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Evaluation of the Mini Nutritional Assessment Short Form Tool Among Elderly Population from Ethiopia

Megersso Urgessa*

Background: For nutritional screening and assessment, various tools have been used, and the Mini Nutritional Assessment (MNA) is one of the most widely used and recommended tools in the geriatric population. However, neither the Body Mass Index-Based Mini Nutritional Assessment Short-Forms (BMI-MNA-SF) nor the Calf Circumference-Based Mini Nutritional Assessment Short-Forms (CC-MNA-SF) have been evaluated in Ethiopia. As a result, this study was conducted in Ethiopia to compare MNA-SFs to the MNA long-form tool.

Methods: The community-based cross-sectional validation study included 176 elders who were chosen at random. Elders who were amputated, bedridden, or had visible deformities were excluded. The original MNA questionnaires have been translated into Afan Oromo and Amharic. Each participant received an MNA questionnaire that had been translated and pretested. All participants had their anthropometric measurements taken, which included their weight, height, Calf Circumference (CC), and Mid-Upper Arm Circumference (MUAC). For statistical analyses, IBM SPSS software version 25 was used. The following variables were calculated: Reliability, Validity, Sensitivity, Specificity, Positive Predictive Values (PPV), and Negative Predictive Values (NPV). For MNA, a Receiver-Operating Characteristic Curve (ROC-curve) analysis was performed to determine the Area Under the Curve (AUC) and optimal cut-off value for malnutrition prediction.

Results: A strong association was observed between MNA-long and MNA-short form score indicated by spearman’s rank correlation coefficients of BMI-MNA-SF 0.771, p <0.05 and CC-MNA-SF 0.759, P<0.05. The agreement between the long and short form of MNA was found to be a weighted kappa 0.396(0.318, 0.474) for BMI-MNA-SF and 0.546(0.422, 0.669) for CC-MNA-SF at 95% CI. These values indicate moderate agreement with the MNA-long form. There is very good agreement between the BMI-MNA-SF and CC-MNA-SF 0.400(0.322, 0.478). Moreover, the overall accuracy using MNA long-form as golden standard with AUC for BMI –MNA-SF 0.908 (0.865-0.951) and 0.880 (0.831-0.929) for CC-MNA-SF at 95% CI. Diagnostic accuracy of both versions of MNA-SF showed that 34.2% sensitivity, 100.0% specificity, 100.0% PPV, and 41.5% NPV for BMI-MNA-SF. Similar sensitivity 75.8%, specificity 83.9%, PPV 91.0%, and 61.8% NPV for CC-MNA-SF. Total Diagnostic accuracy for BMI-MNA-SF 55.12%, and 78.41% for CC-MNA-SF.

Conclusion: In comparison to the Long-form MNA, both versions of MNA-SF were found to be valid screening tools in Ethiopian elders.

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