微型营养评定法在恶性肿瘤病人中的应用

为探讨微型营养评定法 (MNA)在恶性肿瘤病人的营养状况评价中的价值 ,测定 2 6 2例恶性肿瘤病人的MNA总分、身高、体重、年龄、体力状况、血液血红蛋白量 (Hb)、红细胞数 (RBC)、血清白蛋白浓度 (Alb)、血清前白蛋白浓度 (PA)。计算实际体重 健康时平时体重比 (UBW % )。根据MNA总分评价病人营养状况 :营养不良组 (MNA总分 <17) ;营养不良危险组 (MNA总分介于 17～ 2 3 5 ) ;营养良好组 (MNA总分≥ 2 4)。结果显示 :MNA总分与UBW %、Alb、PA、BMI值呈显著相关 (r=0 5 0 1～ 0 72 4,P =0 0 0 0 )。MNA与UBW %、BMI、PA、Alb方法评价病人的营养状况有良好的一致性 ,符合率分别为 82 %、76 %、71%、6 8%。根据MNA方法评价全组病人 ,营养不良者占 31 7% (83 2 6 2例 ) ,营养不良危险者占 2 5 9% (6 8 2 6 2例 ) ,营养良好者占 42 4%(111 2 6 2例 ) ;营养不良与营养不良危险的发生率无显著性差异 ;老年与非老年患者营养不良发生率无明显差异。胃癌、肝癌的营养不良发生率明显高于肺癌 (P =0 0 0 1)。体力状况越差 (ECOG分级越高 )、营养不良发生率越高。贫血患者营养不良发生率明显高于非贫血者。感染患者营养不良发生率明显高于非感染者。结果提示 ,MNA对于恶性肿瘤患者具有良好的营养评价作用。胃癌?     

Mini nutritional assessment and 10-year mortality in free-living elderly women: a prospective cohort study with 10-year follow-up

Background/Objectives:Mini nutritional assessment (MNA) is the most frequently used screening test for malnutrition in elderly populations in continental Europe and Asia. Most studies on MNA's ability to predict mortality have only included persons admitted to hospital, living in nursing homes or at home with professional help with activities of daily living. The aim of this cohort study was to examine if MNA can predict 10-year mortality in the general elderly female population.Subjects/Methods:Of the 584 free-living elderly women invited, 351 agreed to participate and were tested with MNA between 1999 and 2000. A 10-year follow-up was conducted in 2010 with dates of death obtained from the Swedish death register.Results:Participants whose MNA score was 23.5 points at inclusion had a significantly higher age-adjusted 10-year mortality risk than participants with a MNA score of >23.5 points. The hazard ratio was 2.36 (95% confidence interval 1.25-4.46), P <0.01.Conclusions:Participants with a MNA score, indicating an increased risk for malnutrition, were more than twice as likely to die during the 10-year follow-up as participants whose MNA score indicated normal nutritional status. Hence, MNA can predict mortality in a general, free-living, elderly female population.     

简易营养评估法量表在中国老年肺癌手术患者中的应用及与术后并发症相关性分析

目的 通过在中国老年肺癌手术患者人群中应用修订后的简易营养评估法(MNA)量表及简易营养评估精法(MNA-SF)量表,了解中国老年肺癌手术患者的营养状况以及评价营养状况与术后并发症之间的关系.方法 利用修订后的MNA量表及MNA-SF量表对150例2010年6月至2011年6月新人院的老年肺癌准备手术的患者进行术前营养评估,同时收集患者基本资料、患病情况、人体测量指标、生化指标、术后并发症等相关资料.结果 根据MNA修订界值后的评分标准,所调查150例(男98例,女52例)老年肺癌手术患者营养不良的发生率为10.7％(16/150),潜在营养不良发生率为32.0％(48/150),营养正常率为57.3％( 86/150);MNA得分(23.7±3.8)分,MNA得分与体质指数(BMI)、上臂肌围(MAC)和腓肠肌围(CC)呈正相关(P＜0.01);MNA-SF得分(11.5±2.4)分,MNA-SF得分与BMI、三头肌皮褶厚度(TSF)、MAC、CC和MNA得分呈正相关(P＜ 0.01或＜0.05);术后并发症的发生率依次为:呼吸系统37.4％(55/147),心血管系统31.3％(46/147),胸腔0.7％(1/147);术后并发症不同发病数目之间及发病类型之间的营养状况比较差异无统计学意义(P=0.590、0.601).结论 修订界值后的MNA量表适合于中国老年肺癌手术患者的营养状况评估,评估结果表明老年肺癌手术患者的营养不良发生率较高,其MNA量表评估结果与术后并发症之间相关性有待进一步证实.     

