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The Mini Nutritional Assessment (MNA) was developed to compliment more complicated existing tests and aid malnutrition detection at an early stage, when it is most critical, in seniors. Composed of 18 measurement items which can be completed in 15 minutes or less, the MNA ca assess nutrition status in the frail elderly with 92% accuracy without biochemical indices and 98% using all comprehensive nutrition assessment factors. Because the MNA is noninvasive, quick, and an accurate alternative to more expensive biochemical or laboratory procedures, it provides health professionals with a useful alternative for nutrition assessment.

Background. The Mini-Nutritional Assessment (MNA) is a validated assessment instrument for nutritional problems, but its length limits its usefulness for screening. We sought to develop a screening version of this instrument, the MNA-SF, that retains good diagnostic accuracy. Methods. We reanalyzed data from France that were used to develop the original MNA and combined these with data collected in Spain and New Mexico. Of the 881 subjects with complete MNA data, 151 were from France, 400 were from Spain, and 330 were from New Mexico. Independent ratings of clinical nutritional status were available for 142 of the French subjects. Overall, 73.8% were community dwelling, and mean age was 76.4 years. Items were chosen for the MNA-SF on the basis of item correlation with the total MNA score and with clinical nutritional status, internal consistency, reliability, completeness, and ease of administration. Results. After testing multiple versions, we identified an optimal six-item MNA-SF total score ranging from 0 to 14. The cut-point score for MNA-SF was calculated using clinical nutritional status as the gold standard (n = 142) and using the total MNA score (n = 881). The MNA-SF was strongly correlated with the total MNA score (r = .945). Using an MNA-SF score of [is greater than or equal to] 11 as normal, sensitivity was 97.9%, specificity was 100%, and diagnostic accuracy was 98.7% for predicting undernutrition. Conclusions. The MNA-SF can identify persons with undernutrition and can be used in a two-step screening process in which persons, identified as 'at risk' on the MNA-SF, would receive additional assessment to confirm the diagnosis and plan interventions.

The article presents an analysis of a cluster-randomized controlled trial (NutriAlz Trial) in outpatient and day care centers in Catalonia, Spain to estimate the number of fallers and risk factor for falls in cohort with dementia. The analysis has used logistic regression models and linear models to explore risk factors for falls and changes in health. The analysis also aims to compare the changes in health and functional status during the follow-up period between fallers and nonfallers.

A study was conducted in healthy elderly living independently in senior housing to assess the impact of a probiotic yoghurt supplement on small intestinal bacterial overgrowth. Twenty-three participants with positive and thirteen participants with negative hydrogen breath test were studied before and after a period of 4 weeks of probiotic yoghurt administration. Intestinal permeability, plasma endotoxin levels, phagocytic activity of leucocytes, cytokine production by monocytes and free radical response of neutrophils were determined. Intestinal permeability was similar for the two groups and was unaffected by probiotic treatment. Both plasma endotoxin levels and the basal phagocytic activity of leucocytes decreased after yoghurt intake in the two groups. Exposure of monocytes and neutrophils ex vivo led to an increased cytokine response and free radical response, respectively. The normalisation of the various cytokine responses was more apparent in the group with positive breath test. In addition, the plasma levels of lipoplysaccharide binding protein and soluble CD14, lipoplysaccharide pattern recognition receptors and surrogate markers of lipoplysaccharide permeability were diminished by the end of the study. In conclusion, probiotic administration in the elderly normalises the response to endotoxin, and modulates activation markers in blood phagocytes, and therefore may help reduce low-grade chronic inflammation. [ABSTRACT FROM PUBLISHER]

Presents a study which derived a short-form version of the Mini-Nutritional Assessment (MNA-SF) for undernutrition in geriatric practice. Nutritional deficiency among older adults; Methodology; Derivation of MNA-SF; Diagnostic characteristics of screening tests.

