Nestlé Nutrition Institute - MNA Elderly
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Interpreting the MNA Score
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Interpreting the MNA® Score

Nutrition screening and appropriate intervention is critical to providing appropriate and timely nutrition care. The MNA® was specifically designed to identify elderly people age 65 or older who are malnourished or at risk of malnutrition.

The MNA® sensitizes health care professionals to the nutritional status of the elderly and the type of questions and concerns that are important in assessing nutritional status.   It is consistent with the Nutrition Care Process and Model of the American Dietetic Association. The MNA® score helps determine the next step in the nutrition care process.

A high MNA® score indicates satisfactory nutritional status and no need for additional intervention. Lower scores indicate the risk of, or presence of, malnutrition and the need for nutrition intervention.

Guided by the MNA® score, the clinician implements the Nutrition Care Process by referring the patient with a lower MNA® score to a Registered Dietitian or qualified nutrition specialist for a full nutrition assessment. This qualified nutrition specialist uses the problem areas identified on the MNA® and other nutrition assessment data, to make the specific nutrition diagnosis, which then drives specific nutrition interventions and follow-up monitoring.

Suggested Guidelines for Intervention
Clinicians can find practical suggestions on the Scoring Algorithm for maintaining the nutritional status for older adults who are not at risk and, more importantly, improving the nutritional status for those who are at risk for malnutrition or are already malnourished. Click on the Score for helpful steps to guide nutrition care.
Scoring Algorithm


Complete MNA®-SF

(6 questions)

Score < 12Score < 12

Malnutrition Risk

Complete Full MNA®

(12 additional questions)

  • Add scores together

Score > 12Score > 12

Satisfactory Nutrition

  • No further intervention needed
  • Repeat MNA® every 3 months
  • Provide guidelines for a balanced diet
 

Score < 17MNA Score < 17 = Protein Calorie Malnutrition

Refer patient to a Registered Dietitian or qualified nutrition specialist.

STEPS TO GUIDE NUTRITION CARE

  • Nutrition Assessment
  • Characterized by weight loss and/or low serum protein levels
  • Analyze the MNA® results to identify the reasons for the low score
  • Review diet history / evaluate diet quality and quantity
  • Evaluate medications that may affect food intake
  • Identify any difficulty with preparing or obtaining meals
  • Evaluate effect of mental status on oral intake
  • Assess skin integrity
  • Evaluate oral hygiene and swallowing ability
  • Investigate other causes of malnutrition, e.g. disease states increased metabolic needs, etc.
  • Nutrition Diagnosis
  • Analyze the MNA® results as described above to determine nutrition problems and etiologies
  • Prioritize diagnoses (Sample diagnoses)
    • Evident protein-energy malnutrition (NI-5.2)*
    • Inadequate protein/energy intake (NI-5.3)*
    • Inadequate oral food/beverage intake (NI-2.1)*
    • Swallowing difficulty (NC-3.1)*
    • Self-feeding difficulty (NB-2.6)* 
  • Nutrition Intervention
  • Collaborate with physician/healthcare team and develop plan
  • Start nutrition intervention immediately
  • Target interventions to specific diagnosis
  • Individualize the interventions to the patient and setting (Sample interventions)
    • Modify meals and snacks for patient (ND-1)*
    • Consider use of oral nutritional supplements to enhance oral diet (ND-3)*
    • Provide feeding assistance (ND-4)*
    • Adjust the feeding environment (ND-5)*
    • Modify nutrition-related medication (ND-6)*
    • Consider initiation of enteral tube feeding (ND-2)*
  • Nutrition Monitoring and Evaluation
  • Monitor progress to ensure intervention is being implemented
  • Follow-up with repeat MNA® in 3 months
* American Dietetic Association’s Standardized Language for Nutrition Care Process
   

Score 17-23.5MNA Score 17 - 23.5 = At Risk of Malnutrition

Refer patient to a Registered Dietitian or qualified nutrition specialist.

STEPS TO GUIDE NUTRITION CARE

  • Nutrition Assessment
  • Characterized by normal weight and normal serum proteins
  • Analyze the MNA® results to identify the reasons for the low score
  • Review diet history / evaluate diet quality and quantity
  • Evaluate medications that may affect food intake
  • Identify any difficulty with preparing or obtaining meals
  • Evaluate effect of mental status on oral intake
  • Assess skin integrity
  • Evaluate oral hygiene and swallowing ability
  • Nutrition Diagnosis
  • Malnutrition risk with good prognosis given early intervention
  • Analyze the MNA® results as described above to determine any nutrition problems and etiologies
  • Prioritize diagnoses (Sample diagnoses)
      • Inadequate protein/energy intake (NI-5.3)*
      • Inadequate oral food/beverage intake (NI-2.1)*
      • Swallowing difficulty (NC-3.1)*
      • Self-feeding difficulty (NB-2.6)*
  • Nutrition Intervention
  • Collaborate with physician/healthcare team and develop plan
  • Provide the patient with nutrition education (E-2)*
  • Consider oral nutrition supplementation to enhance oral
    diet (ND-3)*
  • Refer patient to community agencies/programs (RC-2)*
    •
  • Nutrition Monitoring and Evaluation
  • Follow-up with repeat MNA® in 3 months
    •
* American Dietetic Association’s Standardized Language for Nutrition Care Process
   

Score > 23.5MNA Score > 23.5 = Satisfactory Nutrition Status

Satisfactory Nutrition

STEPS TO GUIDE NUTRITION CARE

  • Nutrition Assessment

  • Screening of weight, oral intake, mental status changes, and functionality is normal; a full nutrition assessment is not needed
    •

  • Nutrition Diagnosis

  • This patient is in satisfactory nutritional status and has no diagnosed nutritional problems
    •

  • Nutrition Intervention

  • Provide brief nutrition education – simple guidelines for a balanced diet (E-1)*

  • Nutrition Monitoring

  • Repeat MNA® every 3 months
* American Dietetic Association’s Standardized Language for Nutrition Care Process

 
 
 
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