Nutritional status according to the Mini Nutritional Assessment (MNAA®) and frailty in community dwelling older persons: A close relationship

This study investigates the association between MNA results and frailty status in community-dwelling older adults. In addition the relevance of singular MNA items and subscores in this regard was tested. Cross-sectional study. Community-dwelling older adults were recruited in the region of Nurnberg, Germany. 206 volunteers aged 75 years or older without cognitive impairment (Mini Mental State Examination > 24 points), 66.0% female. Frailty was defined according to Fried et al. as presence of three, pre-frailty as presence of one or two of the following criteria: weight loss, exhaustion, low physical activity, low handgrip strength and slow walking speed. Malnutrition (< 17 points) and the risk of malnutrition (17-23.5 points) were determined by MNAA (R). 15.1% of the participants were at risk of malnutrition, no participant was malnourished. 15.5 % were frail, 39.8% pre-frail and 44.7% non-frail. 46.9% of the frail, 12.2% of the pre-frail and 2.2% of the non-frail participants were at risk of malnutrition (p < 0.001). Hence, 90% of those at risk of malnutrition were either pre-frail or frail. For the anthropometric, dietary, subjective and functional, but not for the general MNA subscore, frail participants scored significantly lower than pre-frail (p < 0.01), and non-frail participants (p < 0.01). Twelve of the 18 MNA items were also significantly associated with frailty (p < 0.05). These results underline the close association between frailty syndrome and nutritional status in older persons. A profound understanding of the interdependency of these two geriatric concepts will represent the basis for successful treatment strategies.