Agreement between different versions of MNA

Abstract

Malnutrition occurs frequently in the elderly with important clinical and functional consequences. Moreover, the treatment of malnutrition in the elderly may be effective if clinical and nutritional interventions are performed in the early stages. Therefore the early identification of the risk of malnutrition using validated and handy tools plays a pivotal role in terms of clinical outcome. Mini Nutritional Assessment (MNA) was validated for this purpose since many years but it is still ongoing the debate over whether the use of different items in certain clinical conditions can be effective without affecting the validity of the nutritional status evaluation. The aim of this study was to assess the agreement between different versions of MNA in the evaluation of nutritional risk in elderly subjects.

Methods

522 subjects, 345 women and 177 men, were recruited from nursing homes or were free living in three different regions in Italy. All subjects underwent a multidimensional geriatric evaluation, addressed especially to nutritional status. We compared three different versions of MNA: the “original” version; a “proportional” MNA (MNA-P) in which the total MNA score was replaced by the ratio between the maximum score that each subject could obtain without including the body mass index (BMI) and the total original MNA score; and a third version in which calf circumference (CC) and mid-upper arm circumference (MAC) were used instead of BMI.

Results

According to the original MNA, a high prevalence of malnutrition was found out in both genders (26% of women and 16.3% of men); both the versions of MNA, in which BMI was not considered, showed a good predictive value compared to original MNA. In particular, the MNA-P. showed an overall efficiency equal to 89,1% with specificity and positive predictive value respectively equal to 97.5% and 95.2%. MNA-CC-MAC showed even better results in terms of overall efficiency (91.4%), sensitivity (81.1%), specificity (97.1%), positive and negative predictive values (94.2% and 94.4%, respectively).

Conclusion

The different versions of MNA gave similar results in the classifications of subjects and in comparison with nutritional and biochemical parameters. Moreover MNA versions that did not considered BMI seem to be more effective in singling out subjects with risk factors related to malnutrition (disability, reduced strength and calf circumference, anaemia).     

Overview of the MNA--Its history and challenges

The Mini Nutritional Assessment (MNA) is a simple tool, useful in clinical practice to measure nutritional status in elderly persons. From its validation in 1994, the MNA has been used in hundreds of studies and translated into more then 20 languages. It is a well-validated tool, with high sensitivity, specificity, and reliability. An MNA score > or = 24 identifies patients with a good nutritional status. Scores between 17 and 23.5 identify patients at risk for malnutrition. These patients have not yet started to lose weight and do not show low plasma albumin levels but have lower protein-calorie intakes than recommended. For them, a multidisciplinary geriatric intervention is needed, which takes into account all aspects that might interfere with proper alimentation and, when necessary, proposes therapeutic interventions for diet or supplementation. If the MNA score is less than 17, the patient has protein-calorie malnutrition. It is important at this stage to quantify the severity of the malnutrition (by measuring biochemical parameters like plasma albumin or prealbumin levels, establishing a 3- day record of food intake, and measuring anthropometric features like weight, BMI, arm circumference and skin folds). Nutritional intervention is clearly needed and should be based on achievable objectives established after a detailed comprehensive geriatric assessment. The MNA has been shown to be useful for nutritional intervention follow-up as well. The MNA can help clinicians design an intervention by noting where the patient loses points when performing the MNA. Moreover, when a nutritional intervention is successful, the MNA score increases. The MNA is recommended by many national and international clinical and scientific organizations. It can be used by a variety of professionals, including physicians, dietitians, nurses or research assistants. A short screening version (MNA-SF) has been developed, which, if positive, indicates the need to complete the full MNA. It takes less than 4 minutes to administer the MNA-SF and between 10 and 15 minutes for the full MNA.     

