# Nutritional Assessment in Older Adults: MNA® 25 years of a Screening Tool & a Reference Standard for Care and Research; What Next?

Yves Guigoz, B. Vellas

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Yves Guigoz, B. Vellas. Nutritional Assessment in Older Adults: MNA® 25 years of a Screening Tool & a Reference Standard for Care and Research; What Next?. Journal of Nutrition, Health & Aging, 2021, 25 (4), pp.528-583. 10.1007/s12603-021-1601-y. hal-04494045

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# NUTRITIONAL ASSESSMENT IN OLDER ADULTS: MNA® 25 YEARS OF A SCREENING TOOL & A REFERENCE STANDARD FOR CARE AND RESEARCH; WHAT NEXT?

Y. GUIGOZ, B. VELLAS

Gerontopole, Toulouse University Hospital, INSERM UMR 1027, University of Toulouse, France. Corresponding author:
Yves Guigoz, Chemin du Raidillon, CH-1066 Epalinges, Switzerland. yves.guigoz@gmail.com

**Abstract:** A tool to assess nutritional status in older persons was really needed. It took 5 years to design the MNA® (Mini Nutrition Assessment) tool, complete the first validations studies both in Europe and in the U.S. and to publish it. After the full MNA®, the MNA® short form and the self-MNA® have been validated. As well as Chinese and other national MNA® forms. Now more than 2000 clinical research have used the MNA® all over the world from community care to hospital. At least 22 Expert groups included the MNA® in new clinical practice guidelines, national or international registries. The MNA® is presently included in almost all geriatric and nutrition textbook and part of the teaching program for medicine and other health care professional worldwide. The urgent need is to target the frail older adults more likely to have weight loss and poor appetite and to prevent frailty and weight loss in the robust. We present in this paper the review of 25 years of clinical research and practice using the MNA® worldwide.

**Key words:** Nutrition, MNA, aging.

## Introduction and short history

Malnutrition in older adults is a really important problem, occurs 40% more often in the older ones; and is identified in 1 of 3 older adults in the hospital, and in 1 of 2 rehabilitation patients (1). Subjects intake is often poor from lack of appetite, most adults in the hospital eat less than 50% of the served food at each meal and the proportion of patients with malnutrition increases during hospital stay (2, 3).

A tool to assess nutritional status in older persons was really needed. It is why in 1989 at my first IAGG conference in Acapulco, I spoke about the MNA® idea with Yves Guigoz, from the Nestle International Research Center in Lausanne. I told him we must design and validate a tool for assessing nutritional status in the elderly analogous following the MMSE tool for assessing cognitive functions. Because already most physician know that a total score of 30 is the maximum for cognitive functions our total score for the MNA® must be also at 30.

## Validation of the MNA® full form, short form and self-management form (fig. 1)

It took us 5 years (1994) to convince our colleagues, to design the tool, to complete the first validations studies both in France and in the U.S. and to publish it (4, 5). We would like to acknowledge Werner Bauer, former director of the Nestlé Research Center who took the decision to fund the study, Phill Garry Ph.D., W.C Cameron Chumlea Ph.D., from the University of New Mexico Aging Process Study, Albuquerque, NM, USA and our team at the Gerontopole, including Sylvie Lauque RD. We validated the MNA® screening versus the results from 2 physicians with all the current nutritional

assessment including nutritional intake, anthropometric measurement, and biological biomarkers (e.g. albumin, prealbumin, CRP, α1-acid glycoprotein, cholesterol, triglycerides, vitamins A, D, E, B1, B2, B6, and B12, folate, copper, zinc, haemoglobin, and blood cell count). We did it in two different populations in Toulouse area, France and in Albuquerque, NM, USA. Subjects were classified using principal component and discriminant analysis. Principal component analysis indicated that the MNA® can be used without clinical biochemistry. Threshold value ranges for risk of malnutrition and malnutrition were 22-24 points and 16-18 points, respectively, on a maximum of 30 points. Exact threshold values were then set by cross-tabulation of cut-off values for serum albumin without the presence of inflammation. We have been able to observe that those with an MNA® score less than 17.5 have usually protein-calorie undernutrition, those between 17 and 23 are at risk for malnutrition but have not yet protein-calorie undernutrition and those > 23 have in general an adequate nutritional status (5-7).

In 2001, With Larry Rubenstein, from U.C.L.A we developed validated the MNA® Short-form (8). The MNA® short form includes 6 items to do a first steps to screen those at risk for malnutrition. After completing the MNA® short form it is still useful if the subjects are scored at risk for malnutrition to complete the full MNA®. Carefully looking at the full MNA® items to determine where the subjects lose point can help to guide the nutrition intervention. For e.g. if we observe that a patient doesn't eat on the evening we can propose something, then if some subjects need help to eat... it takes few minutes to do the MNA® SF and it is already a very common used tool.

In 2009 a Revised MNA® short-form (9) has been developed & validated as a stand-alone screening tool; it includes option for substituting calf circumference (CC) for BMI, and takes less than 5 minutes. The MNA®-SF is available in 42 languages,
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>Figure 1
MNA®: History & Development</caption><thead><tr><th>Identification</th><th>MNA® Full Form</th><th>MNA® Short-Form</th><th>Revised MNA® Short-Form</th><th>Self-MNA®</th><th>MNA®, MNA® SF; Self-MNA®</th></tr><tr><th>1989</th><th>1994</th><th>2001</th><th>2009</th><th>2012</th><th>2020</th></tr></thead><tbody><tr><td>B. Vellas, Y Guigoz IAG Acapulco<br><br>Aim: Design a tool for assessing nutritional status in the analogous MMSE</td><td>Y Guigoz, B. Vellas, P. Garry<br><br>Developed & Validated MNA® Full form<br><br>18 questions</td><td>LZ Rubenstein, J O Harker, A Salvà, Y Guigoz, B Vellas<br><br>Developed a 2-step process & Valited<br><br>6 questions</td><td>MJ Kaiser, JM, Bauer, C Ramsch, W, Uter, Y Guigoz, T Cederholm, D R Thomas, P Anthony, KE Charlton, M Maggio, A C Tsai, D Grathwohl, B Vellas, CC Sieber, MNA-International Group<br><br>Validated as a stand-alone screening tool based on the MNA® Full form<br><br>6 questions Includes option for Substituting BMI for CC</td><td>M B Huhmann, V Perez, DD Alexander, D R Thomas<br><br>Validated for self-assessment<br><br>6 questions Includes option for Substituting BMI for CC</td><td>MNA®: The 6-item MNA® is the preferred tool of busy clinicians for nutritional screening.<br><br>MNA® Full form: The 18-item MNA® is useful as a more in-depth assessment.<br><br>Self-MNA®: The Self-MNA® can be used by older adults to determine if they have specific nutritional risks.</td></tr><tr><td></td><td>Facts & Res Gerontol 1994;2:15-70</td><td>J Gerontol 2001;56:M366-M372</td><td>J Nutr Health Aging 2009;13(4):782-788</td><td>J Nutr Health Aging 2013;17(4):339-344</td><td></td></tr></tbody></table>

https://www.MNA®-elderly.com. The validity of substituting CC for BMI has been further validated (10-12).

In 2012 the Self-MNA® was developed (13) and validated in community-dwelling older adults, results shared with their family medicine (14). It takes 3-5 minutes. If we want to, improve the health of older persons self-management and participative care are very useful underlining the importance of such tool (15, 16).

MNA® use in clinical research

As we can see in table 1, more than 2000 clinical research have used the MNA® all over the world on many topics from frailty to hip fractures, from community care to hospital (see recent publications 2018-2020 (1, 14-226) and MNA® and MNA®-SF tables Identifying the elderly at risk of malnutrition (Tables 2 – 13). We observed a prevalence of malnutrition of 5 % (SE 0.1) and 4.3 % (SE 0.1) in the community for MNA® and MNA®-SF respectively; of 11 % (SE 0.2) and 11.0% (SE 0.3) for the frail elderly (outpatients and home care) respectively. A Higher prevalence of malnutrition is observed in hospitals, 22 % (SE 0.2) and 29 % (SE 0.3) for MNA® and MNA®-SF; and for institutionalized elderly 18 % (SE 0.3) and 22 % (SE 0.4) respectively. Cognitively impaired elderly and Parkinson's disease patients have similar prevalence to the frail elderly, 14 % (SE 0.4), and 6.3 (SE 0.9) for MNA®. (see Table 14: Prevalence of malnutrition and risk of malnutrition in different settings).

The MNA® and MNA®-SF have been validated in many

studies, used as reference standard to validate other screening tools and compared to following screening tools: MUST, NRS-2002, GNRI, SGA, PG-SGA, NRI, SNAQ, MST, and NUTRI score, in different settings, community, home care, nursing homes and hospitals (20, 30, 34, 42; 47, 53, 123, 181, 227-258). The sensitivity and specificity of the MNA® are 80% (SD 13) and 68% (SD 22), respectively, against a wide range of criteria in 40 studies (see table 15: MNA® Sensitivity/Specificity against Nutritional assessment parameters & other parameters) (140, 222, 227, 228, 235, 241, 246, 248, 259-287). The same is true for the MNA®-SF with a sensitivity of 87% (SD 10) and a specificity of 85% (SD 15) against the MNA®, and a sensitivity of 81% (SD 18) and a specificity of 63 % (SD 20) against a wide range of criteria in 43 studies (Tables 16 & 17) (8, 12, 20, 41, 54, 67, 140, 222, 227, 228, 230, 234, 235, 240, 247, 266, 270, 278, 282, 284, 286, 288-307). In general, it can be observed that MNA®-SF and MNA® are the most used tools to evaluate the risk of malnutrition in the elderly, independent of the setting, with high sensitivity, ≥ 80%, and a good specificity, ≥ 60% (Tables 15 - 17), and see meta-analysis/systematic review, reviews, and content validity (1, 43, 47, 149, 182, 221, 308-320). MNA®-SF and MNA® are appropriate screening and assessment tools for use in community-dwelling elderly (321), and all other geriatric settings (205, 322-329). Further the MNA®s are the only tools to evaluate the intake of nutrient-rich food groups, which allow for implementation of nutritional intervention. Discrepancies with other screening tools come mainly from the dietary assessment and the difference in weight
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<figure><img src="image_2.png" /><figcaption>**Table 1**
MNA®: Publications
As of October 2020, at least 2500 articles have been published using the MNA®, covering a broad range topics</figcaption></figure>

<table><thead><tr><th>Search terms e.g. Medline</th><th>n Publications</th></tr></thead><tbody><tr><td><strong>Frailty / Sarcopenia</strong><br>[(«Sarcopenia»[Mesh]) OR «Frailty»[Mesh] AND [«Mini Nutritional Assessment» OR MNA®-SF]]</td><td>436</td></tr><tr><td><strong>Functionality</strong><br>«Physical Fitness»[Mesh] AND [«Mini Nutritional Assessment» OR MNA®-SF]</td><td>365</td></tr><tr><td><strong>Disability</strong><br>«Disability Evaluation»[Mesh] AND [«Mini Nutritional Assessment» OR MNA®-SF]</td><td>262</td></tr><tr><td><strong>Community</strong><br>[«Community Health Services»[Mesh] OR «Community Medicine»[Mesh]] AND [«Mini Nutritional Assessment» OR MNA®-SF]</td><td>405</td></tr><tr><td><strong>Outpatient/Home care</strong><br>[(«Home Care Services»[Mesh]) OR «Outpatients»[Mesh]] AND [«Mini Nutritional Assessment» OR MNA®-SF]</td><td>405</td></tr><tr><td><strong>Hospital setting</strong><br>«Hospitals»[Mesh] AND [«Mini Nutritional Assessment» OR MNA®-SF]</td><td>387</td></tr><tr><td><strong>Nursing home / Long term care</strong><br>[(«Nursing Homes»[Mesh]) OR «Long-Term Care»[Mesh]] AND [«Mini Nutritional Assessment» OR MNA®-SF]</td><td>483</td></tr><tr><td><strong>Cognitively impaired elderly</strong><br>[(«Memory Disorders»[Mesh]) OR «Dementia»[Mesh]] AND [«Mini Nutritional Assessment» OR MNA®-SF]</td><td>456</td></tr><tr><td><strong>Total publications Medline</strong><br>«Mini Nutritional Assessment» OR MNA-SF</td><td>1604</td></tr></tbody></table>

loss evaluation. It is the only assessment tool assessing two «functional concept» related to muscle and cognitive function. MNA® can be improved by the addition of inflammatory factors or other biological nutritional biomarkers when needed.

The MNA® appears also to be useful as primary criteria for intervention studies, and move positively in several major studies (56, 89, 98, 330-334).

Further, the MNA® appears useful to measure frail older persons, especially when the MNA® is between 17 and 23.5 (27, 286, 303, 335, 336). Malnutrition and physical frailty seem to be strongly related, however, they should be assessed separately within the geriatric assessment (313, 317, 326, 337-341).

