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Accuracy of different mini nutritional assessment reduced forms to evaluate the nutritional status of elderly hospitalised diabetic patients

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The journal of nutrition, health & aging

Abstract

Background

Disease-associated malnutrition (DAM) is a health problem involving all sanitary levels, especially hospitalised elderly patients. Different MNA (Mini Nutritional Assessment)-based forms have been validated in different settings, but it remains unclear if they are appropriate to evaluate the nutritional status of geriatric hospitalised patients with diabetes.

Objective

The aim of this work was to analyse the accuracy of several MNA reduced forms to detect malnutrition in hospitalised elderly diabetic patients.

Methods

A multicentre observational study was carried out in diabetic patients, who were over the age of 65, from 35 Spanish hospitals. Principal component analysis (PCA) selected the minimal components to elaborate the newly-proposed reduced new version of the MNA (r-MNA). Cohen’s Kappa index (KI), with its 95% confidence interval (CI), was used to measure the agreement between the different reduced forms (r-MNA, MNA-SF-BMI, MNA-SF-CC, m-MNA) with the original MNA.

Results

Five hundred and ninety-one elderly diabetic patients were included in the study. ROC analysis determined the following cut-off points for the newly proposed r MNA: 0-<10 “malnourished”, 10-12 “at risk” and >12-15 “well-nourished”. The upper cut-off point demonstrated a sensitivity of 87.7%, a specificity of 78.3% and an area under the curve of 0.93. The lower cut-off point showed a sensitivity of 95.9%, a specificity of 78.3% and an area under the curve of 0.95. The best agreement with the original MNA was observed for the MNA-SF-BMI (Κ index 80.7; 95% CI: 77.4-84) and the worst for the r-MNA (Κ index 72; 95% CI: 68.2-75.4).

Conclusions

This study found that MNA-SF-BMI is the most accurate screening tool for determining the nutritional status of hospitalised diabetic elderly patients. This is an easy-touse, fast screening tool with a low risk of misclassification.

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References

  1. Guigoz Y. The Mini Nutritional Assessment (MNA®): review of the literature—what does it tell us? J Nutr Health Aging. 2006;6:466–487.

    Google Scholar 

  2. Vellas B, Villars H, Abellan G, et al. Overview of the MNA®—its history and challenges. J Nutr Health Aging. 2006;6:456–46.

    Google Scholar 

  3. Krzyminska-Siemaszko R, Mossakowska M, Skalska A, Klich-Raczka A, Tobis S, Szybalska A, Cylkowska-Nowak M, Olszanecka-Glinianowicz M, Chudek J, Wieczorowska-Tobis K. Social and Economic Correlates of Malnutrition in Polish Elderly Population: The Results of PolSenior Study. J Nutr Health Aging. 2015;19(4):397–402. doi: 10. 1007/s12603-014-0572-7

    Article  CAS  PubMed  Google Scholar 

  4. Arvanitakis M, Coppens P, Doughan L, et al. Nutrition in homes and home care: Recommendations—A summary based on the report approved by the Council of Europe. Clin Nutr. 2009;28(5):492–496.

    Article  CAS  PubMed  Google Scholar 

  5. Dey DK, Rothenberg E, Sundh V, Bosaeus I, Steen B: Body Mass Index, weight change and mortality in the elderly. A 15 year longitudinal population study of 70 y olds. Eur J Clin Nutr 2001;55:482–92.

    Article  CAS  PubMed  Google Scholar 

  6. Amarantos E, Martinez A, Dwyer J: Nutrition and Quality of Life in older Adults. J Gerontol 2001;56A:54–64.

    Article  Google Scholar 

  7. The Prague declaration stop disease-related malnutrition. (Accessed November 25, 2010 at http://www.european-nutrition.org/files/pdf_pdf_66pdf)

  8. Commission of the European Communities. “Together for health: a Strategic Approach for the EU 2008-2013. (Accessed November 25, 2010 at https://wcd. coe. int/ViewDoc. jsp?id=85747)

  9. Guigoz Y, Vellas B, Garry PJ. Mini Nutritional Assessment: a practical assessment tool for grading the nutritional state of elderly patients. Facts Res Gerontol. 1994:15–59

    Google Scholar 

  10. Bauer JM, Kaiser M, Anthony P, Guigoz Y, Sieber CC: The Mini Nutritional Assessment-Its History, Today’s Practice, and Future Perspectives. Nutr Clin Pract

  11. Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony Ps, Charlton KE, Maggio M, tsaia C, Vellas B, Sieber CC, Mini Nutritional assessment international Group. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J AM Geriatr Soc 2010; 58(9): 1734–173.

    Article  PubMed  Google Scholar 

  12. Griep Mi, Metst F, Collys K, Ponjaert-Kristoffersen I, Massart DL. risk of malnutrition in retirement homes elderly persons measured by the “mini-nutritional assessment”. J Gerontol a Biol sci Med sci 2000;55(2):M57–M63.

    Article  CAS  PubMed  Google Scholar 

  13. Kaiser MJ, Bauer JM, Uter W, Donini LM, Stange I, Volkert D, Diekmann R, Drey M, Bollwein J, Tempera S, Guerra A, Ricciardi LM, Sieber CC. Prospective validation of the modified mini nutritional assessment short-forms in the community, nursing home, and rehabilitation setting. J am Geriatr soc 2011;59(11):2124–2128.

