• 대한지역사회영양학회지
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• 제10권5호
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• pp.645-653
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• 2005

The prevalence of undernutrition in hospital populations is known to be high. The presence of malnutrition is associated with depression, infections, sarcopaenia, falls, fractures, reduced autonomy and increased mortality. This study specifically examined the prevalence of malnutrition in patients aged 65 or older at the time of admission as determined by the Mini Nutritional Assessment (MNA) which has been a frequently used nutritional risk screening tools in detecting undernutrition in old people. This study was done for one hundred eight hospitalized geriatric patients in Seoul National University Bundang Hospital, Seoul, Korea. On admission baseline history, anthropometrics measurements, laboratory data and nutritional status by MNA were assessed. Length of hospital stay was obtained by reviewing medical charts. We used one-way analysis of variance to compare the differences in variables. Spearman's rank correlation coefficients were calculated for associations between MNA and variables. On admission, $22.3\%$ of patients were malnourished and $40.7\%$ were at risk of malnutrition according to the MNA. Percent of ideal body weight, anthropometrics data, albumin, and hemoglobin were lower in the malnourished patients (p<0.05). The malnourished patients stayed in the hospital 7.3 days longer, as compared with well nourished patients (p<0.05). Percent of ideal body weight, albumin, hemoglobin and total cholesterol were correlated inversely with nutritional status according to MNA (p<0.05). MNA can be used for nutritional assessment in Korean old people, because MNA significantly correlated with other nutritional assessment parameters, such as, anthropometric and laboratory data in hospitalized geriatric patients. The high prevalence of malnutrition in the elderly was observed and the presence of malnutrition on admission predicted a significant increase in the length of hospital stay in this study. Therefore further studies are needed to determine whether nutritional interventions in old people with low MNA scores can improve clinical outcomes during the hospital course.

• 대한영양사협회학술지
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• 제16권2호
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• pp.122-132
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• 2010

Elderly people comprise an increasing proportion of the population, and nutritional impairments may contribute to health problems among this group. This study was conducted to evaluate the nutritional status by Mini-Nutritional Assessment (MNA) and to identify relationships among anthropometric measurements, biochemical indicators, bone Mineral Density (BMD) and MNA results among older adults (${\geq}$65 yrs, n=98, 66.7${\pm}$2.5 yrs; M=52, F=46, BMI 24.5${\pm}$2.8 $kg/m^2$) at a Health Care Center. A dietitian administered MNA and collected anthropometric measurements (weight, height, waist circumference), biochemical indicators (albumin, hemoglobin, hematocrit, TLC, glucose, lipids) and the BMD (spine, femur, F=46). Subjects were grouped into a normal nutrition group (0~2 risk factors of malnutrition) and a high risk of malnutrition group (>=3 risk factors of malnutrition) based on their risk factor status for malnutrition. The risk factors for malnutrition include age ${\geq}$65 years, PIBW <90%, albumin <3.5 g/dl, TLC <1,500%, Hgb <14 g/dl (men), Hgb <10 g/dl (women), loss of appetite and weight loss 1~3 kg/last 3 months. In addition, subjects were grouped into a normal, osteopenia and osteoporosis group by BMD. We found that 12% of the subjects were at risk of malnutrition (MNA score, 21.4${\pm}$2.1) and that 88% were well nourished (27.3${\pm}$1.5) according to the MNA. Full-MNA scores were positively and significantly (p<0.05) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), albumin and hemoglobin, respectively. The full-MNA score of the high risk of malnutrition group (23.0${\pm}$3.8) was lower than that of the normal nutrition group (27.0${\pm}$2.1) (p<0.05). In addition, the Full-MNA score was negatively associated with the risk factor of malnutrition (r=－0.35, p=0.0004). We found that 39.1% of the subjects had osteoporosis, 45.7% had osteopenia and 15.2% were normal according to their BMD. The MNA score of osteoporosis group (24.58${\pm}$3.3) was lower than that of the normal (27.4${\pm}$1.1) and osteopenia group (26.9${\pm}$1.5) (p<0.05). These results suggested that MNA can be useful as a nutritional screening tool of older adults in Health Care Centers.