**MNA® use in clinical practice**

At least 22 Expert groups included the MNA® in new clinical practice guidelines, national or international registries (113, 116, 131, 132, 136, 151, 189, 190, 319, 324, 342-377). New Global Leadership in Malnutrition (132) consensus publication outlines the diagnostic criteria for malnutrition, for application in clinical settings (131, 151). GLIM Committee involved major global clinical nutrition societies: ASPEN, ESPEN, FELANPE, PENSA representatives (Tables 18). 42 Electronic Health Record Software Companies have incorporated MNA® in software, 22 APPS for Smartphones, tablets have incorporated MNA® (Table 19).
THE JOURNAL OF NUTRITION, HEALTH & AGING

<figure><img src="image_3.png" /><figcaption>**Figure 3**
W.H.O Icope Pogram</figcaption></figure>

Notably, the MNA® screening tool evaluates items that are similar to relevant criteria that GLIM established for the diagnosis of malnutrition (202, 378). Furthermore for the evaluation of malnutrition in the elderly, the MNA® with its two step procedure a) screening with MNA®-SF and b) nutritional status evaluation with the MNA® full form can be completed with evaluation of nutritional makers (e.g. as serum C-reactive protein and transthyretin (prealbumin) (379-386)) or the GLIM criteria (131, 206, 207, 223, 376, 387). This is of importance to separate malnutrition from inflammation, when undernutrition is due to disease related cachexia (174, 380, 383, 388-391). MNA® fulfill the two steps, screening followed by assessment, required by the GLIM criteria procedure for the diagnosis of protein-energy malnutrition in elderly (376, 377), and provides guidance for nutritional intervention. Elderly with malnutrition or at risk of malnutrition should have a nutritional intervention with multidisciplinary team in order to support adequate dietary intake, maintain or increase body weight and/or improve functional and clinical outcome (184, 189, 190, 363, 392).

MNA® and Healthy aging

For the W.H.O Healthy aging is the capacity to maintain function, to be able to do what we value. The ICOPE step 1 includes some nutrition assessment (weight loss, poor appetite), and MNA® is part of the ICOPE program step 2, Integrated care of older persons (figure 3) to maintain functions in older adults (393-395). Our practice needs really to move to prevention and ambulatory care. We need to provide good nutrition to the

senior citizen and monitor their nutritional status, the aims of ICOPE Monitor apps part of the Inspire program is to monitor the main function including nutrition in older adults. The links between Nutrition and Geroscience for a healthy aging have to be studied (396, 397).

Perspective for the future have of course to treat undernutrition in sick old adults; however, the urgent need is to target the frail older adults more likely to have weight loss and poor appetite. To do it, program for early detection of the risk of malnutrition should be implemented as it is in development in Netherlands (80, 81, 115, 184), the NUDAD (Nutrition, the unrecognized determinant in Alzheimer's disease) study (139, 398) and within the Integrated Care for Older People (ICOPE) with the implementation of the INSPIRE study (213, 394, 399). Further the geriatric assessment to be comprehensive should include the MNA®-SF as nutrition parameters and all the elderly detected at risk of malnutrition or malnourished should be further evaluated with GLIM criteria, and MNA® to be able to implement a nutritional intervention. The best MNA® score to predict healthy aging is still to be determined

Funding: Educational Research grant by Nestlé Research Center to develop the MNA®. Publication fees and open access were funded by Nestlé Health Science.

Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 2**
MNA®-SF Clinical practice: Community-dwelling elderly - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age [year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished &lt;8</th><th>At risk of malnutrition 8 - 11</th><th>Well-nourished ≥12</th></tr></thead><tbody><tr><td>Free-living elderly at community pharmacists - Men</td><td>8014</td><td>75.2 ± 6.6</td><td></td><td>67</td><td>33</td><td>2009</td><td>Spain</td><td>Cuervo M. et al. (2008) Arch Gerontol Geriatr 2009;49(1):69-73<br>Public Health Nutr 2008;12(1):82-90</td></tr><tr><td>Free-living elderly at community pharmacists - Women</td><td>13993</td><td>75.2 ± 6.9</td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Community dwelling patients: NutriAction Study</td><td>975</td><td>79.5 ± 7.2</td><td>36</td><td></td><td>64</td><td>2013</td><td>Belgium</td><td>Arvanitakis M. et al. (2013) e-SPEN Journal 2013;8: e213-e215<br>(Aging Clin Exp Res 2019;31:175-183</td></tr><tr><td>Elderly patients at inpatient ward of internal medicine and neurology</td><td>77</td><td>over 60 years old</td><td>53</td><td></td><td>47</td><td>2014</td><td>Indonesia</td><td>Prasetyo W.H. et al. (2014)<br>Indonesian journal of nutrition and dietetics 2014;2:75-84</td></tr><tr><td>Community-dwelling older population: the VERISAÚDE study</td><td>749</td><td>75.8 ± 7.2</td><td>14</td><td></td><td>86</td><td>2016</td><td>Spain</td><td>Maseda A. e<br>Public Health Nutr. 2016;19(12):2220-2228</td></tr><tr><td>Elderly living alone or on a low income in three rural regions of Korea</td><td>187</td><td>77.4 ± 5.1</td><td>78</td><td></td><td>22</td><td>2018</td><td>Korea</td><td>Jang I.-Y. et al. (2018) Clin Interv Aging 2018;13:1799-1814</td></tr><tr><td>Older adults aged ≥65 years, representative of the Portuguese older population: Nutrition UP 65 study</td><td>1495</td><td>74.9 ± 7.0 (65 - 100)</td><td>16</td><td></td><td>84</td><td>2018</td><td>Portugal</td><td>Mendes J. et al<br>Sci Rep 2018;8: 4227<br>Sousa-Santos A.R. et al<br>Nutr Diet 2019;76:604-612</td></tr><tr><td>Community-dwelling (98%) and institutionalized (2%) adults aged ≥ 65: Toledo Study on Healthy Ageing</td><td>1660</td><td>75.6 ± 6.3</td><td>26</td><td></td><td>74</td><td>2020</td><td>Spain</td><td>Rodríguez-Mañas L. et al.<br>Clinicoecon Outcomes Res 2020;12:355-367<br>Clin Nutr Online 2020 Aug 4</td></tr><tr><td>"Survey of Health and Living Status of the Elderly in Taiwan", population-based longitudinal cohort study: wearing fixed denture</td><td>833</td><td>≥ 65</td><td>3</td><td>18</td><td>79</td><td>2011</td><td>Taiwan</td><td>Tsai A. et al.<br>J Nutr Health Aging 2011;15:265-270</td></tr><tr><td>removable-denture</td><td>1237</td><td></td><td>4</td><td>21</td><td>74</td><td></td><td></td><td></td></tr><tr><td>no denture</td><td>696</td><td></td><td>6</td><td>20</td><td>74</td><td></td><td></td><td></td></tr><tr><td>Home-dwelling older people, ≥65 years of age, living in five counties in southern Norway</td><td>1915</td><td>74.5 ± 6.9</td><td>2</td><td>12</td><td>87</td><td>2012</td><td>Norway</td><td>Söderhamn U. et al.<br>Clin Interv Aging 2012;7:383-391</td></tr><tr><td>Elderly ≥75 years, invited for annual health assessments at a general medical practice</td><td>225</td><td>81.3 ± 4.3</td><td>0</td><td>16</td><td>83</td><td>2013</td><td>Australia</td><td>Winter J. et al.<br>J Nutr Health Aging 2013;17:322-325</td></tr><tr><td>Randomly selected sample of community-dwelling older people aged ≥75</td><td>696</td><td>81 ± 4.6</td><td>1</td><td>15</td><td>84</td><td>2013</td><td>Finland</td><td>Nykänen I. et al.<br>Eur J Public Health. 2013;23(3):405-409</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

Table 2 (continued)

MNA®-SF Clinical practice: Community-dwelling elderly - Identifying the elderly/adults at risk of malnutrition

