The journal of nutrition, health & aging

, Volume 18, Issue 3, pp 257–263 | Cite as

Nutritional status according to Mini Nutritional Assessment is related to functional status in geriatric patients — independent of health status

  • Eva Schrader
  • C. Baumgartel
  • H. Gueldenzoph
  • P. Stehle
  • W. Uter
  • C. C. Sieber
  • D. Volkerf



The aim of this study was to investigate the relationship between nutritional and functional status in acute geriatric patients including mobility and considering health status.


Cross-sectional study.




205 geriatric patients (median age 82.0 (IQR: 80–86) years, 69.3% women).


Nutritional status was determined by Mini Nutritional Assessment (MNA) and patients were categorized as well-nourished (≥ 24 points), at risk of malnutrition (17–23.5 points) or as malnourished (< 17 points). Functional status was determined by Barthel Index (BI) and Timed ‘Up and Go’ Test (TUG) and related to MNA categories. Using binary multiple logistic regression the impact of nutritional status on functional status was examined, adjusted for health status.


60.3 % of the patients were at risk of malnutrition and 29.8 % were malnourished. Ability to perform basic activities of daily living (ADL) decreased with declining nutritional status. The proportion of patients unable to perform the TUG increased with worsening of nutritional status (45.0 % vs. 50.4 % vs. 77.0 %, p<0.01). After adjusting for age, gender, number of diagnoses, disease severity and cognitive function, a higher MNA score significantly lowered the risk of being dependent in ADL (OR 0.85, 95 % CI 0.77–0.94) and inability to perform the TUG (OR 0.90, 95 % CI 0.82–0.99).


Nutritional status according to MNA was related to ADL as well as to mobility in acute geriatric patients. This association remained after adjusting for health status.

Key words

Nutritional status MNA functional status mobility hospitalized geriatric patients 