Population-specific Mini Nutritional Assessment effectively predicts the nutritional state and follow-up mortality of institutionalized elderly Taiwanese regardless of cognitive status

The study was conducted to determine the effectiveness of a modified Mini Nutritional Assessment (MNA) for assessing the nutritional status and predicting follow-up mortality of institutionalized elderly Taiwanese. The study was conducted in a large long-term care centre in central Taiwan. Trained interviewers assisted by the caregivers elicited sociodemographic data, healthcare and disease history, and answers to the MNA screen from each subject. One researcher performed all subjects' anthropometric measurements. Plasma albumin and cholesterol concentrations were determined. Results showed that the MNA without BMI, modified according to population-specific mid-arm circumference and calf circumference cut-points, effectively predicted the nutritional risk status of the elderly regardless of cognitive status. Substituting caregiver's assessments for self-viewed nutrition and health status (questions O and P of MNA) improved the predicting power of the tool in cognition-normal subjects. Results showed that 21.9% of the elderly were malnourished, 59.2% were at risk of malnutrition and 18.9% were normal according to self-assessment whereas 14.2% were malnourished, 59.2% were at risk of malnutrition, and 26.6% were normal according to caregiver's evaluation. The tool was also effective in predicting 12- and 6-month follow-up mortality in cognition-normal and cognition-impaired elderly, respectively. Results indicate that a population-specific MNA can effectively predict the nutritional status and 6-month follow-up mortality of elderly Taiwanese regardless of cognitive condition. Easier and wider application of the tool will enable early detection of emerging nutritional problems and timely intervention to prevent the development of severe malnutrition in the elderly.     

简易营养评价法在评价老年糖尿病患者营养状况中的应用

目的探讨简易营养评价法（MNA）在评价老年糖尿病患者营养状况时的敏感性和特异性。方法对116例住院老年糖尿病患者进行MNA问卷调查、人体测量、生化检测和24小时膳食回顾调查。分析MNA用于评价老年糖尿病患者营养状况的敏感性和特异性。结果MNA问卷调查显示住院老年糖尿病患者28．4％营养不良，32．8％具有营养不良危险，38．8％营养良好。当以MNA〈17为界点时，MNA的敏感性分别为75．0％、64．7％和65．8％，特异性分别为76．9％、77．8％和79．5％；当以MNA≤23．5为界点时，MNA的敏感性分别增加为100％、100％和97．4％，特异性下降至43．2％、45．5％和50．0％。MNA与体质指数（r=0．474，P〈0．01）、三头肌皮褶厚度（r=0．369，P〈0．01）、上臂肌围（r=0．479，P〈0．01）、血清白蛋白（r=0．613，P〈0．01）、血红蛋白（r=0．335，P〈0．01）和总淋巴细胞计数（r=0．433，P〈0．01）均呈显著正相关。结论老年糖尿病患者营养不良的发生率高。MNA是一种用于老年糖尿病患者营养状况评价的可靠、灵敏方法。     

Population-specific anthropometric cut-points improve the functionality of the Mini Nutritional Assessment (MNA) in elderly Taiwanese

The objective of this study was to determine the population-specific cut-points of body mass index (BMI), mid-arm circumference (MAC) and calf circumference (CC) for identifying subnormal nutritional status in elderly Taiwanese, and to evaluate the possibility of improving the functionality of the Mini Nutritional Assessment (MNA) by adopting these cut-points. This study analyzed data from 1583 men and 1307 women, 65 years or older, of a national survey. The survey involved in-home, face-to-face, interviews and anthropometric measurements. Results showed that based on the cumulative percentile curves, the fifth percentile values were: BMI, 17 kg/m2 for both men and women; MAC, 22.5 cm for men and 21 cm for women; and CC, 28 cm for men and 25 cm for women. Substitution of these population-specific cut-points for respective values in the MNA screen resulted in lowered proportions of elderly classified malnourished or at risk of malnutrition. The prevalence of malnutrition was reduced from 1.7% to 1.4% in men and from 2.4% to 1.5% in women. The proportions classified at risk of malnutrition were reduced from 10.1% to 8.9% for men and 16.8% to 12.8% for women. In conclusion, results suggest that the MNA is a valuable tool for geriatric nutritional risk assessment. However, in populations where significant differences exist in anthropometric measurements from the Caucasian populations, population-specific cut-points should be used.     