<table><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age [year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished &lt;8</th><th>At risk of malnutrition 8 - 11</th><th>Well-nourished ≥12</th></tr></thead><tbody><tr><td>Community-dwelling subjects urban environment MNA®-SF with BMI</td><td>932</td><td>71.7 ± 5.3</td><td>5</td><td>29</td><td>66</td><td>2014</td><td>Poland</td><td>Kostka J. et al. J Nutr Health Aging 2014;18:366-371 Eur J Clin Nutr 2014;68:1210-1215</td></tr><tr><td>MNA®-SF with Calf circumference</td><td></td><td></td><td>4</td><td>30</td><td>65</td><td></td><td></td><td></td></tr><tr><td>Community-dwelling subjects rural environment MNA®-SF with BMI</td><td>812</td><td>73.0 ± 6.6</td><td>12</td><td>37</td><td>51</td><td>2014</td><td>Poland</td><td>Kostka J. et al. J Nutr Health Aging 2014;18:366-371 Eur J Clin Nutr 2014;68:1210-1215</td></tr><tr><td>MNA®-SF with Calf circumference</td><td></td><td></td><td>16</td><td>39</td><td>45</td><td></td><td></td><td></td></tr><tr><td>Individuals aged ≥ 75 living in the community.</td><td>640</td><td>81.3 ± 5.0</td><td>2</td><td>20</td><td>77</td><td>2014</td><td>Spain</td><td>Jürschik P. et al. Med Clin (Barc) 2014;143:191-195</td></tr><tr><td>Community-dwelling adults in KwaZulu-Natal</td><td>984</td><td>68.9 ± 7.4</td><td>6</td><td>43</td><td>51</td><td>2015</td><td>South Africa</td><td>Naidoo I. et al. J Health Popul Nutr 2015;33:19 Narainsamy J. et al. S Afr J Psychiatr 2015;21(1):13-18</td></tr><tr><td>Community elderly from the SenTo-pael, Wageningen project</td><td>345</td><td>67.1 ± 6.0</td><td>0</td><td>11</td><td>89</td><td>2015</td><td>The Netherlands</td><td>Toussaint N. et al. Chem Senses 2015;40(3):197-203</td></tr><tr><td>Community-dwelling older adults, random sample: Swedish National study on Aging and Care-Kungsholmen</td><td>3041</td><td>73.7 ± 10.7</td><td>2</td><td>25</td><td>74</td><td>2016</td><td>Sweden</td><td>Shakersain B. et al. Eur J Clin Nutr 2016;70:320-325</td></tr><tr><td>Free-living elderly in the province of Valencia selected in 12 community centres MNA®-SF BMI MNA®-SF CC</td><td>660</td><td>74.3 ± 6.6</td><td>1</td><td>27</td><td>73</td><td>2017</td><td>Spain</td><td>Montejano Lozoya R. et al. PeerJ 2017;5:e3345</td></tr><tr><td>Community dwelling elderly</td><td>432</td><td>72 ± 10</td><td>0</td><td>69</td><td>31</td><td>2017</td><td>Taiwan</td><td>Chang S.-F. J Nurs Scholarsh 2017;49:63-72</td></tr><tr><td>Cross-sectional study of population-based cohort (Singapore Longitudinal Ageing Study</td><td>5697</td><td>66.6 ± 7.8</td><td>3</td><td>28</td><td>70</td><td>2017</td><td>Singapore</td><td>Wei K. et al. J Am Med Dir Assoc 2017;18(12):1019-1028</td></tr><tr><td>Community dwelling elderly from various settings in Tabriz (mosques, parks, organizations offering activities for older people, and advertisements)</td><td>164</td><td>74 ± 8.3</td><td>7</td><td>26</td><td>62</td><td>2018</td><td>Iran</td><td>Saghafi-Asl M. et al. Aging Clin Exp Res 2018;30:1117-1125</td></tr><tr><td>Home dwelling elderly individuals</td><td>407</td><td>72 ± 6</td><td>4</td><td>22</td><td>74</td><td>2018</td><td>Turkey</td><td>Acar-Tek N. & Karaçil-Ermumcu M.Ş. (2018) J Nutr Health Aging 2018;22:996-1002</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 2 (Continued)**
MNA®-SF Clinical practice: Community-dwelling elderly - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age [year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished &lt;8</th><th>At risk of malnutrition 8 - 11</th><th>Well-nourished ≥12</th></tr></thead><tbody><tr><td>Dutch community-dwelling older adults: PhysioDom HDIM project</td><td>97</td><td>78.4 ±7.2</td><td>1</td><td>20</td><td>79</td><td>2018</td><td>The Netherlands</td><td>van Doorn-van Atten M.N.<br>Public Health Nutr 2018;22(2):363-374<br>British J Nur 2018;119:1185-1194</td></tr><tr><td>Community-dwelling persons ≥75 years of age from Alabama: University of Alabama at Birmingham (1) Study of Aging II</td><td>414</td><td>81.6 ± 4.7</td><td>12</td><td>52</td><td>37</td><td>2018</td><td>U.S.A.</td><td>Buys D.R. et al.<br>Fam Community Health 2018;41:S33-S45</td></tr><tr><td>Population-based cohort study, community-dwelling adults in Singapore aged 55 years or older at baseline</td><td>2726</td><td>66.0 ± 7.7</td><td>4</td><td>31</td><td>65</td><td>2018</td><td>Singapore</td><td>Wei K. et al.<br>JAMA Network Open 2018;1:e180650<br>J Nutr Health Aging 2018;22:1221-1227</td></tr><tr><td>Community-dwelling residents in urban and rural regions nationwide: Korean Frailty and Aging Cohort Study</td><td>1473</td><td>76.1 ± 3.9</td><td>1</td><td>14</td><td>86</td><td>2018</td><td>Republic of Korea</td><td>Kim J. et al.<br>J Nutr Health Aging 2018;22:774-778</td></tr><tr><td>Patients referring to the GP offices Women</td><td>125</td><td>75.1 ± 8</td><td>11</td><td>23</td><td>66</td><td>2018</td><td>Italy</td><td>Donini L. et al.<br>J Nutr Health Aging 2018;22:44-52</td></tr><tr><td>Men</td><td>101</td><td>75.3 ± 8</td><td>5</td><td>26</td><td>69.6</td><td></td><td></td><td></td></tr><tr><td>Community dwelling patients: NutriAction II Study</td><td>819</td><td>82.7 ± 6.1</td><td>7</td><td>29</td><td>63</td><td>2019</td><td>Belgium</td><td>Vandewoude M.F.J. et al.<br>Aging Clin Exp Res 2019;31:175-183<br>Aging Clin Exp Res 2019;31:295-298</td></tr><tr><td>(Sarcopenia and Physical Impairment with advancing Age)</td><td>411</td><td>73.2 ± 6.1</td><td>2</td><td>11</td><td>87</td><td>2020</td><td>Belgium</td><td>Sanchez-Rodriguez D. et al. (J Cachexia Sarcopenia Muscle 2020;11:1200-1211)</td></tr><tr><td>75 years or older, community-dwelling participants Village with canteen</td><td>140</td><td>83.1 ± 4.2</td><td>3</td><td>30</td><td>67</td><td>2020</td><td>China</td><td>Wang X. et al.<br>BMC Public Health. 2020;20(1):230.</td></tr><tr><td>Village without canteen</td><td>144</td><td></td><td>5</td><td>31</td><td>64</td><td></td><td></td><td></td></tr><tr><td>Elderly living in 10 randomly selected People's Housing Projects (PPR) flats at Kuala Lumpur</td><td>301</td><td>67.1 ± 5.5</td><td>3</td><td>30</td><td>67</td><td>2020</td><td>Singapore</td><td>Norazman C.W. et al. Nutrients 2020;12(6):1713;</td></tr><tr><td>Community-dwelling seniors ≥ 65 years of age from three towns in Bosnia and Herzegovina</td><td>821</td><td>74.1 ± 5.4</td><td>7</td><td>49</td><td>44</td><td>2020</td><td>Bosnia and Herzegovina</td><td>Pavlović J.R. et al.<br>Public Health Nutr 2020;on line September 01, 2020</td></tr></tbody></table><table><thead><tr><th>Community-dwelling elderly</th><th>Under-nourished &lt;8</th><th>At risk of malnutrition 8 - 11</th><th>Well-nourished ≥12</th></tr></thead><tbody><tr><td>Total n</td><td>53617</td><td>mean</td><td>4</td><td>27</td><td>69</td></tr><tr><td></td><td></td><td>SE</td><td>0.1</td><td>0.01</td><td>0.2</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>**Table 3**
MNA® -SF Clinical practice: elderly – Hospital Settings - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation<br/>[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Undernourished & At risk<br/>of malnutrition<br/>&lt;8</th><th>8 - 11</th><th>≥12</th></tr></thead><tbody><tr><td>Consecutive patients ≥ 60 years<br/>admitted to General surgical and<br/>Urological wards for surgery</td><td>190</td><td>69 ± 7.1</td><td>35</td><td></td><td>65</td><td>2004</td><td>Thailand</td><td>Reodecha P. et al. J Med Assoc<br/>Thai 2004;87(3):289-295</td></tr><tr><td>Patients admitted to a Brazilian<br/>public university hospital</td><td>516</td><td>&gt;18 year</td><td>73</td><td></td><td>27</td><td>2010</td><td>Brazil</td><td>Raslan M. et al. Nutrition<br/>2010;26:721-726</td></tr><tr><td>Patients admitted to the<br/>neurological and neurosurgical<br/>wards</td><td>196</td><td>66 ± 13</td><td>41</td><td></td><td>59</td><td>2010</td><td>The Netherlands</td><td>Hafsteinsdóttir T.B. et al. J<br/>Clin Nurs 2010;19:639-648</td></tr><tr><td>Hospitalised patients</td><td>101</td><td>≥ 65</td><td>97</td><td></td><td>3</td><td>2011</td><td>The Netherlands</td><td>Neelemmaat F. et al. J Clin<br/>Nurs 20:2144-52</td></tr><tr><td>Short-stay geriatric department in<br/>nine French hospital centers</td><td>1306</td><td>85 ± 6</td><td>74</td><td></td><td>26</td><td>2012</td><td>France</td><td>Dramé M. et al. Rev Epidemiol<br/>Sante Publique 2012;60:189-196</td></tr><tr><td>Patients admitted to three<br/>different internal medicine units</td><td>106</td><td>79.4</td><td>81</td><td></td><td>19</td><td>2012</td><td>Spain</td><td>Calvo I. et al. Nutr Hosp<br/>2012;27:1619-1625</td></tr><tr><td>Patients undergoing Transcatheter<br/>aortic valve implantation (TAVI)</td><td>119</td><td>83.4 ± 4.6</td><td>45</td><td></td><td>56</td><td>2013</td><td>Switzerland</td><td>Schoenenberger A.W. et al. Eur<br/>Heart J 2013;34:684-692</td></tr><tr><td>Patients ≥70 years with colorectal<br/>cancer</td><td>143</td><td>75 (70-92)</td><td>27</td><td></td><td>73</td><td>2013</td><td>The Netherlands</td><td>Aaldriks A.A. et al. Geriatr<br/>Oncol 2013;4:218-226</td></tr><tr><td>Elderly patients admitted for<br/>surgery</td><td>142</td><td>71.8 ± 5.4 women<br/>72.0 ± 5.9 men</td><td>45</td><td></td><td>55</td><td>2015</td><td>China</td><td>Zhou J. et al. Nutr J 2015<br/>;14:68</td></tr><tr><td>Older adults admitted to rural<br/>rehabilitation facilities</td><td>57</td><td>79.1 ± 7.3</td><td>88</td><td></td><td>12</td><td>2016</td><td>Australia</td><td>Marshall S. et al. J Acad Nutr<br/>Diet 2016;116:795-801</td></tr><tr><td>Ambulatory patients with chronic<br/>heart failure</td><td>130</td><td>66.3 ± 11.5</td><td>26</td><td></td><td>74</td><td>2016</td><td>Germany</td><td>Saitoh M. et al. Wien Klin<br/>Wochenschr 2016;128:497-504</td></tr><tr><td>Geriatric trauma patients</td><td>50</td><td>84.9 ± 5</td><td>62</td><td></td><td>38</td><td>2016</td><td>Germany</td><td>Goost H. et al. Technology<br/>and Health Care 24 (2016)<br/>225-239</td></tr><tr><td>Hospitalized patients of a<br/>Department of Arthroplasty</td><td>351</td><td>67.9 (28-91)</td><td>24</td><td></td><td>76</td><td>2018</td><td>Germany</td><td>Ihle C. et al. BMC Musculos-<br/>keletal Disorders 2018;19:83</td></tr><tr><td>Elderly, aged ≥ 65 years,<br/>hospitalized</td><td>181</td><td>≥ 65</td><td>58</td><td></td><td>42</td><td>2018</td><td>Spain</td><td>Castro-Vega I. et al. Nutr Hosp<br/>2018;35:351-358</td></tr><tr><td>Elderly patients with<br/>gastrointestinal cancer</td><td>255</td><td>76.5 ± 4.8</td><td>48</td><td></td><td>52</td><td>2018</td><td>China</td><td>Ye X-J. et al. BMJ Open.<br/>2018;8(4):e019750</td></tr><tr><td>Adult cancer patients (20-59.9<br/>years) and elderly patients (≥<br/>60 years)</td><td>63</td><td>64.2 ± 12.0</td><td>68</td><td></td><td>32</td><td>2018</td><td>Brazil</td><td>Lima E.M.B. et al. Nutr Hosp<br/>2018;35(5):1138-1144</td></tr><tr><td>Adult vascular surgery patients at<br/>hospital admission</td><td>322</td><td>67.6 ± 14.1</td><td>48</td><td></td><td>53</td><td>2019</td><td>Australia</td><td>Thomas J. et al. Br J Nutr<br/>2019;122:689-697</td></tr><tr><td>Outpatients ≥70 years at the<br/>Emergency Department of the<br/>University Clinical Hospital of<br/>Valladolid</td><td>288</td><td>81.1 ± 6.6</td><td>64</td><td></td><td>36.1</td><td>2019</td><td>Spain</td><td>Bolado Jiménez C. et al. Nutri-<br/>tion 2019;66:142-1466</td></tr><tr><td>Patients in medical wards of<br/>the University College Hospital<br/>(UCH), Ibadan</td><td>350</td><td>71.5 ± 8.0</td><td>5</td><td></td><td>95</td><td>2019</td><td>Nigeria</td><td>Adebusoye, L. et al. Ghana<br/>Med J 2019;53(3):210-216</td></tr><tr><td>Patients aged over 65 years with<br/>cardiovascular diseases</td><td>76</td><td>80</td><td>72</td><td></td><td>28</td><td>2019</td><td>Poland</td><td>Ostrowska, J. et al. J Hum Nutr<br/>Diet. 2019;32(1):119-127</td></tr><tr><td>Consecutive patients, admitted for<br/>the first time to the department of<br/>geriatrics</td><td>358</td><td>82 (76-86)</td><td>13</td><td></td><td>87</td><td>2020</td><td>Poland</td><td>Magnuszewski L. et al. Int J<br/>Environ Res Public Health.<br/>2020;17(13):4768</td></tr><tr><td>Older patients undergoing pace-<br/>maker implantation</td><td>197</td><td>82.9 ± 4.9</td><td>46</td><td></td><td>54</td><td>2020</td><td>Switzerland</td><td>Schoenenberger A.W. et al.<br/>BMC Geriatr 2020;20:287</td></tr><tr><td>Patients ≥50 years admitted in<br/>medical and surgical services of<br/>six hospitals in Togo</td><td>520</td><td>61 (55-70)</td><td>95</td><td></td><td>5</td><td>2020</td><td>Togo</td><td>Gbeasor-Komlanvi F.A. et<br/>al.BMC Geriatr 2020;20:507</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 3 (continued)**
MNA®-SF Clinical practice: elderly – Hospital Settings - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th>Setting</th><th>n</th><th>Age<br/>[year]</th><th colspan="3">Nutritional status evaluation<br/>[% of subjects]</th><th>Pub Year</th><th>Country</th><th>Reference</th></tr><tr><th></th><th></th><th></th><th>Undernourished & At risk<br/>of malnutrition</th><th>Well-nourished</th><th></th><th></th><th></th><th></th></tr><tr><th></th><th></th><th></th><th>&lt;8</th><th>8 - 11</th><th>≥12</th><th></th><th></th><th></th></tr></thead><tbody><tr><td>Consecutive patients aged ≥65 years admitted to and discharged from a 900-bed academic hospital</td><td>5867</td><td>76.0 ± 7.0</td><td>46</td><td>54</td><td>2020</td><td>Japan</td><td>Ishida Y. et al. Geriatr Gerontol Int 2020;20:811-816</td></tr><tr><td>Patients undergoing transcatheter aortic valve implantation (TAVI).</td><td>288</td><td>83.5 ± 5.7</td><td>65</td><td>35</td><td>2020</td><td>Japan</td><td>Doi S. et al. ESC heart failure Online 2020 Sept 10</td></tr></tbody></table><table><thead><tr><th>Setting/Conditions</th><th>n</th><th>Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th>Pub Year</th><th>Country</th><th>Reference</th></tr><tr><th></th><th></th><th></th><th>Under-nourished</th><th>At risk of malnutrition</th><th>Well-nourished</th><th></th><th></th><th></th></tr><tr><th></th><th></th><th></th><th>&lt;8</th><th>8-11</th><th>12-14</th><th></th><th></th><th></th></tr></thead><tbody><tr><td>Patients aged 65 + y admitted to two rehabilitation hospitals</td><td>1615</td><td></td><td>40</td><td>52</td><td>8</td><td></td><td>Australia</td><td>Charlton K.E. J Nutr Health Aging 2010;4:622-628</td></tr><tr><td>MNA®-SF with BMI</td><td></td><td>81 ± 28</td><td></td><td></td><td></td><td>2010</td><td></td><td></td></tr><tr><td>MNA®-SF with Calf circumference</td><td>1512</td><td></td><td>42</td><td>49</td><td>9</td><td></td><td></td><td></td></tr><tr><td>Patients receiving geriatric inpatient care</td><td>444</td><td>85.3 ± 6.7</td><td>26</td><td>51</td><td>24</td><td>2012</td><td>Switzerland</td><td>Vischer U.M. et al. Clin Nutr 2012;31:113-117 & Zekry D. et al. J Nutr Health Aging. 2012;16(3):225-230</td></tr><tr><td>Elderly subjects admitted to either, the surgical and the medical ICU at a tertiary care hospital</td><td>250</td><td>74.2 ± 6.8</td><td>6</td><td>20</td><td>74</td><td>2013</td><td>U.S.A.</td><td>Sheean P.M. et al. Clin Nutr 2013;32:752-757</td></tr><tr><td>Rehabilitation and treatment center for the elderly</td><td>49</td><td>70</td><td>61</td><td>39</td><td>0</td><td>2013</td><td>Switzerland</td><td>Reinert R. et al. Rev Med Suisse. 2013;9(406):2115-2119</td></tr><tr><td>Patients (&gt;18 years old) with advanced heart failure</td><td>162</td><td>&gt;18</td><td>31</td><td>48</td><td>22</td><td>2014</td><td>U.S.A.</td><td>Yost G. et al. Nutr Clin Pract. 2014;29(5):686-691</td></tr><tr><td>Acute care hospital patients on admission</td><td>1333</td><td>74 (65 - 97)</td><td>23.3</td><td>26</td><td>51</td><td>2014</td><td>Austria</td><td>Dorner T.E. et al. J Nutr Health Aging 2014;18:264-269</td></tr><tr><td>Inpatients diagnosed with hospital-associated deconditioning</td><td>169</td><td>79 ± 7</td><td>88</td><td>12</td><td>0</td><td>2014</td><td>Japan</td><td>Wakabayashi H. et al. J Reha-bil Med 2014;46:277-282</td></tr><tr><td>Consecutive patients admitted to the cardiology unit of a tertiary care hospital</td><td>526</td><td>58.5 ± 12 (22 - 85)</td><td>6</td><td>64</td><td>30.4</td><td>2014</td><td>Sri Lanka</td><td>Pathirana A. K. SpringerPlus 2014;3:412</td></tr><tr><td>aged patients consecutively admitted to the acute geriatrics medical ward of Geriatrics and Gerontology department in Ain Shams University hospitals, Cairo</td><td>131</td><td>69.3 ± 8.2</td><td>43</td><td>47</td><td>10.7</td><td>2014</td><td>Egypt</td><td>Abd-El-Gawad W.M. et al. Clin Nutr 2014;33:1108-1116</td></tr><tr><td>Elderly patients hospitalized at a geriatric care hospital</td><td>141</td><td>73.5 ± 5.2</td><td>28</td><td>48</td><td>25</td><td>2015</td><td>Korea</td><td>Baek M-H. & Heo Y-R. Nutr Res Pract 2015;9:637-643</td></tr><tr><td>Patients with Postoperative Acute Care Unit admission after general surgery, and surgery related to orthopedics and urology</td><td>150</td><td>&gt;18 year</td><td>33</td><td>62</td><td>5</td><td>2016</td><td>Turkey</td><td>Özbilgin Ş. et al. Medicine 2016;95:e5038</td></tr><tr><td>Hospitalized pre-dialysis patients</td><td>33</td><td>73 ± 7</td><td>46</td><td>39</td><td>15</td><td>2016</td><td>Turkey</td><td>Buyukaydin B. et al. J Aging Res Clin Practice 2016;5(3):158-161</td></tr><tr><td>Patients hospitalized in the general geriatric and internal medicine units</td><td>392</td><td>84.8 ± 6.3</td><td>14</td><td>44</td><td>42</td><td>2016</td><td>Switzerland</td><td>Frangos E. et al. J Nutr Health Aging 2016;20:705-713</td></tr><tr><td>Older hip fracture patients, aged ≥ 65 years</td><td>472</td><td>84 (77-91)</td><td>9</td><td>42</td><td>49</td><td>2016</td><td>Finland</td><td>Nuotio M. et al. Eur J Clin Nutr 2016;70:393-398</td></tr><tr><td>Orthopedic and traumatology patient cohort</td><td>399</td><td>≥ 65</td><td>7</td><td>27.3</td><td>65</td><td>2017</td><td>Germany</td><td>Lambert C. et al. Nutrition 2017;37:60-67</td></tr><tr><td>Hospitalised trauma patients</td><td>521</td><td>54 ± 18.1</td><td>6</td><td>30</td><td>64</td><td>2017</td><td>Germany</td><td>Ihle c. et al. Z Orthop Unfall 2017;155:184-193</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

