Nutrition Across the Lifespan Quiz

Mini Nutritional Assessment MNA®

M How much fluid (water, juice, coffee, tea, milk...) is consumed per day? 0.0 = less than 3 cups 0.5 = 3 to 5 cups 1.0 = more than 5 cups

Assessment (max. 16 points)

Screening score

Total Assessment (max. 30 points) .

K Selected consumption markers for protein intake  At least one serving of dairy products

(milk, cheese, yoghurt) per day  Two or more servings of legumes

or eggs per week  Meat, fish or poultry every day

0.0 = if 0 or 1 yes 0.5 = if 2 yes 1.0 = if 3 yes

yes .

Last name: First name:

Sex: Age: Weight, kg: Height, cm: Date:

Sex: Age: Weight, kg: Height, cm: Date: Complete the screen by filling in the boxes with the appropriate numbers. Add the numbers for the screen. If score is 11 or less, continue with the assessment to gain a Malnutrition Indicator Score.

Screening

Assessment

References 1. Vellas B, Villars H, Abellan G, et al. Overview of the MNA® - Its History and

Challenges. J Nutr Health Aging. 2006; 10:456-465. 2. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for

Undernutrition in Geriatric Practice: Developing the Short-Form Mini Nutritional Assessment (MNA-SF). J. Geront. 2001; 56A: M366-377

3. Guigoz Y. The Mini-Nutritional Assessment (MNA®) Review of the Literature - What does it tell us? J Nutr Health Aging. 2006; 10:466-487.

® Société des Produits Nestlé, S.A., Vevey, Switzerland, Trademark Owners © Nestlé, 1994, Revision 2009. N67200 12/99 10M For more information: www.mna-elderly.com

Malnutrition Indicator Score 24 to 30 points Normal nutritional status 17 to 23.5 points At risk of malnutrition Less than 17 points Malnourished

L Consumes two or more servings of fruit or vegetables per day? 0 = no 1 = yes

Q Mid-arm circumference (MAC) in cm 0.0 = MAC less than 21 0.5 = MAC 21 to 22 1.0 = MAC 22 or greater

O Self view of nutritional status 0 = views self as being malnourished 1 = is uncertain of nutritional state 2 = views self as having no nutritional problem

P In comparison with other people of the same age, how does the patient consider his / her health status? 0.0 = not as good 0.5 = does not know 1.0 = as good 2.0 = better

N Mode of feeding 0 = unable to eat without assistance 1 = self-fed with some difficulty 2 = self-fed without any problem

yes

yes

no

no

no

J How many full meals does the patient eat daily? 0 = 1 meal 1 = 2 meals 2 = 3 meals

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.

.

.

.

.

R Calf circumference (CC) in cm 0 = CC less than 31 1 = CC 31 or greater

I Pressure sores or skin ulcers 0 = yes 1 = no

H Takes more than 3 prescription drugs per day 0 = yes 1 = no

G Lives independently (not in nursing home or hospital) 1 = yes 0 = no

Screening score (subtotal max. 14 points) 12-14 points: Normal nutritional status 8-11 points: At risk of malnutrition 0-7 points: Malnourished For a more in-depth assessment, continue with questions G-R

F Body Mass Index (BMI) (weight in kg) / (height in m2) 0 = BMI less than 19 1 = BMI 19 to less than 21 2 = BMI 21 to less than 23 3 = BMI 23 or greater

E Neuropsychological problems 0 = severe dementia or depression 1 = mild dementia 2 = no psychological problems

D Has suffered psychological stress or acute disease in the past 3 months? 0 = yes 2 = no

C Mobility 0 = bed or chair bound 1 = able to get out of bed / chair but does not go out 2 = goes out

B Weight loss during the last 3 months 0 = weight loss greater than 3kg (6.6lbs) 1 = does not know 2 = weight loss between 1 and 3kg (2.2 and 6.6 lbs) 3 = no weight loss

A Has food intake declined over the past 3 months due to loss of appetite, digestive problems, chewing or swallowing difficulties? 0 = severe decrease in food intake 1 = moderate decrease in food intake 2 = no decrease in food intake