrossRefGoogle Scholar
  3. 3.
    Ji L, Meng H, Dong B. Factors associated with poor nutritional status among the oldest-old. Clinical Nutrition: 2012 [Epub ahead of print].Google Scholar
  4. 4.
    Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature-What does it tell us? J Nutr Health Aging 2006; 10:466–85; discussion 485–7.PubMedGoogle Scholar
  5. 5.
    Cereda E. Mini nutritional assessment. Curr Opin Clin Nutr Metab Care 2012;15:29–41.PubMedCrossRefGoogle Scholar
  6. 6.
    Bales CW, Ritchie CS. Sarcopenia, weight loss, and nutritional frailty in the elderly. Ann Rev Nutr 2002;22:309–323.CrossRefGoogle Scholar
  7. 7.
    Bauer JM, Wirth R, Volkert D, Werner H, Sieber CC, Teilnehmer des BANSS-Symposiums 2006 [Malnutrition, sarcopenia and cachexia in the elderly: from pathophysiology to treatment. Conclusions of an international meeting of experts, sponsored by the BANSS Foundation]. Dtsch med Wochenschr 2008; 133:305–310.PubMedCrossRefGoogle Scholar
  8. 8.
    Andre MB, Dumavibhat N, Ngatu NR, Eitoku M, Hirota R, Suganuma N. Mini Nutritional Assessment and functional capacity in community-dwelling elderly in Rural Luozi, Democratic Republic of Congo. Geriatr Gerontol Int: 2012 [Epub ahead of print].Google Scholar
  9. 9.
    Santos-Eggimann B, Cuénoud P, Spagnoli J, Junod J. Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. J Gerontol A Biol Sci Med Sci 2009;64:675–681.PubMedCrossRefGoogle Scholar
  10. 10.
    Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the Concepts of Disability, Frailty, and Comorbidity: Implications for Improved Targeting and Care. J Gerontol A Biol Sci Med Sci 2004;59:255–263.PubMedCrossRefGoogle Scholar
  11. 11.
    Fried LP, Tangen CM, Walston JD et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146–M156.PubMedCrossRefGoogle Scholar
  12. 12.
    Boyd CM, Xue Q, Simpson CF, Guralnik JM, Fried LP. Frailty, hospitalization, and progression of disability in a cohort of disabled older women. Am J Med 2005;118:1225–1231.PubMedCrossRefGoogle Scholar
  13. 13.
    van Kan AG, Vellas BJ. Is the mini nutritional assessment an appropriate tool to assess frailty in older adults? J Nutr Health Aging 2011;15:159–161.CrossRefGoogle Scholar
  14. 14.
    Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psych Res 1975; 12:189–198.CrossRefGoogle Scholar
  15. 15.
    Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psych Res 1982–1983; 17:37–49.CrossRefGoogle Scholar
  16. 16.
    Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179–186.PubMedCrossRefGoogle Scholar
  17. 17.
    Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. MD State Med J 1965;14:61–65.PubMedGoogle Scholar
  18. 18.
    Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis 1987;40:373–383.PubMedCrossRefGoogle Scholar
  19. 19.
    Taylor HL, Jacobs DR, Schucker B, Knudsen J, Leon AS, Debacker G. A questionnaire for the assessment of leisure time physical activities. J Chronic Dis 1978;31:741–755.PubMedCrossRefGoogle Scholar
  20. 20.
    Bartali B, Frongillo EA, Bandinelli S, Lauretani F, Semba RD, Fried LP, Ferrucci L. Low nutrient intake is an essential component of frailty in older persons. J Gerontol A Biol Sci Med Sci 2006;61:589–593.PubMedCrossRefGoogle Scholar
  21. 21.
    Chang SS, Weiss CO, Xue Q, Fried LP Association between inflammatory-related disease burden and frailty: Results from the Women’s Health and Aging Studies (WHAS) I and n. Arch Gerontol Geriatr 54:9–15.Google Scholar
  22. 22.
