A new era in nutritional assessment: More effective mini nutritional assessment-short form with alternative calf circumference approaches
Nutrition, cilt.151, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 151
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.nut.2026.113347
- Dergi Adı: Nutrition
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: Body mass index, Calf circumference, Malnutrition, Mini Nutritional Assessment-Short Form, Mortality, Sex- and population-specific cutoffs
- İstanbul Üniversitesi Adresli: Evet
Özet
Objective The Mini Nutritional Assessment–Short Form (MNA-SF) is widely used for nutritional screening in older adults. While body mass index (BMI) is the most common anthropometric parameter, calf circumference (CC) is used when BMI is unavailable, with a cutoff of <31 cm. Recently, sex-and population-specific CC cutoffs and BMI-adjusted CC values have been proposed. This study aimed to examine malnutrition prevalence and its association with mortality among older outpatients using seven MNA-SF modifications, including standard and modified approaches incorporating sex, population-specific CC cutoffs, and/or BMI-adjusted CC values. Methods In this retrospective cohort study, older adults evaluated in our geriatric outpatient clinic between November 2012 and June 2024 were included. Seven MNA-SF modifications were applied. Nutritional status was assessed using seven versions of MNA-SF based on BMI, CC(<31cm), population-specific-CC(<33 cm), sex-specific-CC(<33/34 cm), sex-and population-specific-CC(<32/33 cm), and BMI-adjusted-CC values. Malnutrition was defined as MNA-SF score <8. Malnutrition prevalence and its association with mortality were analyzed using ROC and Cox regression analyses. Results A total of 2051 patients (mean age 74.9 ± 6.9 years, 68.4% female) were analyzed. Mortality was assessed in 1822 patients (median follow-up 74 months), with 631 (33.5%) deaths recorded. The highest mortality incidence (53.8%) was observed in the malnutrition group defined by BMI-adjusted modification. All modifications showed similar predictive value for mortality (AUC 62–64%). However, in multivariate survival analysis, modifications —especially the BMI-adjusted versions—demonstrated stronger and more consistent associations with mortality compared to standard BMI and CC approaches. Conclusions MNA-SF modifications incorporating sex, population-specific cutoffs, and/or BMI-adjusted CC values may improve detection of malnutrition and prediction of adverse outcomes, particularly mortality.