Validez de la escala MNA como factor de riesgo nutricional en pacientes geriátricos institucionalizados con deterioro cognitivo moderado y severo

Introduction: comprehensive geriatric assessment includes examination of the nutritional status given the high prevalence of hyponutrition in this kind of patients, particularly in patients with associated cognitive impair- ment. Scales for screening the nutritional status include questions on self-perception difficult to answer by demented elder patients. Objective: To study the specificity, the positive predic- tive value, and the sensitivity of the MNA scale to detect malnutrition in patients diagnosed with Alzheimer's dis- ease with advanced cognitive impairment. Material and methods: a population-based descriptive study with a sample of 52 patients older than 70 years, institutionalized, and with moderate-severe Alzheimer's disease was designed. The sensitivity, specificity, and pos- itive predictive value of MNA scale were studied regard- ing the parameters on malnutrition of the American Institute of Nutrition (AIN). Results: the sensitivity, specificity, and positive predic- tive values were 60%, 94.7%, and 93.8%, respectively. There was a significant correlation (p < 0.001) between the score obtained with the MNA Scale and the Tinneti's Risk of Fall Scale (r = 0.577), the Barthel's function (r = 0.742), the MCT cognitive assessment (r = 0.651), and cre- atinine levels (r = 0.402). More than 50% of the sample presented at least one malnutrition parameter altered. Conclusions: the MNA Scale presents lower sensitivity and specificity in these patients. Designing a nutritional assessment scale without subjective evaluations and only with objective parameters might improve its efficiency in institutionalized elderly patients with moderate-severe cognitive impairment. (Nutr Hosp. 2009;24:724-731) DOI:10.3305/nh.2009.24.6.4571