Evaluation of mini nutrition assessment (MNA) tool among community dwelling elderly in urban community of Hawassa city, Southern Ethiopia

BACKGROUND: Mini nutrition assessment (MNA) was found to be the most extensively evaluated method of nutritional assessment for geriatrics settings even if there is no gold standard method to assess nutritional status of elderly. However, MNA has not been validated among Ethiopian elderly. Therefore, the present study examined whether full MNA can identify malnutrition and risk of malnutrition in elderly population living in urban community of Hawassa city, Southern Ethiopia. METHOD: Cross-sectional study was conducted among 548 community dwelling elderly (≥60) (‘287women’ and ‘261men’). Simple random sampling method was employed to select eligible elderly after preparing sampling frame. Those with visible deformity of extremities were excluded. MNA tool was administered to 548 elderly. Reliability of the MNA was calculated using coefficient of Cronbach’s α and Spearman’s rank association between total MNA score & eighteen items of MNA. Overall accuracy, sensitivity and specificity of the MNA were estimated using ROC curve. Youden index was also used to determine the best cut-off point. RESULT: The mean MNA score was 18.95 ± 3.89 and there was no significantdifference across gender (19.5 Vs 18.4; P > 0.05). Morethan quarter, 155 (28.3 %) of the elderly were identified as malnourished (MNA: <17) and more than half, 342 (62.4 %) were at risk of malnutrition (MNA: 17–23.5). Cronbach’s α coefficient was found 0.65. Besides, a significant correlation was found between total MNA score and all items of the MNA and the participants’ self-perceived nutritional status (γ = 0.532, P < 0.001). The area under the curve (AUC) was found to be 0.84 (95 % CI 0.792–0.887; P < 0.001) indicating overall accuracy of the tool. The sensitivity and specificity of the MNA tool using established cut off point were found 80.1 and 72.5 % respectively. However, using the Youden index the best cut-off point to detect malnourished and at risk of malnutrition was found 15 with sensitivity of 92.1 % & specificity of 43.5 %. CONCLUSIONS: MNA with its established cut-off points may fit for Ethiopian elderly populations even if it needs modulation with the cut-off point. Further exhaustive research is needed to validate the Mini Nutrition Assessment tool using dietary and clinical data