Burckhardt, Peter

Krieg, Marc-Antoine

Lanham-New, Susan

Wynn, Emma

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Summer Meeting 30 June–3 July 2008High mini nutritional assessment (MNA) correlates with bone ultrasoundmeasurements in Swiss women >75 years of age who havea lifetime fracture historyEmma Wynn1, Marc-Antoine Krieg2, Peter Burckhardt1 and Susan Lanham-New31University Hospital, Lausanne, Switzerland, 2Bois-Cerf Clinic, Lausanne, Switzerland and 3University of Surrey,Guildford, UKTo achieve optimum bone health, numerous factors are required such as optimal genetics, good health, weight-bearing physical activityand adequate nutrition(1). Malnutrition is a risk factor for osteoporotic fractures and is a very common problem in the elderly populationthat is often under-diagnosed(2). The MNA(3) is an effective easily-administered tool designed to identify older adults who have or are atrisk for developing malnutrition. It consists of eighteen questions and can be completed in about 15 min.The aim of the study was to assess the possible relationship between MNA and bone ultrasound (QUS) measurements at the heel(broadband ultrasound attenuation; BUA). A trend for a correlation between the MNA and BUA has already been reported in a previousstudy(4) but the intention was to explore this association further in a very-elderly group of the Swiss population who had reported aprevious fracture. Furthermore, a more recent study has shown that elderly free-living women who have an MNA score <27 have atwofold increased risk of having osteoporosis(5).As part of an ongoing study (EVANIBUS) on the evaluation of nutritional intake and bone ultrasound(6) MNA and QUS were assessedin 256 elderly Swiss ambulatory women who had reported a fracture in their lifetime (age 80.6 (SD 3.0) years, BMI 24.6 (SD 4.4) kg/m2,BUA 96.8 (SD 9.0) dB/mHz). QUS, carried out using an Achilles ultrasound densitometer, (Lunar Corporation, Madison, WI, USA), ispredictive of fracture risk in elderly women. The MNA, a non-invasive and validated questionnaire to evaluate nutritional status in theelderly, was completed by each subject. The MNA, which comprises eighteen questions, evaluates the nutritional status of the subject. Thescore range is 0–30 (<17, malnutrition; 17.5–23.5, risk of malnutrition; ‡ 24, well-nourished).The mean MNA score was 26.5 (SD 2.5). A higher MNA score was significantly associated with higher BUA (r 0.149; P<0.05). BUAincreased significantly between MNA quartile (Q) 1 and MNA Q4 (Q1, 23.5 (SD 2.1); Q2 26.5 (SD 2.4); Q3, 28 (SD 2.1); Q4, 30 (SD 2.2)).The difference among the mean scores for BUA for the four groups was assessed using a one-way ANOVA post-hoc test (P = 0.004) aswell as F test linearity (P = 0.015). BUA values were significantly lower when the MNA score was <24 (risk of malnutrition). A highMNA score was correlated with higher BUA values in women who had suffered fractures, but the effect of the association was relativelylow compared with that of age and BMI.In hospitals a low MNA score is associated with an increase in mortality, longer length of hospitalisation and higher risk of going into anursing home at discharge. The MNA has been shown to detect risk of malnutrition before changes are apparent in weight or serumproteins. The MNA is also a follow-up assessment tool. It should be included in geriatric assessment and has the advantage of being acheap and easily-used tool. In addition, the MNA appears to be a useful tool for the evaluation of patients with osteoporosis, and furtherresearch is required to assess the role of the MNA in these patients.1. Department of Health (1991) Dietary Reference Values for Food, Energy and Nutrients for the United Kingdom. Report on Health and Social Subjectsno. 41. London. H. M. Stationery Office.2. Food and Nutrition Board, Institute of Medicine (1997) Dietary Reference Intakes: For Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride.Washington, DC: National Academy Press.3. Guigoz Y & Vellas B (1999) Nestle Nutr Workshop Ser Clin Perform Programme 1, 3–11; discussion 11-2.4. Gerber V, Krieg MA, Cornuz J, Guigoz Y & Burckhardt P (2003) J Nutr Health Aging 7, 140–145.5. Salminen H, Saaf M, Johansson SE, Ringertz H & Strender LE (2006) Eur J Clin Nutr 60, 486–493.6. Dumartheray EW, Krieg MA, Cornuz J, Whittamore DR, Lanham-New SA & Burckhardt P (2006) J Hum Nutr Diet 19, 431–435.Proceedings of the Nutrition Society (2008), 67 (OCE8), E319 doi:10.1017/S0029665108009920https:/www.cambridge.org/core/terms. https://doi.org/10.1017/S0029665108009920Downloaded from https:/www.cambridge.org/core. University of Basel Library, on 30 May 2017 at 14:08:18, subject to the Cambridge Core terms of use, available at

High mini nutritional assessment (MNA) correlates with bone ultrasound measurements in Swiss women >75 years of age who have a lifetime fracture history

High mini nutritional assessment (MNA) correlates with bone ultrasound measurements in Swiss women >75 years of age who have a lifetime fracture history

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