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  1. 1.
    Coneia MITD, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 2003;22(3): 235–239CrossRefGoogle Scholar
  2. 2.
    Kagansky N, Berner Y, Koren-Morag N et al. Poor nutritional habits are predictors of poor outcome in very old hospitalized patients. Am. J. Clin. Nutr. 2005;82(4): 784–789PubMedGoogle Scholar
  3. 3.
    Miller SL, Wolfe RR. The danger of weight loss in the elderly. J Nutr Health Aging 2008;12(7): 487–491PubMedCrossRefGoogle Scholar
  4. 4.
    Bales CW, Ritchie CS. Sarcopenia, weight loss, and nutritional frailty in the elderly. Annu. Rev. Nutr. 2002;22: 309–323PubMedCrossRefGoogle Scholar
  5. 5.
    Hickson M, Frost G. An investigation into the relationships between quality of life, nutritional status and physical function. Clin Nutr 2004;23(2): 213–221PubMedCrossRefGoogle Scholar
  6. 6.
    Stange I, Poeschl K, Stehle P, Sieber CC, Volkert D. Screening for malnutrition in nursing home residents: comparison of different risk markers and their association to functional impairment. J Nutr Health Aging 2013; 17(4): 357–363PubMedCrossRefGoogle Scholar
  7. 7.
    Kiesswetter E, Pohlhausen S, Uhlig K, Diekmann R, Lesser S, Heseker H, Stehle P, Sieber CC, Volkert D. Malnutrition is related to functional impairment in older adults receiving home care. J Nutr Health Aging 2013; 17(4): 345–350PubMedCrossRefGoogle Scholar
  8. 8.
    Ferdous T, Cederholm T, Razzaque A et al. Nutritional status and self-reported and performance-based evaluation of physical function of elderly persons in rural Bangladesh. Scand J Public Health 2009;37(5): 518–524PubMedCrossRefGoogle Scholar
  9. 9.
    Flodin L, Svensson S, Cederholm T. Body mass index as a predictor of 1 year mortality in geriatric patients. Clin Nutr 2000; 19(2): 121–125PubMedCrossRefGoogle Scholar
  10. 10.
    Persson MD, Brismar KE, Katzarski KS et al. Nutritional status using mini nutritional assessment and subjective global assessment predict mortality in geriatric patients. J Am Geriatr Soc 2002; 50(12): 1996–2002PubMedCrossRefGoogle Scholar
  11. 11.
    Covinsky KE, Martin GE, Beyth RJ et al. The relationship between clinical assessments of nutritional status and adverse outcomes in older hospitalized medical patients. J Am Geriatr Soc 1999;47(5): 532–538PubMedGoogle Scholar
  12. 12.
    Gazzotti C, Albert A, Pepinster A et al. Clinical usefulness of the mini nutritional assessment (MNA) scale in geriatric medicine. J Nutr Health Aging 2000;4(3):176–181PubMedGoogle Scholar
  13. 13.
    Oliveira MRM, Fogaça KCP, Leandro-Merhi VA. Nutritional status and functional capacity of hospitalized elderly. Nutr J 2009;8: 54PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Salvi F, Giorgi R, Grilli A et al. Mini Nutritional Assessment (short form) and functional decline in older patients admitted to an acute medical ward. Aging Clin Exp Res 2008;20(4): 322–328PubMedCrossRefGoogle Scholar
  15. 15.
    Vivanti A, Ward N, Haines T. Nutritional status and associations with falls, balance, mobility and functionality during hospital admission. J Nutr Health Aging 2011;15(5): 388–391PubMedCrossRefGoogle Scholar
  16. 16.
    Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3): 189–198PubMedCrossRefGoogle Scholar
  17. 17.
    Yesavage JA, Brink TL, Rose TL et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982;17(1): 37–49PubMedCrossRefGoogle Scholar
  18. 18.
    Guigoz Y, Vellas B, Garry PJ Mini Nutritional Assessment: A practical assessment tool for grading nutritional state of elderly patients, facts and research in gerontology: 15–59Google Scholar
  19. 19.
    Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. Md State Med J 1965;14: 61–65PubMedGoogle Scholar
  20. 20.
    Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39(2): 142–148PubMedGoogle Scholar
  21. 21.
    Buurman BM, Hoogerduijn JG, Haan RJ de et al. Geriatric conditions in acutely hospitalized older patients: prevalence and one-year survival and functional decline. PLoS ONE 2011;6(11):e26951PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Volpato S, Cavalieri M, Guerra G et al. Performance-based functional assessment in older hospitalized patients: feasibility and clinical correlates. J. Gerontol. A Biol. Sci. Med. Sci. 2008;63(12): 1393–1398PubMedCrossRefGoogle Scholar
  23. 23.
    Cereda E. Mini nutritional assessment. Curr Opin Clin Nutr Metab Care 2012;15(1): 29–41PubMedCrossRefGoogle Scholar
  24. 24.
    Durń Alert P, Milà Villarroel R, Formiga F et al. Assessing risk screening methods of malnutrition in geriatric patients: Mini Nutritional Assessment (MNA) versus Geriatric Nutritional Risk Index (GNRI). Nutr Hosp 2012;27(2): 590–598Google Scholar
  25. 25.
    German L, Feldblum I, Bilenko N et al. Depressive symptoms and risk for malnutrition among hospitalized elderly people. J Nutr Health Aging 2008;12(5): 313–318PubMedCrossRefGoogle Scholar
  26. 26.
    Kuzuya M, Izawa S, Enoki H et al. Is serum albumin a good marker for malnutrition in the physically impaired elderly? Clin Nutr 2007;26(1): 84–90PubMedCrossRefGoogle Scholar
  27. 27.
    Feldblum I, German L, Castel H et al. Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status. Nutr J 2007;6: 37PubMedCentralPubMedCrossRefGoogle Scholar
  28. 28.
    Dent E, Visvanathan R, Piantadosi C et al. Use of the Mini Nutritional Assessment to detect frailty in hospitalised older people. J Nutr Health Aging 2012; 16(9): 764–767PubMedCrossRefGoogle Scholar
  29. 29.
    Detsky AS, McLaughlin JR, Baker IP et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr 1987;11(1): 8–13PubMedCrossRefGoogle Scholar
  30. 30.
    Baker JP, Detsky AS, Wesson DE et al. Nutritional assessment: a comparison of clinical judgement and objective measurements. N. Engl. J. Med. 1982;306(16): 969–972PubMedCrossRefGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France 2014

Authors and Affiliations

  • Eva Schrader
    • 1
  • C. Baumgartel
    • 2
  • H. Gueldenzoph
    • 3
  • P. Stehle
    • 2
  • W. Uter
    • 4
  • C. C. Sieber
    • 1
  • D. Volkerf
    • 1
  1. 1.Institute for Biomedicine of AgingFriedrich-Alexander-Universität Erlangen-NürnbergNurembergGermany
  2. 2.Nutritional PhysiologyRheinische Friedrich-Wilhelms-Universität BonnBonnGermany
  3. 3.Department of Geriatric MedicineMaltester HospitalBonnGermany
  4. 4.Department of Medical Informatics, Biometry & EpidemiologyFriedrich-Alexander-Universität Erlangen-NürnbergNurembergGermany

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