Table 3 (continued)

MNA® -SF Clinical practice: elderly – Hospial Settings - Identifying the elderly/adults at risk of malnutrition

<table><thead><tr><th rowspan="2">Setting/Conditions</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;8</th><th>At risk of malnutrition<br/>8-11</th><th>Well-nourished<br/>12-14</th></tr></thead><tbody><tr><td>Hospitalized elderly patients</td><td>248</td><td>70.0 ± 7.7</td><td>29</td><td>48</td><td>23</td><td>2017</td><td>Saudi Arabia</td><td>Alzahrani S.H. et al. BMC Geriatrics 2017;17(1):136</td></tr><tr><td>Hospitalized older diabetics and middle-aged patients, geriatric outpatients, and healthy elderly and young individuals</td><td>88</td><td>85.2 ± 6.2</td><td>76</td><td>24</td><td>0</td><td>2017</td><td>Spain</td><td>Sánchez-Rodríguez D. et al. Clin Nutr 2017;36:1339-1344</td></tr><tr><td>Patients, aged ≥ 65 who have undergone an operation for a traumatic hip fracture</td><td>71</td><td>85.4 ± 6.3</td><td>18</td><td>48</td><td>34</td><td>2017</td><td>Spain</td><td>Malafarina V. et al. Maturitas 2017;101:42-50</td></tr><tr><td>Elderly aged ≥ 70 years undergoing hip fracture surgery</td><td>415</td><td>84.0 ± 6.6</td><td>19</td><td>45</td><td>37</td><td>2017</td><td>Italy</td><td>Mazzola P. et al. J Am Geriatr Soc 2017;65:1222-1228</td></tr><tr><td>Hip fracture patients age &gt;65 years admitted to a rehabilitation unit</td><td>218</td><td>83.5 ± 7.5</td><td>26</td><td>53</td><td>21</td><td>2017</td><td>Hong Kong China</td><td>Miu K.Y.D. and Lam P.S. Ann Rehabil Med 2017;41:1005-1012</td></tr><tr><td>Elderly consecutively admitted to the geriatric acute care ward</td><td>342</td><td>83.1 ± 6.8</td><td>11</td><td>45</td><td>44</td><td>2018</td><td>Germany</td><td>Pourhassan M. et al. Clinical Nutrition 2018;37:1354e1359</td></tr><tr><td>Elderly consecutively admitted at geriatric hospital ward</td><td>358</td><td>82.1 ± 8.2</td><td>49</td><td>49</td><td>3</td><td>2018</td><td>Germany</td><td>Pourhassan M. et al. Clin Nutr ESPEN 2018;27:100-104</td></tr><tr><td>Patients ≥70 years from the 20-bed Geriatric Evaluation and Management Unit (GEMU)</td><td>172</td><td>85 ± 6.4</td><td>31</td><td>49</td><td>20</td><td>2018</td><td>Australia</td><td>Dent E. et al. Nutr Diet 2018;75:11-16</td></tr><tr><td>Māori or Pacific ethnicity) at admission to hospital</td><td>234</td><td>83.6 ± 7.6</td><td>27</td><td>47</td><td>27</td><td>2018</td><td>New Zealand</td><td>Chatindiara I. et al. BMC Geriatr. 2018;18(1):78</td></tr><tr><td>Elderly &gt; 85 years admitted to one of two hospital wards in Auckland</td><td>88</td><td>90.0 ± 3.7</td><td>28</td><td>43</td><td>28</td><td>2018</td><td>New Zealand</td><td>Popman A. et al. Nutr Diet 2018;75:52-58</td></tr><tr><td>Patients with a proximal femoral fracture</td><td>437</td><td>79 ± 12.8</td><td>13</td><td>35</td><td>52</td><td>2018</td><td>The Netherlands</td><td>van der Sijp M.P.L. et al. Injury 2018;49:2239-2243</td></tr><tr><td>Elderly patients of both sexes, diagnosed with cancer</td><td>200</td><td>72.5 ± 5.3</td><td>16</td><td>41</td><td>43</td><td>2028</td><td>Brazil</td><td>Lopes J.R. et al. Clin Nutr 2018;37(Suppl 1):S201</td></tr><tr><td>Hospitalized elderly patients</td><td>331</td><td>78.4 ± 9.7</td><td>14</td><td>40</td><td>46</td><td>2018</td><td>Brazil</td><td>El Kik R.M. et al. Nutr Hosp 2018;35(5):1059-1065</td></tr><tr><td>N-patients ≥70 years admitted for postacute rehabilitation</td><td>95</td><td>84.7 ± 6.6</td><td>27</td><td>73</td><td>0</td><td>2018</td><td>Spain</td><td>Sánchez-Rodríguez D. et al. Arch Gerontol Geriatr 2018;76:210-214</td></tr><tr><td colspan="9">Consecutive patients admitted to convalescent rehabilitation wards</td></tr><tr><td>with sarcopenia</td><td>343</td><td>80 ± 9</td><td>67</td><td>31</td><td>2</td><td>2018</td><td>Japan</td><td>Yoshimura Y. et al. Clin Nutr 2018;37:2022-2028</td></tr><tr><td>without sarcopenia</td><td>294</td><td>68 ± 11</td><td>11</td><td>64</td><td>25</td><td></td><td></td><td></td></tr><tr><td>Patients newly admitted to a post-rehabilitation hospital</td><td>1056</td><td>70 ± 11</td><td>38</td><td>48</td><td>15</td><td>2019</td><td>Japan</td><td>Shiraishi A. et al. Geriatr Gerontol Int 2019;19:189-196</td></tr><tr><td>Patients with femoral neck, trochanteric, sub-trochanteric and basicervical hip fractures</td><td>205</td><td>83.5 ± 7.0</td><td>22</td><td>50</td><td>27</td><td>2019</td><td>Japan</td><td>Inoue T. et al. Clin Nutr 2019;38:220-226</td></tr><tr><td>Older individuals, who were consecutively admitted to a geriatric acute care ward</td><td>200</td><td>81.4 ± 6.6</td><td>31</td><td>60</td><td>9</td><td>2019</td><td>Germany</td><td>Sieske L. et al. Nutrients 2019;11:1986</td></tr><tr><td>Hospital admission, diagnosis of orthopedic surgery or stroke</td><td>415</td><td>81 ± 7.7</td><td>9</td><td>43</td><td>48</td><td>2019</td><td>Italy Spain</td><td>Lelli D. et al. J Am Coll Nutr. 2019 Jul;38(5):441-446</td></tr><tr><td>Older patients who were consecutively hospitalized to a geriatric acute care ward</td><td>233</td><td>82.1 ± 7.1</td><td>39</td><td>47</td><td>14</td><td>2019</td><td>Germany</td><td>Pourhassan M. et al. J Geriatr Psychiatry Neurol 2019;32(2):90-96</td></tr><tr><td>Patients ≥75 were screened in the Emergency department</td><td>50</td><td>83 (75-94)</td><td>22</td><td>78</td><td>0</td><td>2019</td><td>Ireland</td><td>Brady D. et al. Age Ageing 2019:48 :iii1-iii16</td></tr><tr><td>All patients with cancer, aged 75 years and older, who were referred to the geriatric oncology clinic of Poitiers University Hospital</td><td>433</td><td>82.8 ± 4.8</td><td>29</td><td>47</td><td>24</td><td>2020</td><td>France</td><td>Liuu E. et al. BMC Geriatr 2020;20:295</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 3 (continued)**
MNA® -SF Clinical practice: elderly – Hospial Settings - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting/Conditions</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;8</th><th>At risk of malnutrition<br/>8-11</th><th>Well-nourished<br/>12-14</th></tr></thead><tbody><tr><td>Patients hospitalized in an acute care hospital ≥70 years</td><td>300</td><td>79.4 ± 6.4</td><td>23</td><td>33</td><td>45</td><td>2020</td><td>Japan</td><td>Matsumoto Y. et al. Clin Nutr online 31 January 2020</td></tr><tr><td>Patients hospitalized in an acute care hospital &lt;70 years</td><td>187</td><td>54 ± 13.8</td><td>11</td><td>36</td><td>63</td><td></td><td></td><td></td></tr><tr><td>Elderly inpatients at a tertiary care public teaching hospital</td><td>235</td><td>68 ± 0.4</td><td>46</td><td>50</td><td>3.4</td><td>2020</td><td>India</td><td>Rashid I. et al. Clin Epidemiol Glob Health 2020;8:91-95</td></tr><tr><td>Older non-cardiac surgical patients</td><td>288</td><td>74</td><td>14</td><td>34</td><td>52</td><td>2020</td><td>China</td><td>Zhao Y. et al. BMC Geriatr 2020;20:107</td></tr><tr><td>Cancer patients aged ≥65, in 44 hospitals in Brazil</td><td>3061</td><td>73.4 ± 6.6</td><td>33</td><td>39</td><td>27</td><td>2020</td><td>Brazil</td><td>D'Almeida C.A. et al. J Nutr Health Aging 2020;24:166-171</td></tr><tr><td>Adults, aged ≥ 65 years, admitted to the emergency departments at the University Hospital of Lime-rick: OPTI-MEND study</td><td>353</td><td>80 ± 7.0</td><td>8</td><td>28</td><td>64</td><td>2020</td><td>Ireland</td><td>Griffin A. et al. BMC Geriatr 2020;20:455</td></tr></tbody><thead><tr><th colspan="2">Hospitalized elderly</th><th>Under-nourished<br/>&lt;8</th><th>At risk of malnutrition<br/>8-11</th><th>Well-nourished<br/>12-14</th><th rowspan="2">Total n</th><th rowspan="2">mean</th><th rowspan="2">SE</th></tr><tr><th></th><th></th><th></th><th></th><th></th></tr></thead><tbody><tr><td></td><td></td><td>29</td><td>45</td><td>27</td><td>31068</td><td></td><td></td></tr><tr><td></td><td></td><td>0.3</td><td>0.03</td><td>0.3</td><td></td><td></td><td></td></tr></tbody></table>

