Screening for undernutrition in geriatric practice:: Developing the Short-Form Mini-Nutritional Assessment (MNA-SF)
Screening for undernutrition in geriatric practice:: Developing the Short-Form Mini-Nutritional Assessment (MNA-SF)
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DOI：
10.1093/gerona/56.6.m366
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发表时间：
2001-06-01
影响因子：
5.1
通讯作者：
Vellas, B
中科院分区：
文献类型：
--
作者：
Rubenstein, LZ;Harker, JO;Vellas, B
背景资料。微型营养评估(MNA)是一种经过验证的营养问题评估工具，但其长度限制了其在筛查中的有效性。我们试图开发该仪器的筛查版本，MNA-SF，保持良好的诊断准确性。方法：我们重新分析了来自法国的数据，这些数据用于开发原始的MNA，并将这些数据与在西班牙和新墨西哥州收集的数据相结合。在拥有完整MNA数据的881名受试者中，151名来自法国，400名来自西班牙。还有330人来自新墨西哥州。142名法国受试者获得了独立的临床营养状况评级。总的来说。73.8%为社区住宅，平均年龄为76.4岁。根据条目与MNA总分的相关性，以及与临床营养状况、内部一致性、可靠性、完整性和易管理性的相关性，选择MNA-SF的条目。在对多个版本进行测试后，我们确定了MNA-SF的最佳六项总分，范围为0到14。以临床营养状况为金标准(n=142)和MNA总分(n=881)计算MNA-SF的分界点。MNA-SF与MNA总分显著相关(r=.945)。以MNA-SF评分为正常，预测营养不良的敏感度为97.9%，特异度为100%，诊断准确率为98.7%。MNA-SF可以识别营养不良的人，并可用于两步筛查程序，在该程序中，被MNA-SF确定为“危险”的人将接受额外评估，以确认诊断和计划干预。
Background. The Mini-Nutritional Assessment (MNA) is a validated assessment instrument for nutritional problems, but its length limits its usefulness for screening. We sought to develop a screening version of this instrument, the MNA-SF, that retains good diagnostic accuracy.Methods, We reanalyzed data from France that were used to develop the original MNA and combined these with data collected in Spain and New Mexico. Of the 881 subjects with complete MNA data, 151 were from France, 400 were from Spain. and 330 were from New Mexico. Independent ratings of clinical nutritional status were available for 142 of the French subjects. Overall. 73.8% were community dwelling, and mean age was 76.4 years. Items were chosen for the MNA-SF on the basis of item correlation with the total MNA score and with clinical nutritional status, internal consistency, reliability, completeness, and ease of administration.Results. After testing multiple versions, we identified an optimal six-item MNA-SF total score ranging from 0 to 14. The cut-point score for MNA-SF was calculated using clinical nutritional status as the gold standard (n = 142) and using the total MNA score (n = 881). The MNA-SF was strongly correlated with the total MNA score (r = .945). Using an MNA-SF score of,ll as normal, sensitivity was 97.9%, specificity was 100%, and diagnostic accuracy was 98.7% for predicting undernutrition.Conclusions. The MNA-SF can identify persons with undernutrition and can be used in a two-step screening process in which persons, identified as "at risk" on the MNA-SF, would receive additional assessment to confirm the diagnosis and plan interventions.