Usefulness of the Mini-Nutritional Assessment (MNA) to evaluate the nutritional status of Japanese frail elderly under home care

Background: The Mini-Nutritional Assessment (MNA) has proved useful in Western countries to predict long-term mortality of institutionalized elderly patients, as well as the elderly living at home. However, there are few reports on the usefulness of this evaluation in the elderly in Japan. Our objective was to examine the usefulness of the MNA to screen and diagnose malnutrition in the elderly in Japan and investigate the effect of nutritional status on their activities of daily living (ADL) and mortality. Methods: We recruited 181 frail elderly (62 men and 119 women) under home care whose age was 79.8 +/- 8.8 years old. We assessed their nutritional status (anthropometric measurements, serum albumin, MNA) and ADL; then we followed up these patients for more than 2 years to see whether the MNA reflected their prognosis. Results: The MNA score correlated with anthropometric measurements, serum albumin and ADL (P < 0.01). The hazard ratio of mortality by all causes was significantly higher in the elderly with protein energy malnutrition (PEM) and risk for PEM, compared with well-nourished elderly patients. Conclusion: The MNA was useful to screen the elderly for nutritional status because it reflected the ADL and the prognosis, as well as conventional nutritional indexes such as anthropometric values and serum albumin.