Malnutrition in Older Adults

MiOA: Assessment: Community (2022)

• Assessment
  In older adults living in the community, what is the validity and reliability of the Mini-Nutritional Assessment for identifying malnutrition?

  • Conclusion

    Mini-Nutritional Assessment (MNA) has overall moderate validity and low reliability for the assessment of malnutrition in older adults living in the community. Results should be interpreted with caution due to variability in reference standards among studies.

  • Grade: Moderate (B)
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In older adults living in the community, what is the validity and reliability of the Mini-Nutritional Assessment for identifying malnutrition?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Delacorte R, Moriguti J, Matos F, Pfrimer K, Marchinil J, Ferriolli E. Mini-nutritional assessment score and the risk for undernutrition in free-living older persons. Journal of Nutrition, Health & Aging 2004; 8:531-534
      • Muñoz Díaz B, Molina-Recio G, Romero-Saldaña M, Redondo Sánchez J, Aguado Taberné C, Arias Blanco C, Molina-Luque R, Martínez De La Iglesia J. Validation (in Spanish) of the Mini Nutritional Assessment survey to assess the nutritional status of patients over 65 years of age. Family Practice 2019; 36:172-178
      • Marshall S, Craven D, Kelly J, Isenring E. A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting (the MACRo study). Clinical Nutrition (Edinburgh, Scotland) 2018; 37:1902-1912
      • Sarikaya D, Halil M, Kuyumcu ME, Kilic MK, Yesil Y, Kara, Ozturk OS, Gungor E, Karabulut E, Yavuz BB, Cankurtaran M, Ariogul S. Mini-nutritional assessment test long and short form are valid screening tools in Turkish older adults. Archives of Gerontology and Geriatrics 2015; 61:56-60
  • Search Plan and Results: MiOA: Assessment 2021
     
  In older adults living in the community, what is the ability of the Mini-Nutritional Assessment to predict mortality?

  • Conclusion

     Mini-Nutritional Assessment (MNA) may predict mortality among adults 65 years and older in the community.

  • Grade: Moderate (B)
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In older adults living in the community, what is the ability of the Mini-Nutritional Assessment to predict mortality?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Beck A, Ovesen L, Schroll M. A six months' prospective follow-up of 65+-y-old patients from general practice classified according to nutritional risk by the Mini Nutritional Assessment. European Journal of Clinical Nutrition 2001; 55:1028-1033
      • Maaravi Y, Berry E, Ginsberg G, Cohen A, Stessman J. Nutrition and quality of life in the aged: the Jerusalem 70-year olds longitudinal study. Aging 2000; 12:173-179
      • Marshall S, Craven D, Kelly J, Isenring E. A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting (the MACRo study). Clinical Nutrition (Edinburgh, Scotland) 2018; 37:1902-1912
      • Visvanathan R, Macintosh C, Callary M, Penhall R, Horowitz M, Chapman I. The nutritional status of 250 older Australian recipients of domiciliary care services and Its association with outcomes at 12 months. Journal of American Geriatric Society 2003; 51:1007-1011
  • Search Plan and Results: MiOA: Assessment 2021
     
  In older adults living in the community, what is the ability of the Mini-Nutritional Assessment to predict hospitalization?

  • Conclusion

    Mini-Nutritional Assessment (MNA) may have  predictive ability in identifying the risk of hospitalization in older adults living in the community based on limited evidence.  

  • Grade: Low (C)
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In older adults living in the community, what is the ability of the Mini-Nutritional Assessment to predict hospitalization?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Beck A, Ovesen L, Schroll M. A six months' prospective follow-up of 65+-y-old patients from general practice classified according to nutritional risk by the Mini Nutritional Assessment. European Journal of Clinical Nutrition 2001; 55:1028-1033
      • Maaravi Y, Berry E, Ginsberg G, Cohen A, Stessman J. Nutrition and quality of life in the aged: the Jerusalem 70-year olds longitudinal study. Aging 2000; 12:173-179
      • Visvanathan R, Macintosh C, Callary M, Penhall R, Horowitz M, Chapman I. The nutritional status of 250 older Australian recipients of domiciliary care services and Its association with outcomes at 12 months. Journal of American Geriatric Society 2003; 51:1007-1011
  • Search Plan and Results: MiOA: Assessment 2021
     
  In older adults living in the community, what is the ability of the Mini-Nutritional Assessment to predict a decline in physical function?

  • Conclusion

    Mini-Nutritional Assessment (MNA) has limited ability to predict a decline in physical function for older adults living in the community.   

  • Grade: Low (C)
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In older adults living in the community, what is the ability of Mini-Nutritional Assessment to predict a decline in physical function?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Maaravi Y, Berry E, Ginsberg G, Cohen A, Stessman J. Nutrition and quality of life in the aged: the Jerusalem 70-year olds longitudinal study. Aging 2000; 12:173-179
      • Marshall S, Craven D, Kelly J, Isenring E. A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting (the MACRo study). Clinical Nutrition (Edinburgh, Scotland) 2018; 37:1902-1912
  • Search Plan and Results: MiOA: Assessment 2021
     
  In older adults living in the community, what is the validity and reliability of the Subjective Global Assessment for identifying malnutrition?

  • Conclusion

    The Subjective Global Assessment (SGA) has overall moderate validity for the assessment of malnutrition in older adults living in the community. No studies were identified that evaluated the reliability of SGA.   

  • Grade: Very Low (D)
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In older adults living in the community, what is the validity and reliability of the Subjective Global Assessment for identifying malnutrition?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Marshall S, Craven D, Kelly J, Isenring E. A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting (the MACRo study). Clinical Nutrition (Edinburgh, Scotland) 2018; 37:1902-1912
  • Search Plan and Results: MiOA: Assessment 2021
     
  In older adults living in the community, what is the predictive ability of the Subjective Global Assessment for mortality, hospitalization or declined physical function?

  • Conclusion

    In older adults living in the community, no studies were identified that evaluated the predictive ability of the Subjective Global Assessment for mortality, hospitalization or declined physical function.  

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: MiOA: Assessment 2021