L. Barone, M. Milosavljevic, B. Gazibarich

Correspondence: Lilliana Barone BSc Master Nut Diet (Sydney University) Clinical Dietitian, Wollongong Hospital Nutrition Department, P.O Box 178, Wollongong, New South Wales, Australia 2500. e-mail address : baronel@iahs.nsw.gov.au

OBJECTIVES: A study was undertaken to determine which nutritional assessment tool would be better in assessing changes in nutritional status over time in hospitalised older patients. The two tools used were the Mini Nutritional Assessment (MNA) and the Subjective Global Assessment (SGA). DESIGN: Single blind, prospective study conducted over a 60-day period. SETTING: Five regional hospitals within Southern New South Wales, Australia. SUBJECTS: There were 43 patients at the commencement of the study, then 28 patients at day 30 and 20 patients at day 60. METHODS: All patients over 65 years of age admitted to the five hospitals during May 2001 were eligible. The only exclusions were those patients admitted to palliative care or with severe dementia. Two dietitians saw each patient. Each dietitian assessed the patient using his or her assigned nutritional assessment tool either the SGA or the MNA. All dietitians were randomly assigned the tool at the commencement of the study. They were familiarised with the use of the tool by participating in a workshop prior to the start of the study. RESULT: The MNA was able to detect greater numbers of malnourished subjects when compared to the SGA. This finding was consistent across Day 0, 30 and 60 and statistically significant (p<0.05) at all time periods. CONCLUSIONS: This study has shown the MNA to be a more appropriate nutrition assessment tool for older patients when compared to the SGA. The MNA is better able to identify severely malnourished patients. This study illustrated the potential use of the MNA as an ongoing monitor of nutritional status and hence a measure of the impact of nutrition intervention.

Keywords: Nutritional status, Mini Nutritional Assessment, Subjective Global Assessment, older person, aging.