• Journal of Nutrition and Health
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• 제37권8호
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• pp.675-687
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• 2004

This study is designed to assess the prevalence at risk of malnutrition according to the Mini Nutritional Assessment (MNA) and evaluate the factors influencing on the nutritional risk of the elderly. Three hundred and nine elderly (110 men and 199 women: mean age =74.1) who participated in meal service in the Chung-buk province were investigated. Mean MNA total score was 21.9 and women had significantly lower MNA scores than men (respectively, 21.5 and 22.8). In the mean time mean MNA-SF (Short Form) score was 10.7, respectively 10.6 for the women and 11.0 for the men, with the difference being statistically significant. The MNA classified 33% of the elderly as well-nourished, 61.7% as at risk of malnutrition and 5.3% as overt malnourished. However, MNA-SF categorized the examinees 40.2% as good and 59.8% at nutritional risk. Those who identified as malnourished elderly had significantly lower mean BMI, mid-arm and calf circumference, poorer functional abilities (ADL, IADL) , lower MAR and food habits scores, and higher number of nutrient $\leq$ 75% of RDA than those with at risk of malnutrition and well nourished. Also socioeconomic status such as educational level, self-rated economic status, poverty level, and marital status significantly influenced nutritional status. Similar effect was observed in self-rated nutritional status and health status, dental status, appetite change according to MNA score. Stepwise multiple regression analysis indicated that weight loss was the most predictive item in the total MNA and MNA-SF score. It was found that items such as mobility, living status (home vs institution) , mode of feeding, and pressure sores were inappropriate for assessment of the elderly who are able to participate meal service program. Also, some modifications of items in MNA are needed in order to apply to Korean elderly. Even though the MNA seems to be an useful tool to screen those old people at risk of malnourished, a lot of work is still to be done with this assessment tool to secure its reliability.

• 대한영양사협회학술지
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• 제19권4호
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• pp.400-415
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• 2013

The purpose of the study was to examine the current status of nutritional management at elderly nursing homes. A survey was performed of 83 nursing homes from January 5, 2011 to January 21, 2011 via mail. A total of 34 nursing homes responded to the survey and 149 elderly subjects were analyzed according to the presence of a dietitian. Among the 34 nursing homes, 70.6% had a dietitian on duty. All of the facilities with a dietitian had the dietitian making the meal plan, whereas 70% of the facilities without dietitian served meals planned by a non-professional person. Overall, however, a low proportion of nursing homes implemented dietetic treatments for residents with diseases. For the nutritional assessment of these residents, a mini nutritional assessment (MNA) was performed. MNA scores were significantly associated with body mass index (BMI), mid-arm circumference (MAC), calf circumference (CC), ingestion problems, and weight loss during the last 3 months (P<0.001). Among the elderly studied, 5.4% were malnourished, and 36.9% were at risk for malnutrition by MNA score. The results of this survey show that the current management of nutrition at nursing homes is insufficient because the elderly who needed dietetic treatment did not receive proper care. Dietetic management is the most important service in all nursing homes. Therefore, to improve the nutritional status of elderly residents in nursing homes, systematic nutrition management by nutrition experts should be implemented.

• 동아시아식생활학회지
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• 제25권4호
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• pp.631-642
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• 2015

