The Study of Correlation and Concordance between a Nutrition Alert Form and a Mini Nutritional Assessment in Evaluating the Nutritional Status of the Elderly.

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Weerawan Techakriengkrai, RN, CDT


OBJECTIVES: This research aimed to study the correlation between a Nutrition Alert Form (NAF) and a Mini Nutritional Assessment (MNA) in evaluating the nutritional status of the elderly and evaluated the relation between NAF, MNA and biochemical nutrition data.

MATERIALS AND METHODS: A cross sectional study was conducted in 153 outpatient and inpatient elder at Bangkok Hospital from February to September 2015. The nutrition status of participants was screened by a longevity nurse with MNA and NAF and serum pre-albumin was collected. After that, the dietitian evaluated the nutrition assessment and recalled dietary habit, and the reason of weight change. Statistical analysis of this study used SPSS (Statistical Package for Social Science) version 19.0. Kappa index to analyze the agreement between NAF and MNA. The correlation was analyzed by Spearman’s correlation coefficient.

RESULTS: The kappa index between the NAF and the MNA (standard) which was moderate: K 0.563 with a sensitivity of 80.0% and a specificity of 91.3 %. The data show the risky level of NAF had a positive correlation with pre-albumin, total lymphocyte count and the risk level of MNA at 0.428, 0.302, 0.583, respectively (p < 0.01).

CONCLUSION:A NAF can be applied to screen nutritional status in the elderly because of a moderate agreement between the NAF and MNA and serum pre-albumin, and this is a less time-consuming tool and can be applied in the elderly without body weight data. However, the NAF screening did not focus on age increase. For accurate screening in the elderly using the NAF, increasing age should be assessed as well.


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Techakriengkrai W. The Study of Correlation and Concordance between a Nutrition Alert Form and a Mini Nutritional Assessment in Evaluating the Nutritional Status of the Elderly. BKK Med J [Internet]. 2017Feb.20 [cited 2020Jul.15];13(1):49. Available from:
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1. Corish CA, Kennedy NP. Protein-energy undernutrition in hospital in-patients. Br J Nutr 2000;83:575-91.
2. Hickson M. Malnutrition and ageing. Postgrad Med J2006;82(963):2-8.
3. Burgos R, Sarto B, Elío I, et al. Prevalence of malnutrition and its etiological factors in hospitals. Nutr Hosp 2012;27(2):469-76.
4. Adams NE, Bowie AJ, Simmance N, et al. Recognition by Medical and nursing professionals of malnutrition and risk of malnutrition in elderly hospitalised patients. Nutr Dietetics 2008;65:144-50.
5. Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: the Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev 1996;54:S59-65
6. Small SR. Dietitians’use and perceptions of nutrition screening tools for the older adult. (Assessed September 20, 2016 at
7. Volkert D, Saeglitz C, Gueldenzoph H, et al. Undiagnosed malnutrition and nutrition-related problems in geriatric patients. J Nutr Health Aging 2010;14(5):387-92
8. Komindrg S, Tangsermwong T, Janepanish P. Simplified malnutrition tool for Thai patients. Asia Pac J Clin Nutr 2013;22(4):516-2
9. Frederick K and Thomas C. Prealbumin: a marker for nutritional evaluation. Am Fam Physician 2002;65:1575-8.
10. Gunarsa RG, Simadibrata M, Syam AF. Total Lymphocyte Count as a Nutritional Parameter in Hospitalized Patients. Indonesian J Gastroenter Hepatol Dig Endosc 2011;12 (2):89-94.
11. Rocha NP, Fortes RC. Toyal lymphocyte count and serum albumin as predictors of nutrition risk in surgical patients. Arq Bras Cir Dig 2015; 28(3): 193-6
12. Robinson R. Low serum albumin and total lymphocyte count as predictors of 30 day hospital readmission in patients 65 years of age or older. Peer J 2015; 3:e1181.
13. Durán Alert P, Milà Villarroel R, Formiga F, et al. Assessing risk screening methods of malnutrition in geriatric patients; Mini Nutritional Assessment (MNA) versus Geriatric Nutritional Risk Index (GNRI). Nutr Hosp 2012;27(2):590-8.
14. Holst M, Lindgren Y, Surowiak M, et al. 2013. Nutritional screening and risk factors in elderly hospitalized patients: association to clinical outcome? Scand J Caring Sci 2013; 27:953–61.
15. Sungurtekin H, Sungurtekin U, Hanci V, et al. Comparison of Two Nutrition Assessment Techniques in Hospitalized Patients. Nutrition 2004;20 (5): 428-32.
16. Rolland Y, Perrin A, Gardette V, et al. Screening Older at Risk of Malnutrition or Malnourished Using the Simplified Nutritional Appetite Questionnaire (SNAQ): A Comparison With the Mini-Nutritional Assessment (MNA) Tool. J Am Med Dir Assoc 2012;13(1):31-49-94.