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  • Original Article
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Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients

European Journal of Clinical Nutrition volume 64, pages 887–893 (2010)Cite this article

Subjects

Abstract

Background:

Malnutrition occurs frequently in the elderly and is associated with increased morbidity and mortality. The mini-nutritional assessment (MNA) has been used most frequently in the geriatric literature. The nutritional risk screening 2002 (NRS) has been proposed as universal screening method for hospitalized patients. The aim of our study was to compare both tools as they are correlated with protein malnutrition.

Methods:

MNA, NRS, and markers of protein malnutrition were measured in 104 consecutive inpatients admitted to an acute geriatric ward.

Results:

The median age was 84 years (IQR: 78–89), 81 were females. The median body mass index was 23.1 kg/m2 (IQR: 20–27.3), the median upper-arm and calf circumferences were 25 cm (IQR: 23–29) and 33 cm (IQR: 29–36). According to MNA, 23 patients were malnourished, 50 at risk of malnutrition, and 31 had a normal nutritional status. The NRS indicated that 35 were at moderate to severe risk of malnutrition and 69 at low risk. Serum prealbumin and retinol-binding protein concentrations were inversely associated with the severity of malnutrition as indicated by the NRS (P=0.06 and <0.01, respectively), whereas the MNA was not associated with these serum proteins. After adjustment for C-reactive protein and creatinine clearance, only retinol-binding protein concentrations were consistently associated with both malnutrition scores.

Conclusions:

The NRS seems to be superior compared with the MNA and serum proteins in identifying elderly patients at risk of malnutrition during acute intercurrent illness.

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Acknowledgements

TD was responsible for data analysis and drafted the manuscript. KS developed the study design and data collection. AU was involved in the data collection. MK assisted with statistical analysis. UK contributed to critical revision of the manuscript. MCC coordinated the data analysis and significantly supported the drafting of the manuscript. RWK helped with the study design and the revision of the manuscript. All authors have read and approved the final manuscript.

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Author notes

  1. T Drescher and K Singler: These two authors contributed equally to this work.

Authors and Affiliations

  1. Division of Endocrinology, Department of Internal Medicine, Diabetes and Clinical Nutrition, University Hospital Basel, Basel, Switzerland

    T Drescher, U Keller & M Christ-Crain

  2. Division of Acute Geriatrics, University Hospital Basel, Basel, Switzerland

    T Drescher, K Singler, A Ulrich & R W Kressig

  3. Basel Institute for Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland

    M Koller

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  1. T Drescher
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  2. K Singler
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Correspondence to T Drescher.

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Drescher, T., Singler, K., Ulrich, A. et al. Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients. Eur J Clin Nutr 64, 887–893 (2010). https://doi.org/10.1038/ejcn.2010.64

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