Though the MNA® was originally designed and validated in Europe and the United States, it has been translated into numerous languages and used in countries around the world that have similar Western health care practice settings. However, it may not be directly applicable in many ethnic groups or countries or those with non-Western cultural and dietary habits or health care systems. Adapting the MNA® to those other population groups depends on making it as country or culturally and ethnically specific as possible. The Chinese Nutrition Assessment is an example.
The MNA® has not been validated as a screening tool for the entire age span found in most acute care hospitals. It may, however, augment a more general hospital screen when applied to elderly patients who are found to be at nutrition risk on the more general screen.
Yes, the MNA® can be used to identify elderly patients with cancer who are malnourished or at risk of malnutrition, and it can facilitate timely initiation of nutrition support. Since the MNA® was validated specifically for the elderly, it is not intended to be used across the entire age span of all patients with cancer.
The MNA® may be used in elderly patients who are fed mashed or pureed foods. Elderly patients with chewing or swallowing disorders (i.e. those requiring mashed or pureed foods) are at risk of malnutrition, and evaluating their nutritional status with the MNA® and initiating nutritional therapy is very important. Patients who are identified as “at risk” on the MNA® merit close monitoring to ensure they receive appropriate nutrition intervention. The MNA® should be repeated every three months.
The MNA® -SF is ideally designed to be used at health fair screenings to detect the risk of malnutrition in community-dwelling elderly so simple corrective measures can be taken early.
The MNA® -SF is an excellent tool for mandatory nutrition screening of elderly participants in government-funded nutrition programs (congregate meals sites, meals on wheels, etc.). Early detection of those at risk of malnutrition can lead to early intervention which is more cost effective. In addition, using a validated screen to identify high-risk patients for malnutrition may help document the need for adequate program funding.
The MNA® is a very useful tool for assisted living facilities where routine nutrition screening and assessment is not currently in place, yet maintenance of functional status is important to prevent transfer to a more expensive nursing home setting.
No, the MNA® is a screening tool and was not designed to monitor nutritional intervention. However, the MNA® can be used to do follow-up screening. For example, studies have shown that MNA® scores improve on re-screening in subjects who received timely intervention after being initially identified as at risk for malnutrition or undernourished.
