The Mini Nutritional Assessment (MNA) after 20 years of research and clinical practice

Nutritional assessment in older people to detect malnutrition or risk of malnutrition is essential to avoid adverse nutrition-related outcomes. Poor nutritional status appears to be a major contributing factor for poor prognosis in malnourished individuals. Nowadays, nutritional assessment is considered to be one of the domains which should be evaluated in comprehensive geriatric assessment (CGA). CGA is a comprehensive assessment tool with the capacity of detecting impairments in older people and, at the same time, suggest interventions. Although many assessment tools are proposed, those used in CGA are not widely agreed. After 20 years of clinical practice and research, the Mini Nutritional Assessment (MNA) seems to be the tool most widely accepted by health carers and patients for the assessment of nutritional impairment in CGA. MNA classifies, with well-established thresholds, the nutritional status of older people with the added advantage of proposing and guiding interventions. Even more, the MNA is correlated to nutritional interventions when these are successful, with improved scores showing response to the intervention. Several studies have shown that older people at risk of or suffering malnutrition have a worse prognosis in terms of different adverse clinical outcomes. In community-dwelling elderly people, malnutrition is associated with diminished cognitive and functional performance, diminished self-care ability,1,2 worse oral health, poor eyesight and several difficulties with mealtimes such as problems in using a fork or a knife.3 In hospitalized patients, depression scores (using the Geriatric