Does Mini Nutritional Assessment predict disability among elderly people?

Introduction: Nutritional status has been hypotesized to be a major predictor of functional ability in elderly people. Assessment of nutritional status in clinical practice is obtained by the Mini-Nutritional Assessment (MNA) questionnaire. However, the reliability of MNA for predicting functional decline and disability in older persons needs further evidence. The aim of this study was to assess whether MNA (30-items) in subjects aged 80 and over correlates with functional status measured by the Activities of Daily Living (ADL) score. Methods:We recruited 562 Sardinian subjects (227 men, 335 women, aged 80 and older). Age, ADL, Body Mass Index (BMI), MNA, Mini- Mental State Examination (MMSE), Geriatric Depression Scale (GDS) were collected in each participant. The association of predictors with disability was performed by multiple linear regression analysis with ADL as dependent variable. Results: Mean value of ADL score was 4.12 ± 2.0. Mean value of MNA score was 18.9 ± 5.6. Multiple regression analysis gave the following coefficients: Age (r = −0.127, p = 0.043) BMI (r = −0.250. p < 0.0001); MNA (r = 0.352, p < 0.0001); MMSE (r = 0.299, p < 0.0001) and GDS (r = −0.274, p < 0.0001). Conclusions: Nutrition is a key determinant of geriatric health, and MNA is useful for nutritional assessment. Our analysis in subjects over 80 confirmed that MNA score is among the strongest predictors of disability when compared to similar indicators. However, our data do not allow to determine whether there is a real cause-effect releationship between nutritional status and ADL, and which one is the primary determinant.