Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 395

The evaluation of unintended weight loss begins with identifying people at risk. Several assessment instruments have proven validity in the assessment of weight loss or subsequent mortality. The Mini‐Nutritional Assessment (MNA) was developed to assess malnutrition in elderly populations. The full MNA is a multidimensional tool that identifies malnourished older subjects or those at risk for malnutrition, whatever the cause.⁶³ A shorter form has been developed with similar performance⁶⁴ (Figure 14.2). The MNA assesses body mass with either BMI or calf circumference.

Subjects with a normal baseline score had a lower mortality risk (0.35; 95% CI 0.18–0.66) than subjects with an abnormal MNA score. Subjects judged to be at risk for undernutrition by the MNA had more frequent acute illness, need for more assistance, and more weight loss. The MNA was found to be 96% sensitive and 60% specific for body weight loss. A subsequent analysis found that a six‐item version of the MNA has equivalent predictive value.

The MNA can be used to assess cancer cachexia.⁶⁵ MNA is a powerful prognostic factor for several pathologies, particularly in cancer.^55,66