Abstract: A common finding in the elderly population is a chronic subclinical inflammatory status that coexists with immune dysfunction. These interconnected processes are of sufficient magnitude to impact health and survival time. In this review we discuss the different signals that may stimulate the inflammatory process in the aging population as well as the molecular and cellular components that can participate in the initiation, the modulation or termination of the said process. A special interest has been devoted to the intestine as a source of signals that can amplify local and systemic inflammation. Sentinel cells in the splanchnic area are normally exposed to more than one stimulus at a given time. In the intestine of the elderly, endogenous molecules produced by the cellular aging process and stress as well as exogenous evolutionarily conserved molecules from bacteria, are integrated into a network of receptors and molecular signalling pathways that result in chronic inflammatory activation. It is thus possible that nutritional interventions which modify the intestinal ecology can diminish the pro-inflammatory effects of the microbiota and thereby reinforce the mucosal barrier or modulate the cellular activation pathways. [ABSTRACT FROM AUTHOR]

This introductory review gives an overview on protein metabolism, and discusses protein quality, sources, and requirements as well as the results from recent studies on Swiss spontaneous protein consumption. To assess protein quality in protein mixes and foods, the "protein digestibility-corrected amino acid score" (PDCAAS) is presented as a valuable tool in addition to the biological value (BV). Considering protein intake recommendations, the lower limit recommended has been defined according to the minimal amount needed to maintain short-term nitrogen balance in healthy people with moderate activity. Evaluation of intakes in Switzerland from food consumption data is about 90 g/day of protein per person. Two-thirds of proteins consumed in Switzerland are animal proteins with high biological value [meat and meat products (28 %), milk and dairy products (28 %), fish (3 %), and eggs (3 %)] and about 1/3 of proteins are of plant origin (25 % of cereals, 3 - 4 % of vegetables). Actual spontaneous protein consumption in Switzerland by specific groups of subjects is well within the actual recommendations (10 - 20 % of energy) with only the frail elderly being at risk of not covering their requirements for protein.

Unintentional weight loss and Undernutrition are major problems among older people living in Long-Term Care Facilities (LTCF). Undernutrition manifests in LTCF particularly as weight loss and low Body Mass Index (BMI) and is associated with increased morbidity and mortality as well as with functional decline. There are many factors associated with poor nutritional status and affecting protein-energy intake and/or energy expenditure. These include age of 85 years or older, low nutrient intake, loss of ability to eat independently, swallowing and chewing difficulties, becoming bed-ridden, pressure ulcers, history of hip fracture, dementia, depressive symptoms and suffering from two or more chronic illnesses. Nutritional evaluation is an essential part of the Comprehensive Geriatric Assessment (CGA). This evaluation ranges from methods such as BMI to several validated tools such as Mini-Nutritional Assessment (MNA). After diagnosis, the management of undernutrition in LTCF requires a multidisciplinary approach which may involve dietary and environmental improvements and managing multiple co-morbidities, while avoiding polypharmacy as far as possible. Finally, the need for supplementation or artificial (tube) feeding may be considered taking into account the CGA and individual needs. This document presents a succinct review and recommendations of evaluation and treatment of undernutrition.

Purpose of Review: Recent studies suggest an association between inflammation status and the presence of chronic disease in the elderly. The review examines publications that address the low level of chronic inflammation and emphasizes how an altered host-microbiota interaction at the gut level could contribute to maintaining a low systemic inflammatory status in the elderly., Recent Findings: The first population cross-sectional studies with relevant numbers of healthy elderlies show age-related global changes in gut microbiota with a consistent increase in nonpathogenic Gram-negative mainly Enterobacteria and country-specific changes in bifidobacteria. Noninvasive methods have permitted us to detect subclinical intestinal inflammation in the elderly population. Furthermore, few studies report on immune and/or inflammatory response; however, prebiotics, probiotics or synbiotics might improve the inflammatory condition of the elderly., Summary: A better understanding of the mechanisms of host-gut microbiota cross-talk would significantly help in the design of novel nutritional strategies targeting immune reactivity at the mucosal level.