Screening with MNA-SF A score of 11 or less in the screening indicates a problem and the need for a completion of the assessment portion. A MNA-SF score of 12 and above indicates a good nutritional status without the need to continue the whole assessment. The assessment score is then added to the screening score. Screening plus assessment with full MNA If the total score on both parts totals 17-23.5, there is a risk of malnutrition A score of < 17 indicates existing malnutrition The MNA includes several risk factors for such as low BMI, decrease of “frailty”, mobility, low muscle mass and low calorie intake. A statistically significant U-shaped association has been found between frailty and BMI. It has been shown to accurately identify older people at risk of increased mortality and morbidity. In 2008-2009, Nestle Nutrition embarked on the MNA International Initiative, conducting research in geriatric settings across the globe to validate a new MNA-SF. The new features of this are: It is now validated as a standalone nutrition screening tool, which can be completed in less than 10 minutes Calf circumference may be used instead of BMI It can identify an older person as well nourished, at risk of malnutrition or malnourished. The MNA requires at least 15 minutes with each patient so is hardly applicable in most humanitarian settings. The MNA-SF takes only 3 minutes but has not been validated or used in community-living settings in developing country contexts, or emergencies. For both the MNA and MNA-SF, cultural issues may apply that have not been considered. Annex 6: Guiding principles for nutrition interventions for older people in emergencies 1. Older people should have physical access to an adequate general ration that is suitable in terms of quantity and quality, that is easily digestible and culturally acceptable Older people should have access to milled cereal and legumes that they are familiar with or alternatively to milling facilities in situations where whole grain cereal is produced Measures should be taken to ensure that older people are: (i) Informed of their eligibility, and (ii) Have physical access to the general ration 2. The physiological changes associated with ageing and its consequences for nutritional requirements and special needs should be reflected in programme
Screening with MNA-SF A score of 11 or less in the screening indicates a problem and the need for a completion of the assessment portion. A MNA-SF score of 12 and above indicates a good nutritional status without the need to continue the whole assessment. The assessment score is then added to the screening score. Screening plus assessment with full MNA If the total score on both parts totals 17-23.5, there is a risk of malnutrition A score of < 17 indicates existing malnutrition The MNA includes several risk factors for “frailty”, such as low BMI, decrease of mobility, low muscle mass and low calorie intake. A statistically significant U-shaped association has been found between frailty and BMI. It has been shown to accurately identify older people at risk of increased mortality and morbidity. In 2008-2009, Nestle Nutrition embarked on the MNA International Initiative, conducting research in geriatric settings across the globe to validate a new MNA-SF. The new features of this are: It is now validated as a standalone nutrition screening tool, which can be completed in less than 10 minutes Calf circumference may be used instead of BMI It can identify an older person as well nourished, at risk of malnutrition or malnourished. The MNA requires at least 15 minutes with each patient so is hardly applicable in most humanitarian settings. The MNA-SF takes only 3 minutes but has not been validated or used in community-living settings in developing country contexts, or emergencies. For both the MNA and MNA-SF, cultural issues may apply that have not been considered. Annex 6: Guiding principles for nutrition interventions for older people in emergencies 1. Older people should have physical access to an adequate general ration that is suitable in terms of quantity and quality, that is easily digestible and culturally acceptable Older people should have access to milled cereal and legumes that they are familiar with or alternatively to milling facilities in situations where whole grain cereal is produced Measures should be taken to ensure that older people are: (i) Informed of their eligibility, and (ii) Have physical access to the general ration 2. The physiological changes associated with ageing and its consequences for nutritional requirements and special needs should be reflected in programme
HTP-module-23-technical-notes.docx