Body mass index, Mini Nutritional Assessment, and their association with five-year mortality in very old people - PubMed (original) (raw)

Body mass index, Mini Nutritional Assessment, and their association with five-year mortality in very old people

M Burman et al. J Nutr Health Aging. 2015 Apr.

Abstract

Objectives: to investigate the prevalence of malnutrition and the association between Body Mass Index (BMI), Mini Nutritional Assessment (MNA) and five-year mortality in a representative population of very old (>85 years) people.

Design: A prospective cohort study.

Setting: A population-based study of very old people in northern Sweden and western Finland, living in institutional care or in the community.

Participants: Out of 1195 potential participants, 832 were included (mean age 90.2±4.6 years).

Measurements: Nutritional status was assessed using BMI and MNA and the association of those two variables with five-year mortality was analyzed.

Results: The mean BMI value for the whole population was 25.1±4.5 kg/m2, with no difference between genders (P=0.938). The mean MNA score was 22.5±4.6 for the whole sample, and it was lower for women than for men (P<0.001). Thirteen percent were malnourished (MNA<17) and 40.3% at risk of malnutrition (MNA 17-23.5) according to MNA. Also, 34.8% of those with a MNA score <17 still had a BMI value ≥22.2 kg/m2. A BMI value <22.2 kg/m2 and a MNA score<17 were associated with lower survival. The association with mortality seemed to be J-shaped for BMI, and linear for MNA.

Conclusions: Malnutrition according to MNA was common, but a substantial portion of those with a low MNA score still had a high BMI value, and vice versa. The association with mortality appeared to be J-shaped for BMI, and linear for MNA. The MNA seems to be a good measurement of malnutrition in very old people, and BMI might be misleading and could underestimate the prevalence of malnutrition, especially in women.

PubMed Disclaimer

Figures

Figure 1

Figure 1

Flow chart of the selection of participants. BMI= Body Mass Index (kg/m2), MNA= Mini Nutritional Assessment

Figure 2

Figure 2

Relationship between BMI and five-year mortality for the whole sample

Figure 3

Figure 3

Relationship between MNA and five-year mortality for the whole sample

References

    1. Saletti A., et al. Nutritional status and a 3-year follow-up in elderly receiving support at home. Gerontology. 2005;51(3):192–198. 10.1159/000083993 PubMed PMID: 15832047. - DOI - PubMed
    1. Saletti A., et al. Nutritional status according to mini nutritional assessment in an institutionalized elderly population in Sweden. Gerontology. 2000;46(3):139–145. 10.1159/000022149 PubMed PMID: 10754371. - DOI - PubMed
    1. Flegal K.M., et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309(1):71–82. 10.1001/jama.2012.113905 PubMed PMID: 23280227. - DOI - PMC - PubMed
    1. Cook Z., et al. Use of BMI in the assessment of undernutrition in older subjects: reflecting on practice. Proc Nutr Soc. 2005;64(3):313–317. 10.1079/PNS2005437 PubMed PMID: 16048662. - DOI - PubMed
    1. The National Board of HealthWelfare Nutrition for good health and social care (In Swedish) 2011

Publication types

MeSH terms

LinkOut - more resources