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Mini Nutritional Assessment in geriatric rehabilitation: Inter‐rater reliability and relationship to body composition and nutritional biochemistry
Author(s) -
NEUMANN Sonja A.,
MILLER Michelle D.,
DANIELS Lynne A.,
AHERN Michael,
CROTTY Maria
Publication year - 2007
Publication title -
nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.479
H-Index - 31
eISSN - 1747-0080
pISSN - 1446-6368
DOI - 10.1111/j.1747-0080.2007.00146.x
Subject(s) - malnutrition , intraclass correlation , medicine , rehabilitation , reliability (semiconductor) , body mass index , physical therapy , kappa , gerontology , psychometrics , clinical psychology , power (physics) , linguistics , physics , philosophy , quantum mechanics
Aim: To determine the inter‐rater reliability of the Mini Nutritional Assessment (MNA) and relationship with body composition and nutritional biochemistry among older Australians undergoing rehabilitation. Methods: Thirty‐eight adults aged ≥65 years were prospectively and consecutively recruited from an Australian rehabilitation ward. Two dietitians independently administered the 18‐item MNA to determine inter‐rater reliability. MNA classifications (well nourished, at risk of malnutrition, malnourished) were compared with body composition (using dual‐energy X‐ray absorptiometry) and serum albumin. These analyses were also performed for the short‐form version of the MNA (six items). Results: In this cross‐sectional study, inter‐rater reliability of the 18‐item MNA score, estimated by the intraclass correlation coefficient, was 0.833, while inter‐rater reliability estimated by the weighted kappa index was 0.53. The two raters reached agreement on MNA classification for 26 of 38 cases (68%). Women classified as malnourished/at risk of malnutrition using the 18‐item MNA had lower total body fat (11 kg vs 29 kg, P < 0.01) and per cent body fat (25% vs 40%, P < 0.01), compared with women classified as well nourished. Similar findings were not apparent for men, although men classified as malnourished/at risk of malnutrition had lower serum albumin (32 g/L vs 36 g/L, P = 0.04) compared with men classified as well nourished. Similar findings were evident for the short‐form version of the MNA. Conclusion: The MNA was found to be useful for identifying older women with lower body fat in the Australian rehabilitation setting. The 18‐item MNA score has substantial inter‐rater reliability, and fair inter‐rater reliability when used according to the classifications. Inclusion of subjective and self‐reported items in surveys can be problematic for optimal reliability as can the use of such items in a subject population that is experiencing rapid progress in recovery.