Mini Nutritional Assessment - Short Form
Mini Nutritional Assessment - Short Form
Mini Nutritional Assessment - Short Form
as as
Introduction
While the prevalence of malnutrition in the free living elderly population is relatively low, the risk of
malnutrition increases dramatically in the institutionalized and hospitalized elderly.1 The prevalence
of malnutrition is even higher in cognitively impaired elderly individuals and is associated with
cognitive decline.2
Patients who are malnourished when admitted to the hospital tend to have longer hospital stays,
experience more complications, and have greater risks of morbidity and mortality than those whose
nutritional state is normal.3
By identifying older persons who are malnourished or at risk of malnutrition either in the hospital or
community setting, the MNA-SF allows clinicians to intervene earlier to provide adequate nutritional
support, prevent further deterioration, and improve patient outcomes.4
In 2009 the MNA-SF was validated as a stand alone screening tool, based on the full MNA.8 The
MNA-SF may be completed at regular intervals in the community and in the hospital or long-term
care setting. It is recommended to be done annually in the community, and every 3 months in the
hospital or long-term care or whenever a change in clinical condition occurs.
Instructions to complete the MNA-SF
Before beginning the MNA-SF, please enter the patients information on the top of the form:
Name Gender Age
eight (kg) To obtain an accurate weight, remove shoes and heavy outer clothing. Use a
W
calibrated and reliable set of scales. Pounds (lbs) must be converted to kilograms (1 lb = 0.45 kg).
Height (cm) Measure height without shoes using a stadiometer (height gauge). If the patient is
bedridden, measure height by demispan, half arm-span, or knee height (see Appendix 2). Inches
must be converted to centimeters (1 inch = 2.54 cm).
Date of screen
2
Identify
The Mini Nutritional Assessment Short Form (MNA-SF) is an effective tool to help identify patients
who are malnourished or at risk of malnutrition
4 Effective
- Identifies at-risk persons
before weight loss occurs
Intervene
Recommend Nestl Nutrition
supplements to help your patients
improve their nutritional status
Monitor
4 Inexpensive diagnostic tool
- T
he MNA-SF tool
allows standardised,
reproducible and
reliable determination of
nutritional status
- U
se the MNA-SF
regularly to assess your
patients nutritional
status and provide
intervention as required
Key Points
Ask the patient to answer questions A F, using the suggestions in the shaded areas. If the patient is
unable to answer the question, ask the patients caregiver to answer or check the medical record.
Has food intake declined over the past three Ask patient or caregiver or check the
months due to loss of appetite, digestive medical record
problems, chewing or swallowing difficulties?
Have you eaten less than normal over the
Score 0 = Severe decrease in food intake past three months?
1 = Moderate decrease in food intake If so, is this because of lack of appetite,
2 = No decrease in food intake chewing, or swallowing difficulties?
If yes, have you eaten much less than
before or only a little less?
Involuntary weight loss during the last Ask patient / Review medical record
3 months?
Have you lost any weight without trying
Score 0 = Weight loss greater than 3 kg over the last 3 months?
(6.6 pounds)
Has your waistband gotten looser?
1 = Does not know
How much weight do you think you have
2 = Weight loss between 1 and 3 kg
lost? More or less than 3 kg (or 6 pounds)?
(2.2 and 6.6 pounds)
3 = No weight loss Though weight loss in the overweight
elderly may be appropriate, it may also be
due to malnutrition. When the weight loss
question is removed, the MNA loses its
sensitivity, so it is important to ask about
weight loss even in the overweight.
4
C
Has the patient suffered psychological stress Ask patient / Review patient medical record /
or acute disease in the past three months? Use professional judgment
Score 0 = Yes Have you been stressed recently?
2 = No Have you been severely ill recently?
6
F2 Answer only if unable to obtain BMI.
Screening Score
(Max. 14 points)
12-14 points: Normal nutritional status
8-11 points: At risk of malnutrition
0-7 points: Malnourished
For proposed intervention, please see the algorithm on the next page.
For more information, go to www.mna-elderly.com
MNA Score
Normal At Risk
Nutritional Status Malnourished
of Malnutrition
(12 14 points) (0-7 points)
(8 11 points)
Note: In the elderly, weights and heights are be inaccurate due to the Calf Circumference
important because they correlate with morbidity measurement being counted twice once in the
and mortality. MNA-SF and again in Question R of the
full MNA.
Weight and height measurements are often
available in the patient record and should Follow-Up
be used as a priority. Only when height Rescreen all institutionalized elderly patients
and/or weight are unavailable, should Calf every three months and normally nourished
Circumference (CC) be used instead of BMI. elderly patients annually in the community.