Poor nutritional habits are predictors of poor outcome in very old hospitalized patients

BACKGROUND: Malnutrition is prevalent in elderly populations. Recommended methods of nutritional screening are often too complicated and time-consuming for routine application in frail, very old, hospitalized patients. OBJECTIVE: Our aims were to identify risk factors for development of malnutrition in very old hospitalized patients and to evaluate the total Mini Nutritional Assessment (MNA) score and MNA subscores as predictors of in-hospital and long-term mortality. DESIGN: A prospective cohort study of patients aged > or =75 y was conducted in a geriatric hospital. Assessment included demographic, clinical, and laboratory data and cognitive, functional, and nutritional status. Follow-up was conducted for < or =2.7 y. RESULTS: Of the 414 patients studied, only 73 (17.6%) were well-nourished. Low serum albumin and phosphorus concentrations, dementia, and cerebrovascular accident (CVA) were significant risk factors for malnutrition. Survival was significantly lower in malnourished patients and patients at risk of malnutrition than in well-nourished patients (P < 0.0001). Low MNA-3 subscores (dietary habits) were significantly correlated with laboratory indexes of malnutrition and were significantly lower in patients with infections, malignancy, pressure ulcers, dementia, recent orthopedic surgery, and CVA. Multivariate analysis showed that a low MNA-3 score was an independent predictor of mortality; scores <7.5 increased the risk of death 2.05-fold. CONCLUSIONS: The prevalence of malnutrition was high in elderly hospitalized patients. Dietary habits were significant predictors of poor hospitalization outcome. A questionnaire on dietary habits can serve as a useful tool in assessing nutritional status and prognosis in elderly patients.     

Nutritional status of community-dwelling elderly with newly diagnosed Alzheimer’s disease: Prevalence of malnutrition and the relation of various factors to nutritional status

Objetives

To determine the prevalence of malnutrition and its relation to various factors in community-dwelling elderly with newly diagnosed Alzheimer’s disease (AD).

Design

Retrospective crosssectional study.

Setting

Memory clinic in a rural part of the Netherlands.

Participants

312 Community-dwelling AD patients, aged 65 years or older, were included.

Measurements

At the time the diagnosis AD was made, socio-demographic characteristics and data on nutritional status (Mini Nutritional Assessment (MNA)), cognitive function (Mini Mental State Examination (MMSE), Cambridge Cognitive Examination (Camcog)), functional status (Interview for Deterioration in Daily Living Activities in Dementia (IDDD), Barthel Index (BI)) and behaviour (Revised Memory and Behaviour Problems Checklist (RMBPC)) were assessed. Characteristics of well-nourished patients (MNA score >23.5) were compared to characteristics of patients at risk of malnutrition (MNA score 17–23.5). Linear regression analysis was performed to assess the effect of various factors on nutritional status.

Results

The prevalence of malnutrition was 0% and 14.1% was at risk of malnutrition. AD patients at risk of malnutrition were more impaired in basic and complex daily functioning than well-nourished AD patients (median IDDD score 41.5 [25th–75th percentile 38.8–48.0] versus median IDDD score 40.0 [25th–75th percentile 37.0–43.0], p = 0.028). The degree of impairment in basic and complex daily functioning (IDDD) was independently related to nutritional status (MNA) (p = 0.001, B = ?0.062).

Conclusion

One in seven community-dwelling elderly with newly diagnosed AD is at risk of malnutrition. The degree of impairment in daily functioning is independently related to nutritional status. Therefore, assessment of the nutritional status should be included in the comprehensive assessment of AD patients. The relation between daily functioning, nutritional status and AD warrants further investigation.     

