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Prognostic Differences of the Mini Nutritional Assessment Short Form and Long Form in Relation to 1-Year Functional Decline and Mortality in Community-Dwelling Older Adults Receiving Home Care.

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Title: Prognostic Differences of the Mini Nutritional Assessment Short Form and Long Form in Relation to 1-Year Functional Decline and Mortality in Community-Dwelling Older Adults Receiving Home Care.
Authors: Kiesswetter, Eva, Pohlhausen, Stefanie, Uhlig, Katrin, Diekmann, Rebecca, Lesser, Stephanie, Uter, Wolfgang, Heseker, Helmut, Stehle, Peter, Sieber, Cornel C., Volkert, Dorothee
Source: Journal of the American Geriatrics Society. Mar2014, Vol. 62 Issue 3, p512-517. 6p. 4 Charts.
Subjects: Geriatric assessment, Analysis of covariance, Confidence intervals, Health status indicators, Longitudinal method, Scientific observation, Questionnaires, Research funding, U-statistics, Data analysis, Activities of daily living, Repeated measures design, Proportional hazards models, Geriatric Depression Scale, Data analysis software, Descriptive statistics, Statistics
Geographic Terms: Germany
Abstract: Objectives To compare the prognostic value of the revised Mini Nutritional Assessment short form ( MNA- SF) classification with that of the long form ( MNA- LF) in relation to mortality and functional change in community-dwelling older adults receiving home care in Germany. Design Multicenter, 1-year prospective observational study. Setting Community. Participants Older adults (≥65) receiving home care (n = 309). Measurements Nutritional status (well nourished, at risk of malnutrition, malnourished) was classified using the MNA- SF and MNA- LF at baseline. Functional status was determined according to the Barthel Index of activities of daily living ( ADLs) at baseline and after 1 year. Hazard ratios ( HRs) and 95% confidence intervals ( CIs) of mortality were calculated for MNA- SF and MNA- LF categories using stepwise Cox regression analyses. Repeated-measurements analysis of covariance was used to examine changes in ADL scores over time for MNA- SF and MNA- LF categories. Results MNA- SF classified 15% of the sample as malnourished and 41% as being at risk of malnutrition, whereas the MNA- LF classified 14% and 58%, respectively. During the follow-up year, 15% of participants died. The estimated hazard ratios (HR) for 1-year mortality were lower for MNA-SF than for MNA-LF categories (at risk of malnutrition: HR = 2.21, 95% confidence interval (CI) = 1.02−4.75 vs HR = 5.05, 95% CI = 1.53−16.58; malnourished: HR = 3.27, 95% CI = 1.34−8.02 vs HR = 8.75, 95% CI = 2.45−31.18). For MNA- SF categories, no differences in functional change were found. According to the MNA- LF, ADL decline tended to be greater in those at risk of malnutrition (7.1 ± 10.1 points) than in those who were well nourished (3.7 ± 10.1 points) and malnourished (4.9 ± 10.1 points). Conclusion In this sample of older adults receiving home care, the MNA- LF was superior to the MNA- SF in predicting mortality and differentiating functional decline during 1 year of follow-up. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Objectives To compare the prognostic value of the revised Mini Nutritional Assessment short form ( MNA- SF) classification with that of the long form ( MNA- LF) in relation to mortality and functional change in community-dwelling older adults receiving home care in Germany. Design Multicenter, 1-year prospective observational study. Setting Community. Participants Older adults (≥65) receiving home care (n = 309). Measurements Nutritional status (well nourished, at risk of malnutrition, malnourished) was classified using the MNA- SF and MNA- LF at baseline. Functional status was determined according to the Barthel Index of activities of daily living ( ADLs) at baseline and after 1 year. Hazard ratios ( HRs) and 95% confidence intervals ( CIs) of mortality were calculated for MNA- SF and MNA- LF categories using stepwise Cox regression analyses. Repeated-measurements analysis of covariance was used to examine changes in ADL scores over time for MNA- SF and MNA- LF categories. Results MNA- SF classified 15% of the sample as malnourished and 41% as being at risk of malnutrition, whereas the MNA- LF classified 14% and 58%, respectively. During the follow-up year, 15% of participants died. The estimated hazard ratios (HR) for 1-year mortality were lower for MNA-SF than for MNA-LF categories (at risk of malnutrition: HR = 2.21, 95% confidence interval (CI) = 1.02−4.75 vs HR = 5.05, 95% CI = 1.53−16.58; malnourished: HR = 3.27, 95% CI = 1.34−8.02 vs HR = 8.75, 95% CI = 2.45−31.18). For MNA- SF categories, no differences in functional change were found. According to the MNA- LF, ADL decline tended to be greater in those at risk of malnutrition (7.1 ± 10.1 points) than in those who were well nourished (3.7 ± 10.1 points) and malnourished (4.9 ± 10.1 points). Conclusion In this sample of older adults receiving home care, the MNA- LF was superior to the MNA- SF in predicting mortality and differentiating functional decline during 1 year of follow-up. [ABSTRACT FROM AUTHOR]
ISSN:00028614
DOI:10.1111/jgs.12683