Important: When the Calf Circumference is Please refer results of assessments and re-
used to complete the MNA-SF, do not use the assessments to dietitian/doctor and record in
full MNA. Otherwise, the full MNA score will medical record.
8
Appendices
Appendix
Appendix11 Body Mass Index table
MNA BMI Table for the Elderly (age 65 and above)
Height (feet & inches)
411 50 51 52 53 54 55 56 57 58 59 510 511 60 61 62 63
45 20 20 19 18 18 17 17 16 16 15 15 14 14 14 13 13 13 100
48 21 21 20 19 19 18 17 17 16 16 16 15 15 14 14 14 13 105
50 22 22 21 20 20 19 18 18 17 17 16 16 15 15 15 14 14 110
52 23 23 22 21 20 20 19 19 18 18 17 17 16 16 15 15 14 115
55 24 23 23 22 21 21 20 19 19 18 18 17 17 16 16 15 15 120
57 25 24 24 23 22 22 21 20 20 19 19 18 17 17 17 16 16 125
59 26 25 25 24 23 22 22 21 20 20 19 19 18 18 17 17 16 130
61 27 26 26 25 24 23 23 22 21 21 20 19 19 18 18 17 17 135
64 28 27 26 26 24 24 23 23 22 21 21 20 19 19 18 18 18 140
66 29 28 27 27 26 25 24 23 23 22 21 21 20 20 19 19 18 145
68 30 29 28 27 27 26 25 24 24 23 22 22 21 20 20 19 19 150
70 31 30 29 28 28 27 26 25 24 24 23 22 22 21 20 20 19 155
73 32 31 30 29 28 28 27 26 25 24 24 23 22 22 21 21 20 160
Weight (pounds)
75 33 32 31 30 29 28 28 27 26 25 24 24 23 22 22 21 21 165
Weight (kg)
77 34 33 32 31 30 29 28 27 27 26 25 24 24 23 22 22 21 170
80 35 34 33 32 31 30 29 28 27 27 26 25 24 24 23 23 22 175
82 36 35 34 33 32 31 30 29 28 27 27 26 25 24 24 23 23 180
84 37 36 35 34 33 32 31 30 29 28 27 27 26 25 24 24 23 185
86 38 37 36 35 34 33 32 31 30 29 28 27 27 26 25 24 24 190
89 39 38 37 36 35 34 32 32 31 30 29 28 27 26 26 25 24 195
91 40 39 38 37 35 34 33 32 31 31 30 29 28 27 26 26 25 200
93 41 40 39 38 36 35 34 33 32 31 30 29 29 28 27 26 26 205
95 42 41 40 38 37 36 35 34 33 32 31 30 29 29 28 27 26 210
98 43 42 41 39 38 37 36 35 34 33 32 31 30 29 28 28 27 215
100 44 43 42 40 39 38 37 36 35 34 33 32 31 30 29 28 28 220
102 45 44 43 41 40 39 37 36 35 34 33 32 31 31 30 29 28 225
105 47 45 44 42 41 40 38 37 36 35 34 33 32 31 30 30 29 230
107 48 46 44 43 42 40 39 38 37 36 35 34 33 32 31 30 29 234
109 48 47 45 44 43 41 40 39 38 37 35 34 34 33 32 31 30 240
111 49 48 46 45 43 42 41 40 38 37 36 35 34 33 32 32 31 245
114 51 49 48 46 44 43 42 40 39 38 37 36 35 34 33 32 32 250
150 152.5 155 157.5 160 162.5 165 167.5 170 172.5 175 177.5 180 182.5 185 188 190
Height (cm)
This abbreviated BMI table is provided for your convenience and facilitates completing
the MNA. It is accurate for the MNA. In some cases, calculating the BMI may yield a
more precise BMI determination.
10
2.3 Measuring height using half arm-span
Half arm-span is the distance from the midline Calculate height by multiplying the half
at the sternal notch to the tip of the middle arm-span measurement by 2
finger. Height is then calculated by doubling the
Half arm-span
half arm-span.10
1. Locate and mark the edge of the right collar
bone (in the sternal notch) with the pen.
2. Ask the patient to place the nondominant arm
in a horizontal position.
3. Check that the patients arm is horizontal and
in line with shoulders. Source:
http://www.rxkinetics.com/height_estimate.html.
4. Using the tape measure, measure distance Accessed January 15, 2011.
from mark on the midline at the sternal notch
to the tip of the middle finger.
5. Check that arm is flat and wrist is straight.
6. Take reading in cm.
12
Appendix 3 Determining BMI for amputees
14
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