Nutritional status in cognitively intact older people receiving home care services--a pilot study

Older adults are a potentially vulnerable group for malnutrition. This cross-sectional pilot study aims to assess the nutritional status of elderly patients living at home and receiving home health care services. The data were collected from patient care plans, the Mini Nutritional Assessment (MNA), and a questionnaire on eating problems. In addition, serum nutritional status indicators were measured, and an oral examination including quantitative saliva measurement was carried out. Out of 71 eligible patients 51 (72%) patients aged 76-93 years participated. MNA results showed that 47% were at risk of malnutrition. Care plans for 26 patients made reference to questions of nutrition but provided no detailed forward planning. The mean serum albumin value was 39.1 +/- 3.8 g/l, seven patients had a value lower than 35 g/l. MNA scores were significantly lower for female patients with haemoglobin values lower than 120 g/l (p = 0.027). The dentist's estimation of dry mouth and subjective problems in energy intake were significantly associated with lower MNA scores (p = 0.049 and p = 0.015). Subjects with functioning natural dentition had higher body mass index (BMI) scores than others (p = 0.0485). The results point at the importance of using screening tools such as the MNA for purposes of nutritional assessment, the estimation of oral problems such as dry mouth, chewing and swallowing problems, and advance planning in nutritional issues within the field of home care.     

脑卒中患者营养不良风险评估及对康复护理的对策研究

[目的]分析脑卒中患者营养风险影响因素,并探讨康复护理对策的制定.[方法]随机选取2018年7月—2020年7月丽水市中心医院神经外科收治的急性出血性脑卒中患者152例,根据微型营养评估(MNA)量表评分结果,将患者分为正常组、风险组和不良组.采用单因素分析与相关性分析方法,分析患者可能存在的营养风险影响因素,并针对影...     

Preoperative nutritional evaluation of elderly patients: the Mini Nutritional Assessment as a practical tool

BACKGROUND AND GOAL: Age and malnutrition are each surgical risk factors. Because the Mini Nutritional Assessment (MNA) has been specifically designed for assessing the nutritional status of elderly patients, it can be used for preoperative nutritional evaluation. Therefore, the MNA was included in the preoperative clinical evaluation of patients over 60 years of age to describe their nutritional status. METHODS: Every patient over 60 years of age, scheduled for elective surgery, was seen in anaesthesiology consultation and was submitted to the MNA. The MNA is a clinical score consisting of four additive items: 'Anthropometric assessment' based on BMI, mid-arm and calf circumferences, weight loss; global evaluation; dietetic assessment, and subjective assessment - these last three items being obtained through a specific questionnaire. It requires no biological marker. Awarding to the obtained score, the MNA stratifies patients in the following categories: well-nourished (24 相似文献   

Population-specific anthropometric cutoff standards improve the functionality of the Mini Nutritional Assessment without BMI in institutionalized elderly in Taiwan

Objective: To assess the nutritional status of institutionalized Taiwanese elderly with the Mini Nutritional Assessment (MNA) without BMI and to determine whether the application of population-specific MAC and CC cutoff standards would improve the functionality of the tool.Design: Purposive sampling.Setting: A long-term care facility in central Taiwan.Participants: Two hundred and eight >65 y residents who were free of acute infection/diseases and were able to communicate.Measurements: A questionnaire survey to elicit personal data and administer the MNA and measurements of anthropometric and blood biochemical indicators.Results: The MNA, without BMI, predicted 22.1% of participants malnourished and 61.1% at risk of malnutrition among residents of a long-term care facility in Taiwan. Replacing the population-specific cutoff standards of MAC and CC for the original cutoff standards in the MNA and increasing the weighted score of MAC and CC to replace for the weighted score of BMI preserved and improved the predicting ability of the MNA. The improvement was evidenced by the increase in the correlationships between the MNA scores and the anthropometric, biochemical or health status indicators.Conclusion: The MNA predicted nutritional risk status of the institutionalized elderly Taiwanese. The study suggests that whenever possible population-specific anthropometric cutoff standards should be applied to improve the functionality of the MNA. It also appears possible to preserve or even improve the functionality of the MNA without BMI. The modifications indicate an improvement in the application of the MNA in long-term care patients.     

Baseline plasma levels of interleukin-8 in stage IV non-small-cell lung cancer patients: relationship with nutritional status and prognosis

Interleukin (IL)-8 promotes cellular proliferation and angiogenesis in patients with non-small-cell lung cancer (NSCLC) and may be related to cachexia. Our aim was to investigate the relationship of IL-8 levels with nutritional status, and clinical outcome of patients with NSCLC. Patients with metastatic NSCLC referred for first-line therapy were eligible. Baseline IL-8 levels were measured in plasma. The Mini Nutritional Assessment (MNA) was used for the evaluation of the nutritional status, and patients were classified into 3 groups: A (score 24-30) "well nourished," B (score 17-23.5) "risk of malnutrition," and C (0-16.5) "malnourishment." Response to first-line chemotherapy, time-to-tumor progression (TTP), and overall survival (OS) were also recorded. In total, 114 patients (101 males, 88.5%; mean age = 67.5 yr) were evaluated. Performance status was 0-1 in 62% of the patients. According to the MNA, the majority of patients (71%) was either at nutritional risk or malnourished. IL-8 levels were significantly different between MNA groups (P = 0.023) and correlated with TTP (P = 0.013) and OS (P = 0.001) in univariate analysis. Baseline IL-8 levels correlate with the nutritional status of patients with metastatic NSCLC, suggesting that this cytokine may be related with cachexia.     

Nutritional status using the Mini Nutritional Assessment questionnaire and its relationship with bone quality in a population of institutionalized elderly women

Malnutrition, a risk factor for osteoporotic fractures, is frequent in elderly people and, is underdiagnosed and undertreated. There are only few studies on the nutritional status of elderly people in Europe. The Mini Nutritional Assessment (MNA) is a non invasive and validated questionnaire to evaluate nutritional status in elderly people, classified in three groups: 1 degree score < 17: malnourished, 2 degrees score >17 and < 24: at risk of malnutrition, 3 degrees score >24: well-nourished, with a maximum of 30 points. Quantitative ultrasound of bone (QUS) is a method for assessing quality of bone which can be easily performed in nursing homes. Therefore, these two tests allowed to study the relationships between nutritional status and ultrasonic parameters of bone in 78 institutionalized women aged 86 +/- 6 years, living in 11 nursing homes around Lausanne (Switzerland). All were assessed by the MNA, had a measurement of the tricipital skin fold and of the grip strength. Functional status was evaluated by the scale "Activity of Daily Living" (ADL), and serum albumin level was measured when permitted. All had QUS of the calcaneus (with an Achilles, GE Lunar). The measured parameters are the Broadband Ultrasound Attenuation (BUA), attenuation of a band of ultrasonic frequencies through the medium, expressed in dB/MHz, and the Speed of Sound (SOS), speed of the ultrasounds through the medium, expressed in m/s. A third parameter, the stiffness index (SI), expressed as a percentage of the values obtained by the manufacturer in a young population and derived from BUA and SOS, was calculated automatically : SI = (0.67xBUA) + (0.28xSOS) - 420, expressed in percent compared to a young adult population (%YA). Fifteen percent of the women were undernourished and 58% were at risk of malnutrition. As expected, compared with the well-nourished minority, undernourished subjects had significant lower body mass index (BMI), tricipital skin fold (TSF), ADL score and albumin level (p < 0,01). The subjects "at risk of malnutrition" had significant lower BMI, ADL score (p < 0.01), tricipital skin fold and serum albumin (p < 0.05). Ultrasound parameters were low independently of the nutritional status. MNA score correlated significantly with tricipital skin fold (r = 0.508, p < 0.01), ADL (r = 0.538, p < 0.01) and albumin serum level (r = 0.409, p = 0.01). There was a trend for a correlation between the MNA and the ultrasound parameter BUA (r = 0.207, p = 0.07), whereas no correlation was found with SOS and SI. A multivariate analysis showed that tricipital skin fold and ADL explained 61% of the variance of the MNA. In conclusion, using simple and non invasive methods, this study showed that malnutrition and osteoporosis are frequent in institutionalized elderly persons in our country, and the ultrasound parameters are influenced by many others factors in addition to nutrition, especially at this age and in elderly residents of nursing homes.     