<table><caption>**Table 4**
MNA® -SF Clinical practice - Frail elderly (Outpatient/Home Care) - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Undernourished & At risk of malnutrition<br/>&lt;8</th><th>At risk of malnutrition<br/>8-11</th><th>Well-nourished<br/>≥12</th></tr></thead><tbody><tr><td>Warden controlled sheltered housing in the Blaenau Gwent area of South Wales</td><td>100</td><td>79.3 ± 6.3</td><td>17</td><td></td><td>83</td><td>2008</td><td>U.K.</td><td>Harris D.G. et al. J Hum. Nutr Diet. 2008;21:3-9</td></tr><tr><td>Population of elderly individuals living in community dwellings: Study of Health and Drugs in the Elderly (SHADES)</td><td>315</td><td>85 ± 7</td><td>60</td><td></td><td>40</td><td>2011</td><td>Sweden</td><td>Ernst Bravell M. et al. Arch Gerontol Geriatr 2011;53:40-45</td></tr><tr><td>General practitioners outpatients on restrictive diets</td><td>95</td><td>80.5 ± 3.9</td><td>46</td><td></td><td>53.7</td><td>2012</td><td>France</td><td>Zeanandin G. et al. Clin Nutr 2012;31:69-73</td></tr><tr><td>Patient of similar age and sex, not following any restrictive diet</td><td>95</td><td>81.8 ± 4.8</td><td>23</td><td></td><td>76.8</td><td></td><td></td><td></td></tr><tr><td>Consecutive patients ≥70 years with severe symptomatic aortic stenosis and referred for an in-hospital evaluation for TAVI</td><td>100</td><td>83.7 ± 4.6</td><td>44</td><td></td><td>56</td><td>2012</td><td>Switzerland</td><td>Stortecky S. et al. JACC: Cardiovascular Interventions 2012;5:489-496</td></tr><tr><td>Elderly, aged ≥ 65 years, outpatient</td><td>65</td><td>≥ 65</td><td>9</td><td></td><td>91.2</td><td>2018</td><td>Spain</td><td>Castro-Vega I. et al. Nutr Hosp 2018;35:351-358</td></tr><tr><td>Older adults from the clinics of a northeast US dental school</td><td>19</td><td>71.3 ± 5.2</td><td>32</td><td></td><td>68.4</td><td>2019</td><td>U.S.A.</td><td>Zelig R. et al. JDR clinical and translational research 2019;4:217-228</td></tr><tr><td>Elderly aged ≥65 years from the Department of Internal Medicine, Fattouma Bourguiba University Hospital (Monastir) and from a nursing home (Sousse)</td><td>141</td><td>75 (66-85)</td><td>41</td><td></td><td>59</td><td>2020</td><td>Tunisia</td><td>Hammami S. et al. PLoS One 2020;15:e0242152</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

Table 4 (continued)

MNA® -SF Clinical practice - Frail elderly (Outpatient/Home Care) - Identifying the elderly/adults at risk of malnutrition

<table><thead><tr><th rowspan="2">Setting/Conditions</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="4">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Undernourished<br/>&lt;8</th><th>At risk of malnutrition<br/>8 - 11</th><th>Well-nourished<br/>12 - 14</th></tr></thead><tbody><tr><td>Outpatients with systolic heart failure</td><td>50</td><td>74.3 ± 6.2</td><td>8</td><td>20</td><td>72</td><td>2013</td><td>Portugal</td><td>Sargento L. et al. J Nutr Health Aging 2013;17:300-3044</td></tr><tr><td>Subjects admitted in the nursing homes and elderly community-dwelling ambulatory subjects</td><td>522</td><td>77.5 ± 8</td><td>24</td><td>37</td><td>39</td><td>2013</td><td>Italy</td><td>Donini L.M. et al. J Nutr Health Aging 2013;17:332-328</td></tr><tr><td>Geriatric day hospital of a large community hospital</td><td>190</td><td>82 (80-86)</td><td>9</td><td>36</td><td>55</td><td>2014</td><td>Germany</td><td>Schrader E. et al. J Nutr Health Aging. 2014;18(3):257-263</td></tr><tr><td>Community-dwelling older adults receiving home care</td><td>309</td><td>80.9 ± 7.9</td><td>15</td><td>41</td><td>44</td><td>2014</td><td>Germany</td><td>Kiesswetter E. et al. J Am Geriatr Soc 2014;62:512-517</td></tr><tr><td colspan="10">Outpatients admitted to the Toulouse Frailty Platform</td></tr><tr><td>Non-frail</td><td>30</td><td>78.1 ± 4.6</td><td>0</td><td>3</td><td>97</td><td>2015</td><td>France</td><td>Lilamand M. et al. J Nutr Health Aging 2015:19:570-574</td></tr><tr><td>Pre-frail</td><td>137</td><td>81.1 ± 5.6</td><td>0</td><td>16</td><td>84</td><td></td><td></td><td></td></tr><tr><td>Frail</td><td>98</td><td>83.2 ± 5.7</td><td>5</td><td>39</td><td>56.1</td><td></td><td></td><td></td></tr><tr><td>Patients visiting the geriatric diagnostic day clinic or outpatient clinic</td><td>138</td><td>80.9±7.6</td><td>16</td><td>44</td><td>40</td><td>2015</td><td>The Netherlands</td><td>Toussaint N. et al. Chem Senses 2015;40(3):197-203</td></tr><tr><td>Patients aged ≥65 years who were admitted to our geriatric medicine outpatient clinic</td><td>236</td><td>76.4 ± 7.2</td><td>20</td><td>32</td><td>48</td><td>2015</td><td>Turkey</td><td>Sarikaya D. et al. Arch Gerontol Geriatr 2015;61:56-60</td></tr><tr><td>Patients aged ≥65 years of a geriatric day hospital of a large community hospital in Nuremberg</td><td>190</td><td>80 (75-84)</td><td>9</td><td>36</td><td>55</td><td>2016</td><td>Germany</td><td>Schrader E. et al. J Nutr Health Aging 2016;20:918-926</td></tr><tr><td>Elderly, aged ≥65 years, being treated in community healthcare services in the Community of Madrid: DREAM + 65 Study</td><td>1103</td><td>79.5 ± 8.4</td><td>10</td><td>25</td><td>66</td><td>2016</td><td>Spain</td><td>Cuerda C. et al. Nutr Hosp 2016;33:263-269</td></tr><tr><td>Elderly aged ≥ 60 years who were living at home and using an in-home long-term care support center</td><td>227</td><td>≥ 60</td><td>13</td><td>54</td><td>33</td><td>2016</td><td>Japan</td><td>Okabe Y. et al. J Nutr Health Aging 2016;20:697-704</td></tr><tr><td>Veterans, homebound population of older: Veterans Affairs (VA) Home Based Primary Care (HBPC) program</td><td>2252</td><td>≥ 65</td><td>15</td><td>40</td><td>44</td><td>2017</td><td>U.S.A.</td><td>Win A.Z. et al. J Nutr Health Aging 2017;21:610-613</td></tr><tr><td>Community-dwelling spousal caregivers of older patients</td><td>79</td><td>79.4 ± 5.3</td><td>6</td><td>35</td><td>59</td><td>2018</td><td>Belgium</td><td>Potier L. et al. J Frailty Aging 2018;7:170-175 BMC Geriatr 2018;18:291</td></tr><tr><td>Hospital-based integrated CM Program for older persons at high risk for hospital readmission</td><td>791</td><td>79.9 ± 11</td><td>8</td><td>36.6</td><td>55</td><td>2018</td><td>Spain</td><td>Forcano Sanjuan S. et al. Eur Geriatr Med 2018;9:691-696</td></tr><tr><td>Older adults undergoing cancer care, who lived in the community and were ambulatory</td><td>202</td><td>≥ 65</td><td>33</td><td>31</td><td>36</td><td>2018</td><td>U.S.A.</td><td>Zhang X. et al. J Geriatr Oncol 2018;9:81-83</td></tr><tr><td>Elderly patients who presented consecutively at the Chief Tony Anenih Geriatric Centre</td><td>624</td><td>69.1 ± 7.2</td><td>2</td><td>33</td><td>65.1</td><td>2018</td><td>Nigeria</td><td>Adebusoye L.A. et al. Niger J Clin Pract 2018;21:443-450</td></tr><tr><td>Homecare recipients</td><td>267</td><td>82.9 ± 7.9</td><td>8</td><td>33</td><td>59</td><td>2018</td><td>Switzerland</td><td>Busnel C. et al. Rech Soins Infirm 2018;132:54-63</td></tr><tr><td>Elderly (60 years and above) in selected old people's homes, Lagos State</td><td>56</td><td>≥ 60</td><td>36</td><td>52</td><td>12.5</td><td>2019</td><td>Nigeria</td><td>Okoye C. et al. Niegerian J Nutr Sci 2019;40:91-98</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

Table 4 (continued)

MNA® -SF Clinical practice - Frail elderly (Outpatient/Home Care) - Identifying the elderly/adults at risk of malnutrition

<table><thead><tr><th rowspan="2">Setting/Conditions</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="4">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Undernourished<br/>&lt;8</th><th>At risk of malnutrition<br/>8 - 11</th><th>Well-nourished<br/>12 - 14</th></tr></thead><tbody><tr><td>Persons ≥ 65 years receiving home care and/or living in a service flat or sheltered accommodation</td><td>97</td><td>78.4 ± 7.2</td><td>1</td><td>20</td><td>79.2</td><td>2019</td><td>The Netherlands</td><td>van Doorn-van Atten<br/>M.N. et al. Public Health<br/>Nutr 2019;22:363-374</td></tr><tr><td>Dialysis patients of the hemodialysis units</td><td>216</td><td>67±15</td><td>11</td><td>59</td><td>30.1</td><td>2020</td><td>Belgium</td><td>Holvoet E. et al. PLoS ONE<br/>2020;15(3):e0229722</td></tr><tr><td>Outpatients attending a HF clinic at a university hospital</td><td>555</td><td>69 ± 11.5</td><td>3</td><td>16</td><td>81.4</td><td>2020</td><td>Spain</td><td>Joaquín C. et al. Clin Nutr Online<br/>2020;39:3395-3401</td></tr><tr><td>disabled residents, aged ≥60 years, from a community of the Putuo District, Shanghai</td><td>572</td><td>66.2 ± 4.2</td><td>1</td><td>14</td><td>84.8</td><td>2020</td><td>China</td><td>Fang Q. et al. Front Med (Lausanne)<br/>2020;7:552415</td></tr><tr><th rowspan="2">Frail elderly Outpatient/Home Care</th><th rowspan="2"></th><th rowspan="2"></th><th colspan="3">Under-nourished</th></tr><tr><th>At risk of malnutrition<br/>8 - 11</th><th>Well-nourished<br/>12 - 14</th></tr><tr><td>Total</td><td>9299</td><td>Mean</td><td>11</td><td>34</td><td>55</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td>SE</td><td>0.3</td><td>0.1</td><td>0.</td><td></td><td></td><td></td></tr></tbody></table>

Table 5
MNA® -SF Clinical practice - Institution - Identifying the elderly/adults at risk of malnutrition

