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    Mna Mini English PDF

    Uploaded by

    Lastry Wardani

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Mna Mini English PDF

    Uploaded by

    Lastry Wardani
    115 views1 page

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    mna_mini_english.pdf

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    115 views1 page

    Mna Mini English PDF

    Uploaded by

    Lastry Wardani

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Mini Nutritional Assessment

    MNA
    Last name: First name:

    Sex: Age: Weight, kg: Height, cm: Date:
    Complete the screen by filling in the boxes with the appropriate numbers. Total the numbers for the final screening score.

    Screening
    A Has food intake declined over the past 3 months due to loss of appetite, digestive problems, chewing or
    swallowing difficulties?
    0 = severe decrease in food intake
    1 = moderate decrease in food intake

    2 = no decrease in food intake

    B Weight loss during the last 3 months
    0 = weight loss greater than 3 kg (6.6 lbs)
    1 = does not know
    2 = weight loss between 1 and 3 kg (2.2 and 6.6 lbs)
    3 = no weight loss

    C Mobility
    0 = bed or chair bound
    1 = able to get out of bed / chair but does not go out

    2 = goes out

    D Has suffered psychological stress or acute disease in the past 3 months?
    0 = yes 2 = no

    E Neuropsychological problems
    0 = severe dementia or depression
    1 = mild dementia

    2 = no psychological problems
    2
    F1 Body Mass Index (BMI) (weight in kg) / (height in m)
    0 = BMI less than 19
    1 = BMI 19 to less than 21
    2 = BMI 21 to less than 23
    3 = BMI 23 or greater

    IF BMI IS NOT AVAILABLE, REPLACE QUESTION F1 WITH QUESTION F2.


    DO NOT ANSWER QUESTION F2 IF QUESTION F1 IS ALREADY COMPLETED.

    F2 Calf circumference (CC) in cm


    0 = CC less than 31
    3 = CC 31 or greater

    Screening score
    (max. 14 points)
    Save
    12-14 points: Normal nutritional status Print
    8-11 points: At risk of malnutrition
    Reset
    0-7 points: Malnourished

    Ref. Vellas B, Villars H, Abellan G, et al. Overview of the MNA - Its History and Challenges. J Nutr Health Aging 2006;10:456-465.
    Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini
    Nutritional Assessment (MNA-SF). J. Geront 2001;56A: M366-377.
    Guigoz Y. The Mini-Nutritional Assessment (MNA) Review of the Literature - What does it tell us? J Nutr Health Aging 2006; 10:466-487.
    Kaiser MJ, Bauer JM, Ramsch C, et al. Validation of the Mini Nutritional Assessment Short-Form (MNA-SF): A practical tool for identification
    of nutritional status. J Nutr Health Aging 2009; 13:782-788.
    Socit des Produits Nestl, S.A., Vevey, Switzerland, Trademark Owners
    Nestl, 1994, Revision 2009. N67200 12/99 10M

    For more information: www.mna-elderly.com

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