    Article  PubMed  Google Scholar 

  14. Turnbull PJ, Sinclair AJ. Evaluation of nutritional status and its relationship with functional status in older citizens with diabetes mellitus using the mini nutritional assessment (MNa) tool—a preliminary investigation. J Nutr Health aging 2002;6(5):185–189.

    CAS  PubMed  Google Scholar 

  15. Cohendy R, Rubinstein LZ Eledjam JJ. The mini nutritional short form for preoperative nutritional evolution of elderly patients. aging 2001;13(4):293–297.

    CAS  PubMed  Google Scholar 

  16. Murphy MC, Brooks CN, New SA, Lumbers ML. the use of the Mini-Nutritional Assessment (MNA) tool in elderly orthopedic patients. Eur J Clin Nutr 2000;54(7):555–562.

    Article  CAS  PubMed  Google Scholar 

  17. Kondrup J, Allison SP, Elia M, Vellas B, Plauth M.: ESPEN Guidelines for Nutrition Screening 2002. Clin Nutr 2002;22(4):415–421.

    Article  Google Scholar 

  18. Rubenstein LZ, Harker JO, Salvà A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci. 2001;56(6):M366–37.

    Article  CAS  PubMed  Google Scholar 

  19. M. J. Z Kaiser et al. Validation of the Mini Nutritional Assessment Short-Form (MNASF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009 13(9): 782–78.

    Article  CAS  PubMed  Google Scholar 

  20. Bonnefoy M, Jauffret M, Kostka T, Jusot JF. Usefulness of calf circumference measurement in assessing the nutritional state of hospitalized elderly people. Gerontology. 2002; 48(3)162–6.

    Article  CAS  PubMed  Google Scholar 

  21. Hengstermann S, Nieczaj R, Steinhagen-Thiessen E, Schulz R-J. Which are the most efficient items of mini nutritional assessment in multimorbid patients? J Nutr Health Aging. 2008;12(2):117–22.

    Article  CAS  PubMed  Google Scholar 

  22. Casimiro C, García Lorenzo A, Usan Ly el Grupo de Estudio Cooperativo Geriátrico. [Nutritional and metabolic status and dietary evaluation in institutionalized elderly patients with non-insulin dependent diabetes mellitus (NIDDM)]. Nutr Hosp. 2001 May-Jun; 16(3):104–111.

    CAS  PubMed  Google Scholar 

  23. Alejandro Sanz Paris et al. Malnutrition prevalence in hospitalized elderly diabetic patients. Nutr Hosp. 2013; 28(3):592–59.

    Google Scholar 

  24. Armitage P, Berry G, Matthews JNS. Statistical Methods in Medical Research. Massachusetts: Blackwell Science; 2002.

    Book  Google Scholar 

  25. Sharma S. Applied Multivariate Techniques. New York, NY: John Wiley &amp; Sons, Inc; 1996.

    Google Scholar 

  26. Thurstone LL. Multiple-factor analysis: a development and expansion of The vectors of the mind. Chicago, IL, US: The University of Chicago Press; 1947.

    Google Scholar 

  27. Comrey AL, Lee HB. A First Course in Factor Analysis. Hillsdale, NJ: L. Erlbaum Associates; 1992.

    Google Scholar 

  28. Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med. 2005;37(5):360–3.

    PubMed  Google Scholar 

  29. Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther. 2005;85(3):257–68.

    PubMed  Google Scholar 

  30. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.

    Article  CAS  PubMed  Google Scholar 

  31. Burman M, Säätelä S, Carlsson M, Olofsson B, Gustafson Y, Hörnsten C. J Nutr Health Aging. 2015;19(4):461–7. doi: 10. 1007/s12603-015-0443-x. Body Mass Index, Mini Nutritional Assessment, and their Association with Five-Year Mortality in Very Old People.

    Article  CAS  PubMed  Google Scholar 

  32. García Messeguer MJ, Serrano Urrea R. Validation of the revised Mini Nutritional Assessment Short Forms in nursing homes in Spain. J Nutr Health Aging. 2013;17(1):26–29.

    Article  Google Scholar 

  33. Tsai C, Chang TL, Wang YC, Liao CY. Population-specific short-form mini nutritional assessment with body mass index or calf circumference can predict risk of malnutrition in community-living or institutionalized elderly people in Taiwan. J am Diet assoc 2010;110(9):1328–1334.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Nutrition Department, Hospital San Pedro, Logroño, Spain

    Angela Martín

  2. Department of Epidemiology, La Rioja Regional Authority, Logroño, Spain

    E. Ruiz & E. Ramalle-Gomera

  3. Nutrition Department, University Hospital Miguel Servet, Zaragoza, Spain

    A. Sanz

  4. Nutrition Department, University Hospital Virgen de la Victoria, Málaga, Spain

    J. M. García

  5. Nutrition Department, University Hospital La Paz, Madrid, Spain

    C. Gómez-Candela

  6. Nutritional Support Unit, University Hospital Vall d´Hebron, Barcelona, Spain

    R. Burgos

  7. Nutrition Department, University Hospital Clínico San Carlos, Madrid, Spain

    P. Matía

Authors
  1. Angela Martín
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  2. E. Ruiz
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  3. A. Sanz
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  4. J. M. García
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Correspondence to Angela Martín.

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Martín, A., Ruiz, E., Sanz, A. et al. Accuracy of different mini nutritional assessment reduced forms to evaluate the nutritional status of elderly hospitalised diabetic patients. J Nutr Health Aging 20, 370–375 (2016). https://doi.org/10.1007/s12603-015-0618-5

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  • DOI: https://doi.org/10.1007/s12603-015-0618-5

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