<table><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Undernourished & At risk of malnutrition<br/>&lt;8</th><th>At risk of malnutrition<br/>8 - 11</th><th>Well-nourished<br/>≥12</th></tr></thead><tbody><tr><td>Elderly people living in sheltered housing</td><td>100</td><td>79.3 ± 6.3</td><td>12</td><td>88</td><td>88</td><td>2008</td><td>U.K.</td><td>Harris D.G. et al. J Hum. Nutr Diet 2008;21:3-9</td></tr><tr><td>Institutions South-West: Nursing-home residents</td><td>517</td><td>84.6 ± 9.0</td><td>55</td><td>45</td><td>45</td><td>2009</td><td>France</td><td>Bourdel-Marchasson I. et al. Nutrition 2009;25:155-164</td></tr><tr><td>Institutions South-West: Long-term care home residents</td><td>84</td><td>81.8 ± 10.4</td><td>90</td><td>10</td><td>10</td><td></td><td></td><td></td></tr><tr><td>Nursing home residents: nutrition Study</td><td>4359</td><td>84.0 ± 7.8</td><td>63</td><td>37</td><td>37</td><td>2013</td><td>Belgium</td><td>Arvanitakis M. et al. e-SPEN Journal 2013;8: e213-e215 (Aging Clin Exp Res 2019;31:175-183(page180))</td></tr><tr><td>Elderly, aged ≥ 65 years, institutionalized</td><td>375</td><td>84.2 ± 7.5</td><td>68</td><td>32</td><td>32</td><td>2018</td><td>Spain</td><td>Castro-Vega I. et al. Nutr Hosp 2018;35:351-358</td></tr><tr><td>Older men living in the veterans retirement community, Gangshan Veterans Home</td><td>354</td><td>85.4 ± 5.6</td><td>53</td><td>47</td><td>47</td><td>2019</td><td>Taiwan</td><td>Hsu Y.-H. et al. J Nutr Health Aging 2019;23:876-82</td></tr></tbody></table><table><thead><tr><th rowspan="2">Setting/Conditions</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="4">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Undernourished<br/>&lt;8</th><th>At risk of malnutrition<br/>8 - 11</th><th>Well-nourished<br/>12 - 14</th></tr></thead><tbody><tr><td>Patients in 11 Dutch rehabilitation centres</td><td>366</td><td>55.0 ± 65 (n=269) ≥65 (n=97)</td><td>18</td><td>57</td><td>25</td><td>2012</td><td>The Netherlands</td><td>Hertroijns D. et al. J Rehabil Med 2012;44:696-701</td></tr><tr><td>Elderly from seven different residential care facilities</td><td>534</td><td>79.5 ± 7.2</td><td>16</td><td>54</td><td>29</td><td>2013</td><td>Turkey</td><td>Ulger Z. et al. J Nutr Health Aging 2013;17(4):305-309</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>**Table 5 (continued)**
MNA® -SF Clinical practice - Institution - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting/Conditions</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Undernourished<br/>&lt;8</th><th>At risk of malnutrition<br/>8 - 11</th><th>Well-nourished<br/>12 - 14</th></tr></thead><tbody><tr><td colspan="10"><strong>Institutional environment (nursing homes)</strong></td></tr><tr><td>MNA®-SF with BMI</td><td>859</td><td>79.0 ± 7.9</td><td>17</td><td>42</td><td>41</td><td>2014</td><td>Poland</td><td>Kostka J. et al. J Nutr Health Aging 2014;18:366-371<br/>Eur J Clin Nutr 2014;68:1210-1215</td></tr><tr><td>MNA®-SF with Calf circumference</td><td></td><td></td><td>17</td><td>45</td><td>39</td><td></td><td></td><td></td></tr><tr><td>Eight nursing homes</td><td>200</td><td>85.5 ± 7.8</td><td>17</td><td>70</td><td>14</td><td>2015</td><td>Japan</td><td>Takeuchi K. et al. PLoS One 2015;10:e0141737</td></tr><tr><td>Residential homes for the elderly in Lattakia</td><td>103</td><td>70.9 ± 6.4</td><td>18</td><td>42</td><td>41</td><td>2015</td><td>Syria</td><td>Hallaj F.A. East Mediterr Health J. 2015;21(10):753-761</td></tr><tr><td>Elderly living in 13 French nursing homes: INCUR study</td><td>773</td><td>86.2 ± 7.5</td><td>16</td><td>59</td><td>26</td><td>2015</td><td>France</td><td>Lilamand M. et al. J Nutr Health Aging 2015;19:383-388</td></tr><tr><td colspan="10"><strong>Nursing home residents</strong></td></tr><tr><td>Women</td><td>164</td><td>82.3 ± 9</td><td>29</td><td>56</td><td>15</td><td>2016</td><td>Italy</td><td>Donini L.M. et al. J Am Med Dir Assoc 2018;17(10):959. e11-959.e18</td></tr><tr><td>Men</td><td>82</td><td>76.5 ± 11</td><td>22</td><td>63</td><td>15</td><td></td><td></td><td></td></tr><tr><td colspan="10"><strong>Institutionalized women</strong></td></tr><tr><td>MNA®-SF with BMI</td><td>53</td><td>44.9 ± 9.1</td><td>15</td><td>57</td><td>28</td><td>2018</td><td>Kuweit</td><td>Alkazemi D.U. et al. J Taibah Univ Med Sci 2018;13(3):238-246</td></tr><tr><td>MNA®-SF with Calf circumference</td><td></td><td></td><td>32</td><td>47</td><td>21</td><td></td><td></td><td></td></tr><tr><td>older people living in a long-term care health facility</td><td>116</td><td>82.1 ± 7.7</td><td>73</td><td>27</td><td>7</td><td>2018</td><td>Japan</td><td>Nishida Y. et al. J Gen Fam Med 2018;19(1):9-14</td></tr><tr><td>Individuals living in nursing homes</td><td>773</td><td>75.9 ± 7.7</td><td>8</td><td>37</td><td>55</td><td>2019</td><td>Turkey</td><td>Basibüyük G.Ö. Et al. Maedica (Buchar) 2019;14:38-44</td></tr><tr><td>nursing home residents: NutriAction II Study</td><td>2480</td><td>86.3 ± 6.2</td><td>14</td><td>49</td><td>37</td><td>2019</td><td>Belgium</td><td>Vandewoude M.F.J. et al. Aging Clin Exp Res 2019;31:175-183<br/>Aging Clin Exp Res 2019;31:295-298</td></tr><tr><td>Representative sample of permanent residents in long-term care homes for older adults</td><td>227</td><td>84.9 ± 6.7</td><td>17</td><td>55</td><td>28</td><td>2020</td><td>Spain</td><td>Rodríguez-Rejón A.I. et al. Nutr Clin Pract 2020;35:642-648</td></tr><tr><td colspan="10"><strong>Institutionalized elderly</strong></td></tr><tr><td></td><td></td><td></td><td>Under-nourished<br/>&lt;8</td><td>At risk of malnutrition<br/>8 - 11</td><td>Well-nourished<br/>12 - 14</td><td></td><td></td><td></td></tr><tr><td>Total</td><td>12391</td><td>Mean</td><td>22</td><td>50</td><td>28</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td>SE</td><td>0.4</td><td>0.1</td><td>0.5</td><td></td><td></td><td></td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 6**
MNA® -SF Clinical practice- Cognitively impaired elderly/elderly-adults with Parkinson's disease - Identifying the elderly/ adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Undernourished & At risk of malnutrition<br/>&lt;8</th><th>8 - 11</th><th>Well-nourished<br/>≥12</th></tr></thead><tbody><tr><td colspan="9"><strong>Cognitively impaired elderly</strong></td></tr><tr><td>Elderly with mild, moderate and severe Alzheimer's disease, neurology outpatient clinic</td><td>43</td><td>80.6 ± 7.0</td><td>74</td><td></td><td>26</td><td>2018</td><td>Brazil</td><td>Santos T.N.B. et al. Nutr Hops 2018;35(6):1298-1304</td></tr><tr><td>Patients with diagnosis of Alzheimer type (n = 21) or mixed type (Alzheimer type plus vascular type, n = 4) dementia</td><td>25</td><td>88 (73;85)</td><td>74</td><td></td><td>26</td><td>2020</td><td>Austria</td><td>Stadlbauer V. et al. BMC Geriatr 2020;20:248</td></tr><tr><th rowspan="2">Setting/Conditions</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;8</th><th>At risk of malnutrition<br/>8-11</th><th>Well-nourished<br/>12-14</th></tr><tr><td colspan="9"><strong>Cognitively impaired elderly</strong></td></tr><tr><td>Persons with dementia living in ordinary housing or special housing</td><td>1912</td><td>83.3 ± 6.4</td><td>20.2</td><td>54.1</td><td>25.7</td><td>2017</td><td>Sweden</td><td>Johansson L. et al. J Nutr Health Aging 2017 21:292-8</td></tr><tr><td colspan="9"><strong>Elderly/adults with Parkinson's disease</strong></td></tr><tr><td>Community-dwelling adults with Parkinson's disease, aged &gt;18 years</td><td>125</td><td>70.0 (35-92)</td><td>2</td><td>30</td><td>68</td><td>2013</td><td>Australia</td><td>Sheard J.M. et al. Et al. e-SPEN Journal 2013;8:e187-e92</td></tr><tr><td>Hospitalized elderly patients with Parkinson's disease</td><td>92</td><td>73.6 ± 6.7</td><td>7</td><td>39</td><td>54</td><td>2020</td><td>Germany</td><td>Gruber M.T. et al. PLoS One 2020;15:e0232764</td></tr><tr><th colspan="9">Cognitively impaired elderly Elderly/ adults with Parkinson's disease</th></tr><tr><td>Total</td><td>2172</td><td>Mean</td><td>10</td><td>41</td><td>49</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td>SE</td><td>0.6</td><td>0.2</td><td>1.1</td><td></td><td></td><td></td></tr></tbody></table>

