Evaluation of the Mini Nutritional Assessment short-form [MNA-SF] as Compared to Serum Albumin Concentration in the Community Dwelling Elders, Meki, East Ethiopia

Abstract

Megersso Urgessa*

Department of Public Health, School of Health Sciences, Madda Walabu University Shashemenne campus, Ethiopia

*Correspondence: Megersso Urgessa, Department of Public Health, Madda Walabu University Shashemenne campus, Ethiopia, E-mail: megurgessa@gmail.com; DOI: https://doi.org/10.56147.Ajfnae.1.1.4

Abstract

Background: Different tools have been used to perform a nutritional screening and assessment, and MNA is one of the widely used and recommended tools in the geriatric’s population. MNA has two forms, long and short. However, MNA short-forms have not been evaluated in Ethiopia. Therefore, this study was aimed to evaluate MNA short form against serum albumin concentration among Ethiopian elders.

Methods: One hundred and seventy-six randomly selected elders entered into the community-based cross-sectional validation study. Amputated, bedridden, those with visible deformity were excluded. Original MNA questionnaires were translated to Afan Oromo and Amharic languages. All translated and pretested MNA questionnaires were administered to each participant. The anthropometrics and serum albumin concentration were measured. Reliability, validity, sensitivity, specificity, positive and negative predictive values were calculated. Receiver-Operating Characteristic curve [ROC-curve] analysis was plotted for MNA, to identify the Area Under the Curve [AUC] and optimal cut-off value for prediction of malnutrition.

Result: Strong association between serum albumin concentration score and MNA-short form score indicated by spearman’s rank correlation coefficients of BMI-MNA-SF 0.526, p <0.05 and CC-MNA-SF 0.501, P<0.05. Similarly, the agreement between the long and short form of MNA was found to be a weighted kappa 0.404 [0.288, 0.521] for BMI-MNA-SF and 0.426[0.333, 0.519] for CC-MNA-SF at 95% CI. These values indicate moderate agreement with the serum albumin concentration. There is very good agreement between the BMI-MNA-SF and CC-MNA-SF 0.400[0.322, 0.478]. Also, high power to identify two categories using serum albumin concentration as golden standard with AUC for BMI –MNA-SF 0.789 [0.722-0.855] and 0.791 [0.726-0.857] for CC-MNA-SF at 95% CI. Diagnostic accuracy for BMI-MNA-SF showed that 37.1% sensitivity, 90.8% specificity, 58.5% PPV, and 80.5% NPV. Similar sensitivity 77.5%, specificity of 64.4% PPV 73.7%, and 69.0%, NPV for CC-MNA-SF. Total Diagnostic accuracy for BMI-MNA-SF 63.64%, and 71.02% for CC-MNA-SF.

Conclusion: Both versions of MNA-SF were found to be valid screening tools in the Ethiopian elders against serum albumin concentration.

Keywords: MNA-SF, Meki, Geriatrics

Abbreviation: AUC: Area under Curve; BMI: Body Mass Index; CC: Calf Circumference; CI: Confidence Interval; MNA: Mini Nutritional Assessment; MNA-LF: Mini Nutritional Assessment Long-Form; MNA-SF: Mini Nutritional Assessment Short-Form; MUAC: Mid-Upper Arm Circumference; NPV: Negative Predictive Value; PPV: Positive Predictive Value; ROC-Curve: Receiver-Operating Characteristic Curve