Nutrition screening in geriatric rehabilitation: Criterion (concurrent and predictive) validity of the Malnutrition Screening Tool and the Mini Nutritional Assessment-Short Form

Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring

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Abstract

Background: Nutrition screening is required for early identification and treatment of patients at risk for malnutrition so that clinical outcomes can be improved and health care costs reduced. Objective: To determine the criterion (concurrent and predictive) validity of the Malnutrition Screening Tool (MST) and Mini Nutritional Assessment-Short Form (MNA-SF) in older adults admitted to inpatient rehabilitation facilities. Design: Observational, prospective cohort. Participants/setting: Participants were 57 adults aged 65 years and older (mean±standard deviation age=79.1±7.3 years) from two rural rehabilitation units in New South Wales, Australia. Main outcome measurements: MST; MNA-SF; International Statistical Classification of Diseases and Health Related Problems, 10th revision, Australian Modification (ICD-10-AM) classification of malnutrition; rehospitalization; admission to a residential aged care facility (institutionalization); and discharge location. Statistical analysis performed: Measures of diagnostic accuracy with 95% CIs generated from a contingency table, Mann-Whitney U test, and χ2 test. Results: When compared with the ICD-10-AM criteria, the MST showed stronger diagnostic accuracy (sensitivity 80.8%, specificity 67.7%) than the MNA-SF (sensitivity 100%, specificity 22.6%). Neither the MST nor the MNA-SF was able to predict rehospitalization, institutionalization, or discharge location. Conclusions: The MST showed good concurrent validity and can be considered an appropriate nutrition screening tool in geriatric rehabilitation. The MNA-SF may overestimate the risk of malnutrition in this population. The predictive validity could not be established for either screening tool.

Original languageEnglish
Pages (from-to)795-801
Number of pages7
JournalJournal of the Academy of Nutrition and Dietetics
Volume116
Issue number5
Early online date24 Jul 2015
DOIs
Publication statusPublished - 1 May 2016

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Nutrition Assessment
nutrition assessment
rehabilitation (people)
Malnutrition
Geriatrics
malnutrition
Rehabilitation
screening
International Classification of Diseases
Institutionalization
health care costs
Sensitivity and Specificity
South Australia
New South Wales
Nonparametric Statistics
Health Care Costs
Inpatients
statistical analysis
testing

Cite this

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title = "Nutrition screening in geriatric rehabilitation: Criterion (concurrent and predictive) validity of the Malnutrition Screening Tool and the Mini Nutritional Assessment-Short Form",
abstract = "Background: Nutrition screening is required for early identification and treatment of patients at risk for malnutrition so that clinical outcomes can be improved and health care costs reduced. Objective: To determine the criterion (concurrent and predictive) validity of the Malnutrition Screening Tool (MST) and Mini Nutritional Assessment-Short Form (MNA-SF) in older adults admitted to inpatient rehabilitation facilities. Design: Observational, prospective cohort. Participants/setting: Participants were 57 adults aged 65 years and older (mean±standard deviation age=79.1±7.3 years) from two rural rehabilitation units in New South Wales, Australia. Main outcome measurements: MST; MNA-SF; International Statistical Classification of Diseases and Health Related Problems, 10th revision, Australian Modification (ICD-10-AM) classification of malnutrition; rehospitalization; admission to a residential aged care facility (institutionalization); and discharge location. Statistical analysis performed: Measures of diagnostic accuracy with 95{\%} CIs generated from a contingency table, Mann-Whitney U test, and χ2 test. Results: When compared with the ICD-10-AM criteria, the MST showed stronger diagnostic accuracy (sensitivity 80.8{\%}, specificity 67.7{\%}) than the MNA-SF (sensitivity 100{\%}, specificity 22.6{\%}). Neither the MST nor the MNA-SF was able to predict rehospitalization, institutionalization, or discharge location. Conclusions: The MST showed good concurrent validity and can be considered an appropriate nutrition screening tool in geriatric rehabilitation. The MNA-SF may overestimate the risk of malnutrition in this population. The predictive validity could not be established for either screening tool.",
author = "Skye Marshall and Adrienne Young and Judith Bauer and Elizabeth Isenring",
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T1 - Nutrition screening in geriatric rehabilitation: Criterion (concurrent and predictive) validity of the Malnutrition Screening Tool and the Mini Nutritional Assessment-Short Form

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AU - Young, Adrienne

AU - Bauer, Judith

AU - Isenring, Elizabeth

PY - 2016/5/1

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N2 - Background: Nutrition screening is required for early identification and treatment of patients at risk for malnutrition so that clinical outcomes can be improved and health care costs reduced. Objective: To determine the criterion (concurrent and predictive) validity of the Malnutrition Screening Tool (MST) and Mini Nutritional Assessment-Short Form (MNA-SF) in older adults admitted to inpatient rehabilitation facilities. Design: Observational, prospective cohort. Participants/setting: Participants were 57 adults aged 65 years and older (mean±standard deviation age=79.1±7.3 years) from two rural rehabilitation units in New South Wales, Australia. Main outcome measurements: MST; MNA-SF; International Statistical Classification of Diseases and Health Related Problems, 10th revision, Australian Modification (ICD-10-AM) classification of malnutrition; rehospitalization; admission to a residential aged care facility (institutionalization); and discharge location. Statistical analysis performed: Measures of diagnostic accuracy with 95% CIs generated from a contingency table, Mann-Whitney U test, and χ2 test. Results: When compared with the ICD-10-AM criteria, the MST showed stronger diagnostic accuracy (sensitivity 80.8%, specificity 67.7%) than the MNA-SF (sensitivity 100%, specificity 22.6%). Neither the MST nor the MNA-SF was able to predict rehospitalization, institutionalization, or discharge location. Conclusions: The MST showed good concurrent validity and can be considered an appropriate nutrition screening tool in geriatric rehabilitation. The MNA-SF may overestimate the risk of malnutrition in this population. The predictive validity could not be established for either screening tool.

AB - Background: Nutrition screening is required for early identification and treatment of patients at risk for malnutrition so that clinical outcomes can be improved and health care costs reduced. Objective: To determine the criterion (concurrent and predictive) validity of the Malnutrition Screening Tool (MST) and Mini Nutritional Assessment-Short Form (MNA-SF) in older adults admitted to inpatient rehabilitation facilities. Design: Observational, prospective cohort. Participants/setting: Participants were 57 adults aged 65 years and older (mean±standard deviation age=79.1±7.3 years) from two rural rehabilitation units in New South Wales, Australia. Main outcome measurements: MST; MNA-SF; International Statistical Classification of Diseases and Health Related Problems, 10th revision, Australian Modification (ICD-10-AM) classification of malnutrition; rehospitalization; admission to a residential aged care facility (institutionalization); and discharge location. Statistical analysis performed: Measures of diagnostic accuracy with 95% CIs generated from a contingency table, Mann-Whitney U test, and χ2 test. Results: When compared with the ICD-10-AM criteria, the MST showed stronger diagnostic accuracy (sensitivity 80.8%, specificity 67.7%) than the MNA-SF (sensitivity 100%, specificity 22.6%). Neither the MST nor the MNA-SF was able to predict rehospitalization, institutionalization, or discharge location. Conclusions: The MST showed good concurrent validity and can be considered an appropriate nutrition screening tool in geriatric rehabilitation. The MNA-SF may overestimate the risk of malnutrition in this population. The predictive validity could not be established for either screening tool.

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