    Santos-Eggimann B, Karmaniola A, Seematter-Bagnoud L et al. The Lausanne cohort Lc65+: a population-based prospective study of the manifestations, determinants and outcomes of frailty. BMC Geriatr 2008; 8:20.PubMedCrossRefGoogle Scholar
  23. 23.
    Cawthon PM, Marshall LM, Michael Y, Dam T, Ensrud KE, Barrett-Connor E, Orwoll ES. Frailty in older men: prevalence, progression, and relationship with mortality. J Am Geriatr Soc 2007;55:1216–1223.PubMedCrossRefGoogle Scholar
  24. 24.
    Kaiser MJ, Bauer JM, Uter W et al. Prospective Validation of the Modified Mini Nutritional Assessment Short-Forms in the Community, Nursing Home, and Rehabilitation Setting. J Am Geriatr Soc 2011;59:2124–2128.PubMedCrossRefGoogle Scholar
  25. 25.
    Johansson Y, Bachrach-Lindstrom M, Carstensen J, Ek A. Malnutrition in a home-living older population: prevalence, incidence and risk factors. A prospective study. J Clin Nurs 2009;18:1354–1364.PubMedCrossRefGoogle Scholar
  26. 26.
    Mirarefin M, Sharifi F, Fakhrzadeh H, Nazari N, Ghaderpanahi M, Badamchizade Z, Tajalizadekhoob Y. Predicting the value of the mini nutritional assessment (MNA) as an indicator of functional ability in older Iranian adults (Kahrizak elderly study). J Nutr Health Aging 2011;15:175–180.PubMedCrossRefGoogle Scholar
  27. 27.
    Hubbard RE, Lang IA, Llewellyn DJ, Rockwood K. Frailty, body mass index, and abdominal obesity in older people. J Gerontol A Biol Sci Med Sci 2010;65:377–381.PubMedCrossRefGoogle Scholar
  28. 28.
    Chin A Paw MJM, Groot LCPGM de, van Gend SV, Schoterman MHC, Schouten EG, Schroll M, van Staveren WA. Inactivity and weight loss: effective criteria to identify frailty. J Nutr Health Aging 2003;7:55–60.Google Scholar
  29. 29.
    Blaum CS, Xue Q, Michelon E, Semba RD, Fried LP. The association between obesity and the frailty syndrome in older women: the Women’s Health and Aging Studies. J Am Geriatr Soc 2005;53:927–934.PubMedCrossRefGoogle Scholar
  30. 30.
    Drey M, Wehr H, Wehr G et al. The frailty syndrome in general practitioner care: a pilot study. Z Gerontol Geriatr 2011;44:48–54.PubMedCrossRefGoogle Scholar
  31. 31.
    Morley J. Anorexia of aging: A true geriatric syndrome. J Nutr Health Aging 2012; 16:422–425.PubMedCrossRefGoogle Scholar
  32. 32.
    Beasley JM, LaCroix AZ, Neuhouser ML et al. Protein intake and incident frailty in the Women’s Health Initiative observational study. J Am Geriatr Soc 2010;58:1063–1071.PubMedCrossRefGoogle Scholar
  33. 33.
    Montero-Odasso M, Muir SW, Hall M, Doherty TJ, Kloseck M, Beauchet O, Speechley M. Gait Variability Is Associated With Frailty in Community-dwelling Older Adults. J. Gerontol. A Biol. Sci. Med. Sci 2011;66:568–576.PubMedCrossRefGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France 2013

Authors and Affiliations

  • Julia Bollwein
    • 1
    • 5
  • D. Volkert
    • 1
  • R. Diekmann
    • 1
  • M. J. Kaiser
    • 1
  • W. Uter
    • 2
  • K. Vidal
    • 3
  • C. C. Sieber
    • 1
  • J. M. Bauer
    • 4
  1. 1.Institute for Biomedicine of AgingFriedrich-Alexander Universität Erlangen-NürnbergNürnbergGermany
  2. 2.Institute for Medical Informatics, Biometrics und EpidemiologyFriedrich-Alexander Universität Erlangen-NürnbergNürnbergGermany
  3. 3.Nestlé Research CenterLausanneSwitzerland
  4. 4.Geriatrics Centre OldenburgOldenburgGermany
  5. 5.Institute for Biomedicine of AgingFriedrich-Alexander Universität Erlangen-NürnbergNürnbergGermany

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