<table><caption>**Table 7**
MNA® Clinical practice- Community-living elderly - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 - 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>New Mexico Aging Process Study</td><td>330</td><td>77+6</td><td>1</td><td>18</td><td>81</td><td>1994</td><td>USA</td><td>Guigoz Y. et al. Facts, Research in Gerontology 1994 (Suppl2):15-59<br/>Vellas B. et al. Nutrition 1999;15:116-122<br/>Scheirlinckx K. et al. Nestlé Nutr Workshop Ser Clin Perform Programme 1999;1:61-65</td></tr><tr><td>Community elderly city of Mataro</td><td>199</td><td>72 ± 5</td><td>1</td><td>10</td><td>90</td><td>1996</td><td>Spain</td><td>Salvà A et al. Rev Gerontol 1996;6:319-28<br/>Nestle Nutr Workshop Ser.Clin Perform. Programme 1999;1:123-129</td></tr><tr><td>Non-Hispanic white elderly</td><td>420</td><td></td><td>0</td><td>15</td><td>85</td><td>1997</td><td>USA</td><td>Guigoz Y et al. Ther Umsch 1997;54:345-350</td></tr><tr><td>SENECA study</td><td>783</td><td>&gt;75</td><td>1</td><td>44</td><td>55</td><td>1998</td><td>Europe</td><td>De Groot LCPGM et al. Eur J Clin Nutr 1998;52:877-83</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>**Table 7 (continued)**
MNA® Clinical practice- Community-living elderly - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 - 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>SENECA study</td><td>171</td><td>&gt;70</td><td>0</td><td>22</td><td>78</td><td>1999</td><td>Denmark</td><td>Beck AM et al. Ugeskr.Laeger 1997;159:6377-6381<br/>Br J Nutr 1999;81:31-36</td></tr><tr><td>Hispanic elderly</td><td>356</td><td>&gt;65</td><td>1</td><td>27</td><td>72</td><td>1999</td><td>USA</td><td>Pareo-Tubbeh SL et al J Am Diet Assoc 1999;99:572-582</td></tr><tr><td>Inner city African Americans</td><td>134</td><td>&gt; 70</td><td>2</td><td>39</td><td>60</td><td>1999</td><td>USA</td><td>Miller DK et al. Nestle Nutr Workshop Ser.Clin Perform.Programme 1999;1:79-86 Morley JE et al. Nestle Nutr Workshop Ser.Clin Perform.Programme 1999;1:67-76</td></tr><tr><td>Random selection of elderly<br/>aged 75 years living at home in<br/>Warsaw</td><td>102</td><td>75</td><td>1</td><td>16</td><td>83</td><td>1999</td><td>Poland</td><td>Chartewska J et al. Nestle Nutr Workshop Ser Clin Perform Programme 1999;1:161</td></tr><tr><td>Elderly persons in the commu-<br/>nity, Jerusalem</td><td>463</td><td>&gt;70</td><td>1</td><td>8</td><td>91</td><td>2000</td><td>Israel</td><td>Maaravi Y. et al Aging (Milano.) 2000;12:173-9</td></tr><tr><td>Elderly in rural and semi-rural<br/>regions of central Greece</td><td>502</td><td>74 ± 7</td><td>3</td><td>28</td><td>69</td><td>2001</td><td>Greece</td><td>Spartharakis GC et al. J Nutr Health Aging 2002;6:19</td></tr><tr><td>Free-living elders</td><td>97</td><td>76 (70-90)</td><td>0</td><td>33</td><td>64</td><td>2001</td><td>Chili</td><td>Urteaga C et al. Rev Méd Chile 2001;129:871-876</td></tr><tr><td>Elderly selected among 7 Spanish<br/>regions (Andalucia, Catalunya,<br/>Galicia, Madrid, Murcia, Navarra<br/>&amp; Valencia)</td><td>3459</td><td>73.2 ± 2</td><td>4</td><td>34</td><td>62</td><td>2001</td><td>Spain</td><td>Spanish Geriatric Oral Health Research Group. Int Dent J 2001;51(3):228-234<br/>Ramon J.M. et al. Med Clin (Barc) 2001;117:766-770</td></tr><tr><td>Older Hispanics living<br/>independently</td><td>51</td><td>70 (52 - 92)</td><td>2</td><td>33</td><td>65</td><td>2002</td><td>USA</td><td>Kicklighter J.R. &amp; Duchon D. J Appl Gerontol 2002;21(1), 119-133</td></tr><tr><td>Home living retired elderly,<br/>Tallinn</td><td>51</td><td>51-97</td><td>0</td><td>26</td><td>74</td><td>2002</td><td>Estonia</td><td>Saava M. &amp; Kisper-Hint I.-R. J Nutr Health Aging 2002;6:93-95</td></tr><tr><td>Free-living elderly participating<br/>in congregate meal-site programs</td><td>69</td><td>50-90</td><td>3</td><td>32</td><td>65</td><td>2004</td><td>USA</td><td>Davidson J. &amp; al. J Nutr Elder 2004;(24)1: 53-67</td></tr><tr><td>Older persons living in the<br/>community</td><td>42</td><td>70.9 + 6.7</td><td>0</td><td>31</td><td>69</td><td>2004</td><td>Brazil</td><td>Delacorte R.R. et al J Nutr Health Aging 2004;8:531-534</td></tr><tr><td>Retires resident from a<br/>community, Shanghai</td><td>115</td><td>68 ± 9 (50 - 89)</td><td>2</td><td>19</td><td>79</td><td>2004</td><td>China</td><td>Fei X.F. et al. Chinese Journal of Clinical Rehabilitation 2004;8(21):4364-4365</td></tr><tr><td rowspan="5">Representative randomly slected<br/>elderly &gt;53 yrs</td><td></td><td>&gt;53</td><td></td><td></td><td></td><td rowspan="5">2004</td><td rowspan="5">Taiwan</td><td>Tsai A.C. et al. Public Health Nutr 7(1):69-76, 2004<br/>Asia Pac J Clin Nutr 2007;16 (4):656-662<br/>J Nutr Health Aging 2008;12(4):239-243</td></tr><tr><td>910</td><td>50 - 60</td><td>1</td><td>8</td><td>91</td></tr><tr><td>1180</td><td>60 - 70</td><td>2</td><td>12</td><td>86</td></tr><tr><td>1820</td><td>70 - 80</td><td>4</td><td>15</td><td>81</td></tr><tr><td>530</td><td>&gt;80</td><td>5</td><td>24</td><td>71</td></tr><tr><td>Healthy free-living elderly<br/>(MNA®-SF)</td><td>150</td><td>55-85</td><td>0</td><td>0</td><td>100</td><td>2004</td><td>UK</td><td>Nayak USL &amp; Queiroga JM Gerontechnology 2004;3(2):77-88</td></tr><tr><td>Elderly volunteers living in<br/>Ankara</td><td>1564</td><td>70 + 8</td><td>8</td><td>76</td><td>16</td><td>2005</td><td>Turkey</td><td>Kucukdonmez O. et al. Saudi Med J 2005;26:1611-1616</td></tr><tr><td>«middle class» non-<br/>institutionalised individuals aged<br/>70-75</td><td>128</td><td>70-75</td><td>0</td><td>17</td><td>83</td><td>2005</td><td>Sweden</td><td>Eriksson B.G. et al. J Nutr Health Aging 2005;9:212-220</td></tr><tr><td>Community-dwellin elders</td><td>240</td><td>81.7 + 8.7 (61-93)</td><td>5</td><td>39</td><td>56</td><td>2005</td><td>USA</td><td>Chen C.C-H. et al. Adv Nursing Sci 2005;28:376-389</td></tr><tr><td>Active healthy elderly women</td><td>82</td><td>≥65</td><td>0</td><td>0</td><td>100</td><td>2005</td><td>France</td><td>Rolland Y. et al. J Nutr Health Aging 2005;9:397-402</td></tr><tr><td>Elderly free-living women</td><td>351</td><td>73 + 2.3</td><td>0</td><td>7</td><td>92</td><td>2006</td><td>Sweden</td><td>Salminen H. et al. Eur J Clin Nutr 2006;60:486-493</td></tr><tr><td>Independently living elderly<br/>at home</td><td>172</td><td>71.8 ± 8.4</td><td>6</td><td>19</td><td>80</td><td>2006</td><td>Austria</td><td>Hackl J.M. et al. Journal fur Ernährungsmedizin 2006;8(1):13-20</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 7 (continued)**
MNA® Clinical practice- Community-living elderly - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 - 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Rural elderly people</td><td>457</td><td>69 ± 8</td><td>26</td><td>62</td><td>13</td><td>2006</td><td>Bangladesh</td><td>Kabir Z.N. et al. Public Health Nutr 2006;9(8):968-974</td></tr><tr><td>Free living (85%) and Institutionalized (15%) elderly</td><td>238</td><td>71.5 ± 8.0</td><td>5</td><td>50</td><td>44</td><td>2007</td><td>South Africa</td><td>Charlton K.E. et al. Nutrition 2007;23(7-8):533-542</td></tr><tr><td>Elderly people living in one district of a city in southern Brazil</td><td>267</td><td>66.5 ± 4.2</td><td>2</td><td>20</td><td>78</td><td>2007</td><td>Brazil</td><td>Cabrera M.A. et al. J Am Med Dir 2007;8:582-584</td></tr><tr><td>Healthy free-living elderly</td><td>170</td><td>81.2 ± 7.4</td><td>1</td><td>36</td><td>63</td><td>2009</td><td>Italy</td><td>Buffa R. et al. Nutrition 2009;25(1):(3-5)</td></tr><tr><td>Free living elderly, recruited using a cluster-stratified sampling method from the people of Razavi-Khorasan province</td><td>1957</td><td>70 ± 7.8</td><td>12</td><td>45</td><td>43</td><td>2008</td><td>Iran</td><td>Aliabadi M. et al. Asia Pac J Clin Nutr 2008;17(2):285-289</td></tr><tr><td>Free-living elderly at community pharmacists - Men</td><td>8014</td><td>75.2 ± 6.6</td><td>3</td><td>21</td><td>76</td><td>2008</td><td>Spain</td><td>Cuervo M. et al. Arch Gerontol Geriatr 2009;49(1):69-73</td></tr><tr><td>Free-living elderly at community pharmacists - Women</td><td>13993</td><td>75.2 ± 6.9</td><td>5</td><td>28</td><td>67</td><td>2009</td><td></td><td>Public Health Nutr 2008;12(1):82-90</td></tr><tr><td>Random sample of free-living elderly</td><td>471</td><td>>60 (60 - 92)</td><td>1</td><td>19</td><td>79</td><td>2008</td><td>Brazil</td><td>De Marchi R.J. et al. Nutrition 2008;24:546-553</td></tr><tr><td>Elderly living on the island of Sardinia</td><td>111</td><td>75.0 ± 7.2</td><td>1</td><td>29</td><td>70</td><td>2008</td><td>Italy</td><td>Mandas A. et al. Mediterr J Nutr Metab 2008;1:99-107</td></tr><tr><td>Community older adults in Wuhan</td><td>162</td><td>74.1 ± 7.95</td><td>8</td><td>36</td><td>56</td><td>2009</td><td>China</td><td>Han Y. et al. Public Health Nutr 2009;12(8):1189-1196</td></tr><tr><td>Representative sample of Spaniards over 65 years old</td><td>2860</td><td>73.7 ± 6.8</td><td>4</td><td>32</td><td>65</td><td>2008</td><td>Spain</td><td>Gil-Montoya J.A. et al. J Public Health Dent 2008;68(2):88-93</td></tr><tr><td>Elderly people from a senior college in Tokyo</td><td>130</td><td>72.2 ± 4.3</td><td>0</td><td>13</td><td>87</td><td>2008</td><td>Japan</td><td>Iizaka S. et al. Geriatr Gerontol Int 2008;8(1):24-31</td></tr><tr><td>2001-2006 in home-living older people, southern Sweden</td><td>579</td><td>75(2001)<br/>80(2002)</td><td>0</td><td>15</td><td>86</td><td>2009</td><td>Sweden</td><td>Johansson .et al. J Clin Nursing 2009;18(9):1354-1364</td></tr><tr><td>Representative sample of older people in Ourense</td><td>728</td><td>80.7 ± 7.4</td><td>13</td><td>58</td><td>30</td><td>2009</td><td>Spain</td><td>De la Montana Miguelez J.et al. Arch Latinoam Nutr 2009;59(4):390-395<br/>J Nutr Health Aging. 2011 Mar;15(3):187-91</td></tr><tr><td>Polish older persons aged 65+, living in five selected regions of Poland,</td><td>420</td><td>65+</td><td>1</td><td>22</td><td>77</td><td>2010</td><td>Poland</td><td>Niedźwiedzka E. et al. Adv Med Sci 2010;55(2):172-8</td></tr><tr><td>Elderly people aged 60 years or older living in 19 sub-districts of the Mueang district, Phitsanuloke province</td><td>612</td><td>68.8 ± 5.9</td><td>8</td><td>67.2</td><td>25</td><td>2011</td><td>Thailand</td><td>Samnieng P. et al. J Nutr Gerontol Geriatr 2011;30:291-304</td></tr><tr><td>Community-dwelling elderly</td><td>83</td><td>73.7 ± 6.5</td><td>0</td><td>6</td><td>94</td><td>2012</td><td>Ireland</td><td>Claesson M.J. et al. Nature 2012:488:178-84</td></tr><tr><td>Community dwelling (94%), hospitalized, and nursing home residents.</td><td>175</td><td>77.8 ± 6.5</td><td>2</td><td>25</td><td>73</td><td>2012</td><td>France</td><td>Rolland Y. et al. J Am Med Dir Assoc. 2012;13(1):31-34</td></tr><tr><td>Community-dwelling elderly fully dentates</td><td>50</td><td>70.1 ± 6.1</td><td>0</td><td>0</td><td>100</td><td>2012</td><td>France</td><td>Cousson P.Y. et al. Gerodontology. 2012 Jun;29(2):e685-e692.</td></tr><tr><td>Community-dwelling elderly complete denture wearer</td><td>47</td><td>70.1 ± 8.1</td><td>2</td><td>19</td><td>79</td><td></td><td></td><td></td></tr><tr><td>Quasi-probabilistic sample of people ≥ 60 years old: "Thousand's Study"</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Women</td><td>570</td><td>71 ± 7.7</td><td>9</td><td>51</td><td>41</td><td>2012</td><td>Mexico</td><td>Rodriguez-Tadeo A. et al. J Nutr Health Aging 2012;16:426-431</td></tr><tr><td>Men</td><td>190</td><td>73.7 ± 7.9</td><td>6</td><td>51</td><td>43</td><td></td><td></td><td></td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

Table 7 (continued)

MNA® Clinical practice- Community-living elderly - Identifying the elderly/adults at risk of malnutrition