The purpose of the study was to examine health status and mini nutritional assessment (MNA) according to self-esteem status of elderly in care hospital. The survey was carried out from $13^{th}$ to $31^{st}$ of September, 2014 in five care hospitals. Analysis was performed for 226 subjects. Evaluation criteria included demographics, clinical status, MNA, health-related quality of life (EQ-5D) and self-esteem. The SE I, SE II and SE III groups were divided by self-esteem scores. Data were analyzed one-way ANOVA, Duncan' multiple range test and Pearson's correlation using SPSS 15.0. Education level, religion, dental condition and medical endurance type were significantly different in all groups. Many elderly people were normal BMI ($20.94{\sim}21.67kg/m^2$). Self-esteem significantly increased in order of SE I, SE II and SE III. Mobility, usual activity and anxiety or depression were significantly different in all groups, and EQ-5D of SE II and SE III groups were significantly higher than that of SE I group. Comparison of MNA screening score in elderly patients was as follows : Score for food intake, psychological stress or acute disease, neuropsychological problems, pressure scores or skin ulcer, protein intake, mode of feeding, nutritional status and health status in SE I group were significantly lower than those of SE II and SE III groups. Mobility and drug intake of SE I group were significantly lower than those of SE III groups. Fruit and vegetable intake SE I group were significantly higher than those of SE II and SE III groups. MIS (Malnutrition Indicator Score) was significantly different among the SE I, SE II and SE III groups. We conclude that self-esteem score is positively correlated with protein intake, nutrition status, health status and MIS in elderly care hospital. To improve nutritional status of elderly in care hospitals, systematic nutrition management and self-esteem education program should be implemented.

• Nutrition Research and Practice
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• 제9권6호
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• pp.637-643
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• 2015

BACKGROUND/OBJECTIVES: Malnutrition in the elderly is a serious problem, prevalent in both hospitals and care homes. Due to the absence of a gold standard for malnutrition, herein we evaluate the efficacy of five nutritional screening tools developed or used for the elderly. SUBJECTS/METHODS: Elected medical records of 141 elderly patients (86 men and 55 women, aged $73.5{\pm}5.2years$) hospitalized at a geriatric care hospital were analyzed. Nutritional screening was performed using the following tools: Mini Nutrition Assessment (MNA), Mini Nutrition Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated as a reference tool. Each patient evaluated as malnourished to any degree or at risk of malnutrition according to at least four out of five of the aforementioned tools was categorized as malnourished in the combined index classification. RESULTS: According to the combined index, 44.0% of the patients were at risk of malnutrition to some degree. While the nutritional risk and/or malnutrition varied greatly depending on the tool applied, ranging from 36.2% (MUST) to 72.3% (MNA-SF). MUST showed good validity (sensitivity 80.6%, specificity 98.7%) and almost perfect agreement (k = 0.81) with the combined index. In contrast, MNA-SF showed poor validity (sensitivity 100%, specificity 49.4%) and only moderate agreement (k = 0.46) with the combined index. CONCLUSIONS: MNA-SF was found to overestimate the nutritional risk in the elderly. MUST appeared to be the most valid and useful screening tool to predict malnutrition in the elderly at a geriatric care hospital.

• 한국지역사회생활과학회지
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• 제28권1호
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• pp.5-16
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• 2017

This study was conducted to compare the nutritional status, nutrient intakes, and chronic disease risks of Chinese elderly people. MNA (Mini Nutritional Assessment) developed for elderly people was used to determine their nutritional status. In this study, participants consisted of 148 urban residents aged 65 years and over residing in three cities in Shandong Province, China. Participants were 67 (45.3%) men and 81 (54.7%) women, and average age was 72.8 years. According to MNA score, 77.7% of participants were 'well nourished', 22.3% were 'at risk of malnutrition', and 2% were 'malnourished'. Nutritional status was divided into two groups by MNA score as 'well nourished' and 'malnourished', which was formed with the combination of 'at risk of malnutrition' and 'malnourished'. Compared with the well nourished group, the malnourished group was older, and physical status indicators such as weight, BMI (Body Mass Index), and calf circumference of the malnourished group were much smaller. The malnourished group had higher prevalence rates of heart disease and stomach disorders while the well nourished group had a higher rate of hypertension. There was no significant difference between the malnourished group and well nourished group in nutritional intake below Chinese DRIs (Dietary Reference Intakes) among elder males. A higher proportion of elder females showed insufficient intakes of energy, protein, vitamin A, vitamin E, and zinc in the malnourished group compared to the well nourished group. The INQ (Index of Nutrition Quality) of calcium, magnesium, zinc, iodine, and most vitamins was less than 1 in both the malnourished and well nourished groups.