Evaluation of Mini-Nutritional Assessment for Japanese frail elderly

OBJECTIVE: We evaluated the Mini-Nutritional Assessment (MNA) test and the short-form MNA as screening tools for malnutrition in the Japanese elderly population. METHODS: A cross-sectional study of 226 elderly Japanese patients (78.6 +/- 0.5 y of age, mean +/- standard deviation; 67 men and 159 women) in various settings was carried out. Nutritional assessment included MNA, anthropometric measurements, and biochemical markers. RESULTS: According to the original cutoff point of the full MNA, 19.9% of those assessed were malnourished, 58.0% were at risk of malnutrition, and 22.1% were well nourished. Significant correlations were found between full MNA scores and age (r = -0.14), body mass index (r = 0.59), serum albumin (r = 0.60), total cholesterol (r = 0.36), midarm circumference (r = 0.50), and triceps skinfold (r = 0.37). The sensitivity and specificity of the full MNA score (< 17) for hypoalbuminemia were 0.810 and 0.860, respectively. With a cutoff point lower than 18, sensitivity and specificity hypoalbuminemia were 0.857 and 0.815, respectively. Using a short-form MNA score 12 and higher as normal, its sensitivity and specificity for predicting undernutrition were 0.859 and 0.840, respectively. CONCLUSIONS: The full and short forms of the MNA were useful tools to identify elderly Japanese patients with malnutrition or risk of malnutrition. However, the full MNA cutoff point for malnutrition should be modulated for this population.     

Suboptimal Tongue Pressure Is Associated with Risk of Malnutrition in Community-Dwelling Older Individuals

The tongue plays an important role in swallowing, and its dysfunction theoretically leads to inadequate oral intake and subsequent malnutrition. This study aimed to explore how different levels of tongue pressure are related to malnutrition among community-dwelling older individuals. The target population was community-dwelling adults aged ≥ 65 years. Tongue pressure was measured using the Iowa Oral Performance Instrument, whereas the mini nutrition assessment (MNA) test was administered to determine the nutritional status. A full MNA score of less than 24 points was defined as risk of malnutrition. Multivariate logistic regression analyses were conducted to calculate the odds ratio (OR) of risk of malnutrition among different quartiles of tongue pressure. Among the 362 participants, 26 (7.1%) were classified as having risk of malnutrition. Body weight, body mass index, handgrip strength, skeletal muscle mass index, sum MNA score, and serum levels of albumin were lower in the malnutrition risk groups than in the normal nutrition status group. A positive correlation was identified between tongue pressure and the MNA score (r = 0.143, p < 0.01). Treating the subgroup of the highest quartile of tongue pressure as the reference, the crude odds ratio (OR) of having risk of malnutrition was 5.37 (95% CI, 1.14–25.28) in the subgroup at the third quartile, 3.10 (95% CI, 0.60–15.84) in the subgroup at the second quartile, and 3.95 (95% CI, 0.81–19.15) in the subgroup at the lowest quartile. After adjustment for age and sex, the subgroup in the third quartile still presented with a significantly higher risk (OR, 4.85; 95% CI, 1.02–22.99) of risk of malnutrition. Compared with the subgroup at the highest quartile of tongue pressure, the crude OR for all the subgroups in the lower three quartiles was 4.17 (95% CI, 0.96–18.04), showing borderline significance (p = 0.05). In conclusion, we found hints for an association between decreased tongue pressure and an increased risk of malnutrition in community-dwelling older individuals. Older people with suboptimal tongue pressure should undergo a thorough assessment of their nutritional status and swallowing function for the early identification of subclinical malnutrition and dysphagia.     

利用简易营养评价法调查住院老年人的营养状况

目的 利用简易营养评价法(MNA)评价住院老年人的营养状况，了解MNA与传统营养指标的相关性。方法 利用MNA量表对144名住院老年人进行调查，同时收集人体测量指标、生化指标和其他资料。结果 住院老年人营养不良的患病率为36．1％，潜在营养不良为46．5％，营养正常占17．4％；年龄、牙齿状况和疾病状态是影响老年人营养的重要因素；MNA与多数传统营养指标之间有良好相关性。结论 住院老年人营养不良的患病率高，MNA是一种可靠、快捷、简便的老年人营养状况评价方法。