Development and Validation of the MNA®
The MNA® was originally developed in the 1990’s and has evolved over time through three versions.
Original full MNA
The original MNA® was developed by practicing geriatricians in the United States and Europe. It was developed to provide a simple, reliable way to screen nutritional status of persons over age 65 and to add a nutrition component to the Comprehensive Geriatric Assessment. The full MNA® has 18 items and classifies one as normally nourished, at risk for malnutrition, or malnourished. It was well validated in the hospital, community and long term care settings.
The MNA®-SF and full MNA: A 2-step process
To save time in screening, Rubenstein et al developed a shortened version, the Mini Nutritional Assessment®-Short Form or MNA®-SF in 2001, and created a 2-step screening process. Six questions with the strongest correlation on the original MNA® comprised the MNA®-SF. The short form was validated in the ambulatory care setting as a quicker way to screen large groups of people and eliminated the need to complete the full MNA® when a person was normally nourished. When the MNA®-SF classified a person at risk, the full 18-question MNA® had to be completed to determine if the person was truly malnourished.
Revised MNA®-Short Form
To further streamline the MNA® and make it more clinically applicable, researchers revised and revalidated the MNA®-SF using pooled data on the MNA® from 28 previously published studies. The new MNA®-SF incorporates the 3 cut-off points for nutritional status from the full MNA®, thus allowing the identification of those who are malnourished with just 6 questions. The new form also includes an option to substitute calf circumference when BMI is not available. With the revisions, the new MNA®-SF is a stand-alone screening tool, eliminates the need to complete the longer full MNA®, and reduces time to screen to less than 5 minutes.
Indications for Use
- The revised MNA®-SF makes the link to intervention easier and is now the preferred form of the MNA® for clinical use.
- The full MNA® is useful in research settings. The full MNA® can also be used as a more in-depth screen.
Both the MNA®-SF and the full MNA® are nutrition screening tools.
Neither should substitute for a complete nutrition assessment by a qualified nutrition professional.