What is the Mini Nutritional Assessment (MNA)?
The Mini Nutritional Assessment (MNA) is a simple, non-invasive, and effective screening tool designed to evaluate the nutritional status of older adults (aged 65 and over). It helps healthcare providers identify individuals who are malnourished or at risk of malnutrition early on, allowing for timely and effective nutritional intervention. While the original MNA was an 18-item questionnaire, a shorter, 6-item version (MNA-SF) is now widely used for clinical practice due to its speed and accuracy.
The MNA-Short Form (MNA-SF) Scoring
The MNA-SF calculates a maximum score of 14 points, based on six key questions related to a person's health and eating habits over the past three months. The total score is then used to determine the nutritional status. The questions cover areas such as:
- Food intake decline: Has there been a decrease in food intake due to loss of appetite, digestive issues, or chewing/swallowing difficulties?
- Weight loss: Has the individual experienced unintended weight loss?
- Mobility: Is the person bed-bound, able to get up but not go out, or able to go out independently?
- Psychological stress/disease: Has the individual suffered from psychological stress or acute disease?
- Neuropsychological problems: Does the person have severe dementia, mild dementia, or no psychological issues?
- Body Mass Index (BMI) or Calf Circumference: BMI is calculated, or if height and weight aren't available, calf circumference is measured as a proxy.
The MNA Score for Malnutrition: Interpretation and Ranges
Interpreting the MNA score is straightforward and falls into three primary categories for both the short-form and full versions. This helps healthcare professionals quickly determine the severity of risk and the necessary steps for intervention.
MNA-Short Form (MNA-SF) Score Ranges
The MNA-SF, with its maximum of 14 points, provides a quick screening result:
- 12–14 points: Normal nutritional status. A person in this range is typically considered well-nourished. Regular monitoring is still advised, especially if any weight loss is noted.
- 8–11 points: At risk of malnutrition. This score indicates the individual needs further assessment and may benefit from nutritional intervention, such as dietary counseling or supplements.
- 0–7 points: Malnourished. A person with this score requires immediate and comprehensive nutritional intervention and a referral to a dietitian.
Full MNA Score Ranges
For scores of 11 or less on the MNA-SF, the full 18-item MNA assessment is often completed for a more detailed evaluation. The full MNA has a maximum score of 30 and slightly different score ranges:
- 24–30 points: Normal nutritional status.
- 17–23.5 points: At risk of malnutrition.
- Less than 17 points: Malnourished.
Comparison of MNA-SF vs. Full MNA Scores
| Assessment Tool | Score Range | Nutritional Status | Action | Max Score |
|---|---|---|---|---|
| MNA-Short Form (MNA-SF) | 12–14 | Normal | Regular monitoring | 14 |
| 8–11 | At Risk | Further assessment & intervention | ||
| 0–7 | Malnourished | Immediate, comprehensive intervention | ||
| Full MNA | 24–30 | Normal | Regular monitoring | 30 |
| 17–23.5 | At Risk | Intervention (e.g., counseling, supplements) | ||
| <17 | Malnourished | Urgent and comprehensive nutritional care |
Components of the Full MNA
The full MNA provides a more holistic picture of a person's nutritional health, incorporating four key areas:
- Anthropometric Measurements: This includes physical data such as weight, height, BMI, mid-arm circumference, and calf circumference. These measurements provide important information about body composition and muscle mass.
- General Assessment: This section covers lifestyle factors, mobility, medication use, psychological stress, and the presence of acute disease or neuropsychological problems like dementia or depression.
- Dietary Assessment: Evaluates the number of meals consumed, food and fluid intake, and the individual's self-perception of their nutritional status.
- Subjective Assessment: Questions about the person's own view of their health and nutritional status compared to others their age.
Conclusion
The MNA score for malnutrition is a critical indicator used by healthcare professionals to identify and address nutritional issues in older adults. By distinguishing between normal, at-risk, and malnourished statuses, the MNA facilitates prompt intervention, which can significantly improve health outcomes and quality of life for seniors. Regular use of the MNA in clinical settings is essential for effective geriatric nutritional care. You can find more comprehensive information on the MNA and its use in geriatric practice on authoritative sources such as the NIH website.
