Relationships between nutritional screening and functional impairment in institutionalized Spanish older people

Abstract

Objectives: An association between functional status and nutritional status has previously been demonstrated and the value of the Mini Nutritional Assessment (MNA) as an indicator of functional status has been investigated. However, experience in nursing homes is still limited. The objectives of this survey were to study the relationships between functional impairment as measured by the Barthel Index (BI) and broad nutritional assessment categories as measured by the MNA.

Study design: Cross-sectional study developed with data collected from 895 residents in 34 nursing homes all over the province of Albacete (Spain).

Main outcome measures: Nutritional and functional statuses were assessed using the MNA and the BI, respectively. Correlations between MNA and BI were evaluated. Analyses of BI against the MNA were utilized to obtain cut-off points for three broad categories of the MNA, "well", "at risk" and "malnourished". Multiple logistic regression analyses were used to assess the association of the MNA items with the BI.

Results: MNA and BI were significantly correlated. The BI cut-off point that best determined malnourished versus well or at risk was 40.5. The BI cut-off point that best determined well versus malnourished or at risk was 85.5. The BI was positively associated with the following MNA items: mobility, mode of feeding, self view of health status and mid-arm circumference.

Conclusions: Both tests, MNA and BI, are positively associated. The scores of BI can help determine who may be at risk of poor nutrition.

Keywords: Barthel Index; Functional status; Mini Nutritional Assessment; Nursing home; Older people.