• 대한지역사회영양학회지
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• 제18권2호
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• pp.142-153
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• 2013

The purpose of the study was to examine nutritional management and nutritional care demands of home-visit care service and the nutritional status of serviced elderly. The survey was carried out from $5^{th}$ to $21^{st}$ of January, 2011 among 37 In-Home Service institutions. The number of elderly surveyed by 143 care helpers was 281. Analysis was performed for 203 subjects (male: 44, female: 159). The age distribution was from 50 to 99 years. The grading by long-term care insuranceshowed 18,2% on level 1 and 2, and 81.8% on level 3. For the disease treatment, the proportion of implementing diet treatment turned out to be very low. The proportion of subjects living with their children was 45.3%, and living alone was 29.1%. The proportion of home-visit care among types of In-Home Service was 70%. Subjects who needed additional necessary diet management service turned out to be 40.9%. Diet management was the most necessary services from all levels. MNA (specifiy MNA) scores were significantly (p < 0.001) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), intake problems, and weight loss during the last 3 months. For studied elderly, 45.3% were malnourished, and 46.8% were at the risk of malnutrition by MNA score. Based on the result of this survey, the nutritional care was not systematic on the In-Home Service. Prevention and management of the disease was much better than the treatment to improve the quality of life. We conclude that nutrition management is necessary for the elderly. To improve nutritional status of elderly in home care services, systematic nutrition management should be implemented.

• 기본간호학회지
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• 제21권4호
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• pp.413-422
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• 2014

Purpose: The purpose of this study was to identify the nutrition-related factors influencing the prevalence of pressure ulcers among patients admitted to an intensive care unit. Methods: Research participants were 112 patients who were admitted to the ICU of a university hospital. Data were collected through questionnaires which included general characteristics, diet-related characteristics, nutritional status, and pressure ulcer status. Multivariate logistic regression was used to identify independent factors association with prevalence of pressure ulcer Results: The prevalence of pressure ulcers was 58 patients (51.8%) at 10th day after ICU admission. In multivariate analysis, prevalence of pressure ulcers at 10th day in ICU was significantly higher in the nutritional risk group (OR=6.43), malnutrition group (OR=88.02), and deceased serum albumin group (OR=28.83). Conclusion: The results of this research indicate that scores on MNA (Mini Nutritional Assessment) and serum albumin were significant predictors of pressure ulcer prevalence in ICU patients. Therefore, regular MNA-SF and albumin checkups are needed to identify risk for pressure ulcer for ICU patients. In the case of decreased MNA-SF scores and serum albumin levels, more intensive pressure ulcer care is needed for ICU patients.

• Nutrition Research and Practice
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• 제17권5호
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• pp.934-944
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• 2023

BACKGROUND/OBJECTIVES: Maintaining total muscle mass in the older adults with swallowing difficulty (dysphagia) is important for preserving swallowing function. Increasing protein intake can help sustain lean body mass in the older adults. The aim of this study was to evaluate the effect of various high-protein texture-modified foods (HPTMFs) on muscle mass and perform dietary assessment in ≥ 65-yrs-old patients with dysphagia. SUBJECTS/METHODS: Participants (n = 10) received the newly developed HPTMFs (average 595.23 ± 66.75 kcal/day of energy, 54.22 ± 6.32 g/day of protein) for 10 days. Relative handgrip strength (RHS), mid-upper arm circumference (MUAC), body composition, mini nutritional assessment (MNA), mini dietary assessment (MDA), and Euro Quality-of-Life questionnaire 5-dimensional classification (EQ-5D) were assessed. RESULTS: After 10 days, an increase in MUAC (26.36 ± 2.35 cm to 28.50 ± 3.17 cm, P = 0.013) and RHS (0.38 ± 0.24 kg/kg body weight to 0.42 ± 0.22 kg/kg body weight, P = 0.046) was observed. Although MNA, MDA, EQ-5D, subjective health status, muscle mass, and calf circumference showed a tendency to increase after intervention, no significant differences were found. CONCLUSIONS: These results suggest that the HPTMFs can be used for improving the nutritional and health status in patients with dysphagia.