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Predictive Power of Mini Nutritional Assessment (MNA) Score and Body Mass Index (BMI) for Frailty in the Elderly
Istingadah Desiana1, Irma Ruslina Defi1, Astrid Feinisa Khairani2
1Physical Medicine and Rehabilitation Department, Faculty of Medicine, Universitas Padjadjaran-Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.
Background:
Frailty screening and nutritional assessment are essential for identifying and managing frailty in older adults. This study investigates the predictive power of the Mini Nutritional Assessment (MNA) score and Body Mass Index (BMI) in assessing frailty among the elderly in the community of Bandung, Indonesia, using Kihon's Frailty Checklist (KCL).
Methods:
A cross-sectional study was conducted among 71 elderly individuals attending community health centers routinely in Bandung. The mean age of participants was 67.1 ± 5.13 years with 81.6% female. Frailty status was assessed using the KCL, while nutritional status was evaluated using the short-form MNA and BMI. Predictive accuracy was analyzed through Receiver Operating Characteristic (ROC) curves and Area Under the Curve (AUC) values. DeLong's test was used to compare the predictive capacities of MNA and BMI.
Results:
Of the participants, 30.99% were frail, 39.44% prefrail, and 29.58% robust. Nutritional status categorized by MNA revealed 59.15% with normal nutrition, 33.80% at risk of malnutrition, and 7.04% malnourished. BMI indicated 47.89% healthy weight, 32.39% overweight, 11.27% obese, and 8.45% underweight. The AUC for MNA (0.73; 95% CI: 0.67-0.79) demonstrated good discriminatory power, significantly outperforming BMI (AUC: 0.52; 95% CI: 0.46-0.58) in predicting frailty (p < 0.05).
Conclusion:
The MNA score showed superior predictive power compared to BMI for identifying frailty in this elderly community population. MNA's multidimensional approach, capturing factors such as nutrition, cognitive function, and mobility, provides a more comprehensive assessment of frailty. This study underscores the importance of adopting comprehensive tools like MNA for frailty screening and highlights its potential for early intervention and improving elderly care in community settings. Further research is recommended to explore long-term outcomes and integration into routine health practices.
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