The Mini Nutritional Assessment (MNA®)
With the number of persons 65 years and older expected to double in coming decades, there is growing interest in the United States on containing healthcare costs for the elderly by increasing support to maintain them in community settings. The success of this shift in care depends on elders being able to maintain functional status. This occurs at a time when many older persons face failing health or other physiological or psychosocial changes that can lead to undernutrition. If undetected and untreated, progressive undernutrition can lead to malnutrition and cause loss of independence, lower quality of life, increased institutionalization, and death. This scenario presents opportunities for Registered Dietitians (RD) to demonstrate their value by designing effective nutrition programs that can help older Americans maintain or restore their nutrition status and maximize independent function. The first step is effective nutrition screening that quickly and accurately identifies those elders who are at risk for malnutrition so they can receive intervention early, when it is most effective.
The causes of malnutrition in the aging population vary from physical reasons to social and psychological reasons that affect functionality (Table 1). Because each cause has a different treatment, screening tools should use multiple measures to detect specific causes of malnutrition. This article discusses the Mini Nutrition Assessment (MNA®), a nutrition screening tool developed specifically for persons 65 years and older, that helps the RD to target nutrition interventions to specific causes of malnutrition identified by specific questions in the MNA®. Pinpointing the causes of malnutrition helps the RD make accurate nutrition diagnoses and implement early intervention, without wasting resources on those who need no intervention.
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