Validity of the Mini-Nutritional Assessment Scale for Evaluating Frailty Status in Older Adults

Abstract

Objectives: Comprehensive Geriatric Assessment (CGA) may not be performed in clinical practice as it takes too much time and requires special training. The Mini-Nutritional Assessment (MNA) is widely used to assess nutritional status in older adults. We aimed to determine whether or not the MNA can estimate frailty status defined by the Fried criteria. Setting and Participants: Six hundred two outpatients aged 65 years or older who underwent the CGA were included the study. Measures: Frailty status was defined by 5 dimensions including shrinking, exhaustion, low levels of activity, weakness, and slowness: 0 for robust, 1–2 for prefrail, and 3–5 for frail. MNA was performed in all participants even if their MNA-Short Form scores were ≥12. Results: Of the 602 outpatients, of whom the mean age was 74.2 ± 8.2 years, 190 participants (31.6%) were considered frail and 218 (36.2%) prefrail. Internal consistency of the MNA had a Cronbach-alpha of 0.701. Interclass correlation coefficient for the test-retest reliability was found as 0.697. MNA with a cut-off point of 22.5 had a sensitivity of 72.1% and a specificity of 91.2% to detect frail participants. MNA with a cut-off point of 25.5 had a sensitivity of 66.9% and a specificity of 85.4% to detect prefrailty. For the estimation of frailty and prefrailty, the area under the receiver operating characteristics curve of MNA was 0.903 and 0.834, respectively. Conclusions: MNA can be a useful tool for frailty screening indicating that 2 common geriatric syndromes, malnutrition and frailty, can be identified by MNA simultaneously in clinical practice. © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine