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Queries raised about MNA for frail older hospital patients
Clinical Nutrition 34 (2015) 1282
Contents lists available at ScienceDirect
Clinical Nutrition journal homepage: http://www.elsevier.com/locate/clnu
Letter to the editor
Queries raised about MNA for frail older hospital patients Dear Editor, In recent issue of Clinical Nutrition, we have read with a great interest the article by Slee et al. entitled “A comparison of the malnutrition screening tools, MUST, MNA and bioelectrical impedance assessment in frail older hospital patients” [1]. They show the potential ability of the MNA-SF and BIA to accurately assess malnutrition risk over MUST in frail older hospital patients. ESPEN recommends subjects at risk of malnutrition are identified by validated screening tools like NRS-2002, MNA-SF and MUST. They use different criteria and cut-offs, and were designed for different purposes and populations [2]. There were some queries raised about MNA esp for frail older hospital patients. 1) Regarding the question of ''Involuntary weight loss during the last 3 months?'' What does “does not know” exactly mean? What if the individual signs that he lost weight but no idea about how many kilograms? And what if the individual does not know whether he lost weight? 2) Regarding the question of 'Neuropsychological problems?' How about 'moderate' dementia? And regarding depression, does it sign only 'severe' depression? What about minor depression? 3) How many drugs (only one drug but 2 doses; Means 2 drugs or one drug/vitamin supplemans??) 4) Feeling pain on skin??(We have patients feeling pain because of osteomalacia not malnutrition)
I am interested how they could address these queries in their study. Best regards. Conflict of interest None. References [1] Slee A, Birch B, Stokoe D. A comparison of the malnutrition screening tools, MUST, MNA and bioelectrical impedance assessment in frail older hospital patients. Clin Nutr May 2, 2014:296e301. Published online. [2] van Bokhorst-de van der Schueren MA, Guaitoli PR, Jansma EP, de Vet HC. Nutrition screening tools: does one size fit all? A systematic review of screening tools for the hospital setting. Clin Nutr 2014;33:39e58.
a
Asli Tufana,*, Birkan Ilhanb, Gulistan Bahatb Marmara University, Marmara Medical School, Department of Internal Medicine, Division of Geriatrics, Turkey b
Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Turkey *
Corresponding author. E-mail address: [email protected] (A. Tufan).
http://dx.doi.org/10.1016/j.clnu.2015.07.021 0261-5614/© 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
23 April 2015
Contents lists available at ScienceDirect
Clinical Nutrition journal homepage: http://www.elsevier.com/locate/clnu
Letter to the editor
Queries raised about MNA for frail older hospital patients Dear Editor, In recent issue of Clinical Nutrition, we have read with a great interest the article by Slee et al. entitled “A comparison of the malnutrition screening tools, MUST, MNA and bioelectrical impedance assessment in frail older hospital patients” [1]. They show the potential ability of the MNA-SF and BIA to accurately assess malnutrition risk over MUST in frail older hospital patients. ESPEN recommends subjects at risk of malnutrition are identified by validated screening tools like NRS-2002, MNA-SF and MUST. They use different criteria and cut-offs, and were designed for different purposes and populations [2]. There were some queries raised about MNA esp for frail older hospital patients. 1) Regarding the question of ''Involuntary weight loss during the last 3 months?'' What does “does not know” exactly mean? What if the individual signs that he lost weight but no idea about how many kilograms? And what if the individual does not know whether he lost weight? 2) Regarding the question of 'Neuropsychological problems?' How about 'moderate' dementia? And regarding depression, does it sign only 'severe' depression? What about minor depression? 3) How many drugs (only one drug but 2 doses; Means 2 drugs or one drug/vitamin supplemans??) 4) Feeling pain on skin??(We have patients feeling pain because of osteomalacia not malnutrition)
I am interested how they could address these queries in their study. Best regards. Conflict of interest None. References [1] Slee A, Birch B, Stokoe D. A comparison of the malnutrition screening tools, MUST, MNA and bioelectrical impedance assessment in frail older hospital patients. Clin Nutr May 2, 2014:296e301. Published online. [2] van Bokhorst-de van der Schueren MA, Guaitoli PR, Jansma EP, de Vet HC. Nutrition screening tools: does one size fit all? A systematic review of screening tools for the hospital setting. Clin Nutr 2014;33:39e58.
a
Asli Tufana,*, Birkan Ilhanb, Gulistan Bahatb Marmara University, Marmara Medical School, Department of Internal Medicine, Division of Geriatrics, Turkey b
Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Turkey *
Corresponding author. E-mail address: [email protected] (A. Tufan).
http://dx.doi.org/10.1016/j.clnu.2015.07.021 0261-5614/© 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
23 April 2015