Evaluation of Mini Nutritional Assessment tool among Elderly population in Yeka Sub city, Addis Ababa, Ethiopia
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Date
2017-06
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Addis Abeba Universty
Abstract
Background: Malnutrition is the most important determinant factor for elders on their general
health and quality of life. Eventhogh the life expectancy of Ethiopian elders is increasing; there
was no valid tool to assess the nutritional status of elders. Body Mass Index (BMI) may be
unreliable to assess the nutritional status of elders if used as single measurement. Mini nutritional
assessment (MNA) tool is the most widely used and noninvasive tool to assess the nutritional
status of elders. MNA tool was not validated and practiced for intervention in Ethiopian elderly
population.
Objective: To evaluate the reliability and validity of mini nutritional assessment tool among
elders in Yeka sub city, Addis Ababa, Ethiopia.
Method: Community based cross sectional study was conducted among 506 elders. Two stage
cluster sampling method and systematic random sampling technique was employed to address
study subjects. The reliability and validity of the MNA tool and MNA-SF were evaluated against
BMI. A modified short Mini Nutritional Assessment (MS-MNA) tool was derived by a principal
component analysis. The items to create MS-MNA were derived from the full MNA tool and
appetite assessment tool. Accuracy, sensitivity, specificity and cut off point were evaluated to
determine validity of full MNA and MS-MNA. The reliability also assessed using Cronbaches α
coefficient. Criterion-related validity of the MNA tool was evaluated computing the correlation
between total MNA score and single anthropometric measurements. Youden index used to
determine best cut of points for MNA and MS-MNA tool.
Result: The mean MNA score was 19.9± 4.5. Cronbaches α value of full MNA tool was found
0.7.The overall accuracy of full MNA was 91% (95 % CI, 87.5%--94.9%, p< 0.001). The
sensitivity and specificity of full MNA tool using established cut of point was 87.9% and 89.6%
respectively. Using Youden index the best cut of point to detect malnourished and risk of
malnutrition was found 16 with sensitivity 90.4% and specificity 86.8%. Cronbaches α value of
MS-MNA tool was found 0.71. The overall accuracy of MS-MNA was found 87 %( 95%CI,
0.837-0.910, p<0.001). Using Youden index the best cut of point was 14.5 with sensitivity and
specificity of 80% and 80.2% respectively.
Conclusion: Full MNA tool was valid and reliable to identify elders as malnourished, at risk
of malnutrition and well-nourished with modulation of cut of points. The MS-MNA tool was
also reliable and valid nutritional assessment tool. However, the short MNA tool was not valid
and reliable in this study. Further research is recommended to validate the MS-MNA tool against
biochemical markers.
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Evaluation of Mini Nutritional Assessment tool