Characteristics of the Mini-Nutritional Assessment in elderly home-care patients

Objective: To assess the risk of malnutrition among elderly people living at home and receiving regular home-care services using the Mini-Nutritional Assessment (MNA) and to study the characteristics of the instrument in this patient group. Design: A cross-sectional study using the MNA score to assess the nutritional status of elderly home-care patients. Setting: Municipal home-care services in rural Finland. Subjects: A total of 178 (65%) out of 272 eligible patients aged 75-94 y agreed to participate. Major outcome methods: MNA questionnaire, anthropometrics, structured questionnaire, menu record. Results: According to MNA, 3% were malnourished (MNA < 17 points), 48% at risk for malnutrition (17-23.5 points) and 49% well nourished (>23.5 points). The mean MNA score was 23.4. Weight loss, psychological stress, nutritional status, decline in food intake, self-perceived health status and mid-arm circumference (MAC) showed the strongest significant correlations (P = 0.0001) to total MNA score. MNA questions with the strongest significant intercorrelations (P = 0.0001) were body mass index with MAC and calf circumference; and the decline of food intake and self-perceived nutritional status. The number of eating problems correlated significantly to the MNA score (P = 0.0011). Those with chewing and swallowing problems (n = 64, 36%) had a significantly lower MNA score than others (P = 0.0001). Dry mouth together with chewing and swallowing problems (n = 40, 22%) reduced the MNA score even further (P = 0.0001). Conclusions: The results suggest that MNA is a useful tool in the identification of elderly home-care patients at risk for malnutrition.