What is the Mini Nutritional Assessment (MNA)?
The Mini Nutritional Assessment (MNA) is a simple tool to assess nutritional status in the geriatric population. Developed in the 1990s and widely validated, it is used globally in various clinical settings. It can be administered by healthcare professionals like physicians, dietitians, and nurses. The MNA has two formats: the Short Form (MNA-SF) for quick screening and the Full MNA for a detailed assessment if risk is found.
The MNA Short Form (MNA-SF)
The MNA-SF is a quick, 6-item screening tool taking under five minutes. It evaluates key nutritional indicators to see if a full assessment is needed. The six items cover decreased food intake, weight loss, mobility, psychological stress or acute disease, neuropsychological problems, and BMI or calf circumference. Scoring is done by summing points for each item. A score of 12 or more indicates normal nutritional status, while 11 or less requires the Full MNA.
The Full MNA
If the MNA-SF suggests risk, the Full MNA is used. This 18-item questionnaire includes more detailed questions and measurements in four areas: anthropometric measurements (BMI, weight loss, circumferences), global assessment (lifestyle, medication, stress/disease), dietary questions (intake, meals, self-feeding), and subjective assessment (patient's perception of health/nutrition). The total score, up to 30 points, comes from the MNA-SF score plus the additional questions.
How to Interpret MNA Scores
Interpreting MNA scores is based on three main categories, applying to both the MNA-SF and Full MNA, which guide nutritional care.
Interpretation of the MNA-SF Score (maximum 14 points)
- 12–14 points: Normal nutritional status. These individuals are well-nourished. Regular monitoring is advised.
- 8–11 points: At risk of malnutrition. This indicates a need for a full nutritional assessment with the Full MNA.
- 0–7 points: Malnourished. This signifies a serious nutritional issue requiring immediate intervention.
Interpretation of the Full MNA Score (maximum 30 points)
- 24–30 points: Normal nutritional status. This confirms healthy nutrition. Continue monitoring and promote a balanced diet.
- 17–23.5 points: At risk of malnutrition. These individuals need a detailed nutritional evaluation and a tailored intervention plan.
- Less than 17 points: Malnourished. This indicates protein-calorie undernutrition requiring immediate, intensive intervention, often with a dietitian.
Comparison of MNA-SF vs. Full MNA
| Feature | MNA-SF | Full MNA |
|---|---|---|
| Purpose | Rapid initial screening to identify risk. | Comprehensive assessment to diagnose malnutrition. |
| Number of Items | 6 items. | 18 items (adds 12 to the SF). |
| Max Score | 14 points. | 30 points. |
| Interpretation (Risk) | Score of 8–11 indicates at-risk status. | Score of 17–23.5 indicates at-risk status. |
| Interpretation (Malnourished) | Score of 0–7 indicates malnourished status. | Score of <17 indicates malnourished status. |
| Clinical Action | If score is ≤11, complete Full MNA. | Develop a targeted nutritional intervention plan. |
The Clinical Relevance of Interpreting MNA Scores
Accurate MNA interpretation is clinically important. Malnutrition in older adults is linked to worse health outcomes, including more complications and higher mortality. The MNA helps identify risks early, allowing interventions that can improve outcomes. By noting specific areas of concern in the assessment, interventions can be tailored. Regular MNA reassessment monitors intervention effectiveness.
Nutritional Intervention Strategies Based on MNA Results
Based on the MNA score, specific nutritional strategies are used, varying with the severity of the issue.
For Normal Nutritional Status (MNA ≥ 24)
- Maintain regular dietary monitoring.
- Provide general counseling on a balanced diet.
- Encourage activity and hydration.
- Schedule routine follow-ups, e.g., every 6-12 months.
For At-Risk of Malnutrition (MNA 17–23.5)
- Conduct a deeper nutritional evaluation.
- Address specific issues found by the MNA.
- Consider oral nutritional supplements.
- Follow up with more frequent MNA assessments, e.g., every three months.
For Malnourished Status (MNA < 17)
- Provide immediate, aggressive intervention under medical care.
- Assess severity with tests and food records.
- Set nutritional goals with a dietitian.
- Use supplements, fortified foods, or consider tube/parenteral feeding if needed.
- Treat underlying conditions.
Conclusion: Using the MNA for Proactive Nutritional Care
Understanding how to interpret MNA results is essential for good nutritional care in older adults. The MNA is a reliable tool for screening and assessment. By using it, healthcare providers can proactively identify those at risk and provide timely, tailored interventions. This approach can improve health outcomes and quality of life for older patients. Including the MNA in regular geriatric assessments is important for better nutrition in this group.
Visit the official MNA website for further resources on administering and interpreting the tool.