<table><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17-23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Community-dwelling volunteer older adults</td><td>206</td><td>83 (75-96)</td><td>0</td><td>15</td><td>85</td><td>2013</td><td>Germany</td><td>Bollwein J. et al. J Nutr Health Aging 2013;17:351-356</td></tr><tr><td>Geriatric people aged 60 years and above in four Union Councils of Sargodha city</td><td>380</td><td>≥60</td><td>6</td><td>42</td><td>52</td><td>2013</td><td>Pakistan</td><td>Ghani A. et al. Int J med Appl health. 2013;1(1):22-28</td></tr><tr><td>Volunteer community-dwelling elderly people aged 65-88 year, Luoci city, rural area located in Bas-Congo province, DRC</td><td>370</td><td>69.9 ± 5.6</td><td>28</td><td>58</td><td>14</td><td>2013</td><td>Democratic Republic of Congo</td><td>Andre M.B. et al. Geriatr Geron-tol Int 2013;13:35-42</td></tr><tr><td>Random sample of elderly in rural El-Burgaia village</td><td>350</td><td>67.7 ± 6.6</td><td>9</td><td>30</td><td>62</td><td>2013</td><td>Egypt</td><td>Mahfouz E, et al. J Aging Res Clin Pract 2:300-202</td></tr><tr><td>Elderly community-dwelling ambulatory subjects</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>women</td><td>277</td><td>75.6 ± 7</td><td>15</td><td>39</td><td>47</td><td>2013</td><td>Italy</td><td>Donini L.M. et al. J Nutr Health Aging 2013;17:332-328</td></tr><tr><td>Men</td><td>125</td><td>76.1 ± 6</td><td>2</td><td>36</td><td>62</td><td></td><td></td><td></td></tr><tr><td>Community-dwelling subjects urban environment</td><td>932</td><td>71.7 ± 5.3</td><td>2</td><td>30</td><td>68</td><td>2014</td><td>Poland</td><td>Kostka J. et al. J Nutr Health Aging 2014;18:366-371 Eur J Clin Nutr 2014;68:1210-1215</td></tr><tr><td>Rural environment</td><td>812</td><td>73.0 ± 6.6</td><td>8</td><td>41</td><td>52</td><td></td><td></td><td></td></tr><tr><td>Elderly aged ≥ 60, representative of the urban population: SABE Study</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Men</td><td>437</td><td>69.6 ± 0.6</td><td>2</td><td>26</td><td>73</td><td>2014</td><td>Brazil</td><td>da Silva Alexandre T. et al. J Nutr Health Aging 2014;18:284-290</td></tr><tr><td>Women</td><td>712</td><td></td><td>1</td><td>30</td><td>69</td><td></td><td></td><td></td></tr><tr><td>Healthy controls selected from the medical staff and the patients' relatives</td><td>145</td><td>59.6 ± 8.8</td><td>6</td><td>29</td><td>65</td><td>2014</td><td>Iran</td><td>Fereshtehejad S.-M. et al. J Parkinsons Dis 2014;4:473-81</td></tr><tr><td>Independent elderly attending two primary care clinics in Beirut, Lebanon</td><td>202</td><td>72 ± 6</td><td>9</td><td>34</td><td>58</td><td>2014</td><td>Lebanon</td><td>El Osta N. et al. Clin Nutr 2014;33:316-21</td></tr><tr><td>Community-dwelling elderly, recipients of the Public Assistance (PA) scheme for socio-economically disadvantaged Singaporeans</td><td>399</td><td>76.0 ± 7.8</td><td>3</td><td>50</td><td>47</td><td>2014</td><td>Singapore</td><td>Koo Y.X. et al. Public Health Nutr 2014;17(12):2834-2843</td></tr><tr><td>Free living and institutionalized subjects from Kochi, Kerala</td><td>296</td><td>>60</td><td>7</td><td>40</td><td>53</td><td>2014</td><td>India</td><td>Shilpa J. & Kumari K.S. Int J of Adv Res 2014;2:214-221</td></tr><tr><td>Individuals aged ≥ 75 years living in the community.</td><td>640</td><td>81.3 ± 5.0</td><td>2</td><td>20</td><td>78</td><td>2014</td><td>Spain</td><td>Jürschik P. et al. Med Clin (Barc) 2014;143:191-195</td></tr><tr><td>Community dwellers ≥ 65 years, randomly recruited: Three-City (3C) study</td><td>6040</td><td>73.5 ± 5.2</td><td>0</td><td>12</td><td>88</td><td>2015</td><td>France</td><td>Torres M.J. et al. Osteoporos Int 2015;26:2157-2164</td></tr><tr><td>Elderly, aged ≥ 60, randomly selected from the chosen cities of 5 provinces representing the country (geography, climate, ethnicity, and culture)</td><td>1338</td><td>69.1 ± 7.3</td><td>6</td><td>41</td><td>53</td><td>2015</td><td>Iran</td><td>Tanjani P.T. et al. Arch Gerontol Geriatr 2015;60:281-287</td></tr><tr><td>Elderly >60 years of age residing in the villages for longer than 6 months</td><td>360</td><td>>60</td><td>15</td><td>55</td><td>30</td><td>2015</td><td>India</td><td>Agarwalla R. et al. J Family Community Med. 2015;22(1):39-43</td></tr><tr><td>Independent-living older adults with mild to moderate limitations in physical function : PROVIDE study</td><td>380</td><td>77.7 ± 9.8</td><td>1</td><td>9</td><td>91</td><td>2015</td><td>Belgium<br/>Germany<br/>Ireland<br/>Italy<br/>Sweden<br/>U. K.</td><td>Bauer J.M. et al. J Am Med Dir Assoc 2015;16:740-747</td></tr><tr><td>Older adults ≥ 65 years, living independently, recruited in the Taipei, Taiwan region</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Nonfrail (n = 91)</td><td></td><td></td><td>0</td><td>28</td><td>72</td><td>2016</td><td>Taiwan</td><td>Chang S.-F. et al. J Clin Nurs 2016;25:424-433</td></tr><tr><td>Prefrail (n = 61)</td><td>152</td><td>80.9 ± 7.7</td><td>8</td><td>46</td><td>46</td><td></td><td></td><td></td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 7 (continued)**
MNA® Clinical practice- Community-living elderly - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2"></th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 - 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td colspan="10">Community-dwelling elderly in cities in Latin America (SABE-study)</td></tr><tr><td rowspan="2">Sao paulo (brazil)</td><td>women</td><td>1449</td><td>73.3 ± 8.4</td><td>3</td><td>35</td><td>62</td><td rowspan="2">2016</td><td rowspan="2">Brazil</td><td rowspan="2">Lera L. et al. J Nutr Health Aging 2016;20:797-805</td></tr><tr><td>Men</td><td>569</td><td></td><td>3</td><td>32</td><td>66</td></tr><tr><td rowspan="2">Santiago (chile)</td><td>women</td><td>1160</td><td>71.5 ± 8.0</td><td>1</td><td>15</td><td>84</td><td rowspan="2">Chile</td><td rowspan="2"></td><td rowspan="2"></td></tr><tr><td>Men</td><td>403</td><td></td><td>1</td><td>9</td><td>90</td></tr><tr><td rowspan="2">Havana (cuba)</td><td>women</td><td>1220</td><td>72.0 ± 8.8</td><td>8</td><td>42</td><td>50</td><td rowspan="2">Cuba</td><td rowspan="2"></td><td rowspan="2"></td></tr><tr><td>Men</td><td>413</td><td></td><td>5</td><td>33</td><td>61</td></tr><tr><td rowspan="2">Mexico (df (mexico))</td><td>women</td><td>817</td><td>69.7 ± 7.6</td><td>3</td><td>34</td><td>63</td><td rowspan="2">Mexico</td><td rowspan="2"></td><td rowspan="2"></td></tr><tr><td>Men</td><td>310</td><td></td><td>2</td><td>34</td><td>64</td></tr><tr><td rowspan="2">Montevideo (uruguay)</td><td>women</td><td>880</td><td>71.2 ± 7.3</td><td>3</td><td>33</td><td>65</td><td rowspan="2">Uruguay</td><td rowspan="2"></td><td rowspan="2"></td></tr><tr><td>Men</td><td>294</td><td></td><td>2</td><td>27</td><td>71</td></tr><tr><td colspan="10">Elderly population living in urban community of Hawassa city</td></tr><tr><td></td><td></td><td>548</td><td>69.0 ± 7.0</td><td>28</td><td>62</td><td>9</td><td>2016</td><td>Ethiopia</td><td>Hailemariam H. et al. BMC Nutrition 2016;2:11</td></tr><tr><td colspan="10">Community-dwelling elderly residing in Okharpauwa Village Development Committee</td></tr><tr><td></td><td></td><td>242</td><td>69.8 ± 7.4</td><td>24</td><td>65</td><td>11</td><td>2017</td><td>Nepal</td><td>Ghimire S. et al. PLoS One 2017;12:e0172052</td></tr><tr><td colspan="10">Non-institutionalized inhabitants aged ≥75 years</td></tr><tr><td></td><td></td><td>102</td><td>81.3 ± 4.6</td><td>2</td><td>21</td><td>77</td><td>2017</td><td>Spain</td><td>Hernández-Galiot A. & Goñi I. Nutrition 2017;35:81-86</td></tr><tr><td colspan="10">Free-living elderly in the province of Valencia selected in 12 community centres</td></tr><tr><td colspan="10">Community-dwelling Indonesians from both rural and urban areas of Yogyakarta</td></tr><tr><td></td><td>Rural area</td><td>203</td><td>74 ± 7</td><td>3</td><td>73</td><td>24</td><td rowspan="2">2017</td><td rowspan="2">Indonesia</td><td rowspan="2">Arjuna T. et al. Nutrients 2017;9:1240</td></tr><tr><td></td><td>Urban area</td><td>324</td><td></td><td>6</td><td>44</td><td>50</td></tr><tr><td colspan="10">Persons aged ≥60 years permanent resident in urban and rural areas of Dharwad district in Karnataka</td></tr><tr><td></td><td>Rural area</td><td>102</td><td>67 ± 7.1</td><td>28</td><td>40</td><td>31</td><td>2017</td><td>India</td><td>Ananthesh B.G. et al. Int J Community Med Public Health 2017;4:51-58</td></tr><tr><td></td><td>Urban area</td><td>102</td><td></td><td>9</td><td>37</td><td>54</td><td></td><td></td><td></td></tr><tr><td colspan="10">Older adults in a community in Pathanamthitta district of Kerala</td></tr><tr><td></td><td></td><td>129</td><td>≥ 60</td><td>12</td><td>47</td><td>42</td><td>2017</td><td>India</td><td>Abraham J. et al. Int J Res Med Sci 2017;6:210-215</td></tr><tr><td colspan="10">Households with members aged 65 to74 y</td></tr><tr><td></td><td></td><td>287</td><td>69.3 ± 3.5</td><td>3</td><td>45</td><td>52</td><td>2018</td><td>Brazil</td><td>Stoffel L.M.B. et al. Nutriton 2018;55-56;104-110</td></tr><tr><td colspan="10">Community-dwelling individuals ≥60 years living in the Brazilian state of Minas Gerais</td></tr><tr><td></td><td></td><td>2868</td><td>≥60</td><td>2</td><td>28</td><td>71</td><td>2018</td><td>Brazil</td><td>Damião R. et al. J Nutr Health Aging 2018;22(1):111-116</td></tr><tr><td colspan="10">Community dwelling elderly from various settings in Tabriz (mosques, parks, organizations offering activities for older people, and advertisements)</td></tr><tr><td></td><td></td><td>164</td><td>74 ± 8.3</td><td>1</td><td>27</td><td>72</td><td>2018</td><td>Iran</td><td>Saghafi-Asl M. et al. Aging Clin Exp Res 2018;30:1117-1125</td></tr><tr><td colspan="10">Elderly of Jahandidegan Council</td></tr><tr><td></td><td></td><td>180</td><td>65.4 ± 7.5</td><td>1</td><td>13</td><td>86</td><td>2018</td><td>Iran</td><td>Abdollahzade S.M. et al. Int J Nutr Sci 2018;3(2):86-91</td></tr><tr><td colspan="10">Rural primary health care centre</td></tr><tr><td></td><td></td><td>169</td><td>75.1 ± 7.0</td><td>5</td><td>43</td><td>52</td><td>2018</td><td>Lithuania</td><td>Spirgienė L. et al. Int J Nurs Pract. 2018;24:e12688</td></tr><tr><td colspan="10">Community-dwelling persons 75+ years of age from Alabama</td></tr><tr><td></td><td></td><td>414</td><td>≥ 75</td><td>3</td><td>41</td><td>56</td><td>2018</td><td>U.S.A.</td><td>Buys D.R. et al. Fam Community Health 2018;41:S33-S45</td></tr><tr><td colspan="10">Elderly population in four villages of rural Puducherry</td></tr><tr><td></td><td></td><td>279</td><td>69.4 ± 8.1</td><td>18</td><td>59</td><td>23</td><td>2018</td><td>India</td><td>Krishnamoorthy Y. et al. J Family Med Prim Care 2018;7(6):1429-1433</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

Table 7 (continued)

MNA® Clinical practice- Community-living elderly - Identifying the elderly/adults at risk of malnutrition

<table><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 - 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td colspan="9">Patients referring to the GP offices</td></tr><tr><td>Women</td><td>125</td><td>75.1 ± 8</td><td>8</td><td>33</td><td>59</td><td>2018</td><td>Italy</td><td>Donini L. et al. J Nutr Health Aging 2018;22:44-52</td></tr><tr><td>Men</td><td>101</td><td>75.3 ± 8</td><td>4</td><td>31</td><td>65</td><td></td><td></td><td></td></tr><tr><td>Home dwelling elderly individuals</td><td>407</td><td>72 ± 6</td><td>6</td><td>40</td><td>54</td><td>2018</td><td>Turkey</td><td>Acar-Tek N. & Karaçil-Ermumcu M.Ş. J Nutr Health Aging 2018;22:996-1002</td></tr><tr><td>Elderly randomly enrolled from seven different Greek cities</td><td>2092</td><td>75.0 ± 8.4</td><td>11</td><td>35</td><td>54</td><td>2018</td><td>Greece</td><td>Mantzorou M, et al. Nutr Neurosci 2018;23(3):201-209</td></tr><tr><td>Cross-sectional analysis, Portuguese older adults age ≥65 years: Nutrition UP 65 study</td><td>1493</td><td>74.0 (65 - 100)</td><td>1</td><td>15</td><td>84</td><td>2018</td><td>Portugal</td><td>Sousa-Santos A.R. et al. Food Nutr Bull 2018;39(3):487-492 Nutr Diet 2019;76:604-612</td></tr><tr><td>Elderly people in the city of Voronezh and the Region</td><td>160</td><td>69.4 ± 7.2</td><td>2</td><td>47</td><td>52</td><td>2018</td><td>Russia</td><td>Skrebneva A.V. et al. Voprosy pitanii [Problems of Nutrition] 2018; 87 (6):42-47</td></tr><tr><td>Community-dwelling persons ≥75 years of age from Alabama: University of Alabama at Birmingham Study of Aging II</td><td>414</td><td>81.6 ± 4.7</td><td>3</td><td>41</td><td>56</td><td>2018</td><td>U.S.A.</td><td>Buys D.R. et al. Fam Community Health 2018;41:S33-S45</td></tr><tr><td>Home-living old-age population in Hong Kong</td><td>613</td><td>78.5 ± 7.4</td><td>1</td><td>28</td><td>71</td><td>2019</td><td>China</td><td>Wong M.M.H. et al. BMC Geriatrics 2019;19(1):138</td></tr><tr><td>Community very old residents of Veranópolis, Rio Grande do Sul, Brazil</td><td>153</td><td>86 ± 4</td><td>0</td><td>7</td><td>94</td><td>2019</td><td>Brazil</td><td>Senger J. et al. J Nutr Health Aging. 2019;23(10):923-929</td></tr><tr><td>Older adults was recruited from community recreational centres for the elderly</td><td>211</td><td>72.4 +/- 8.5</td><td>5</td><td>48</td><td>46.4</td><td>2019</td><td>Greece</td><td>Grammatikopoulou M.G. Maturation 2019;119:8-13</td></tr><tr><td>Community dwelling elderly, aged ≥6 years</td><td>326</td><td>68.8 ± 7.2</td><td>3</td><td>25</td><td>72</td><td>2020</td><td>Iran</td><td>Bakhtiari A. et al. BMC Geriatr 2020;20:278</td></tr><tr><td>Older People Living in the Community</td><td>100</td><td>74.9 ± 8.50</td><td>2</td><td>25</td><td>73</td><td>2020</td><td>Poland</td><td>Pigłowska M. et al. Nutrients 2020;12(7): 2042</td></tr><tr><td>Nationally representative sample of community-dwelling older adults (≥ 65), PEN-3S-Study</td><td>1120</td><td>76 ± 8</td><td>0.5</td><td>16</td><td>83</td><td>2020</td><td>Portugal</td><td>Madeira T. et al. Acta Med Port. 2020;33(7-8):475-482 Nutrition 2020;73:110660</td></tr><tr><td colspan="2">Community-dwelling elderly</td><td></td><td>Under-nourished<br/>&lt;17</td><td>At risk of malnutrition<br/>17 - 23.5</td><td>Well-nourished<br/>≥24</td><td></td><td></td><td></td></tr><tr><td>Total</td><td>12391</td><td>Mean</td><td>5</td><td>31</td><td>64</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td>SE</td><td>0.1</td><td>0.2</td><td>0.2</td><td></td><td></td><td></td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 8**
MNA® Clinical practice- Hospital Settings - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 - 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Acute care Elderly patients admitted for acute medical pathology in two geriatric units of a regional hospital</td><td>39</td><td>79 + 9</td><td>17</td><td>58</td><td>24</td><td>1997</td><td>Belgium</td><td>Gazotti C et al. J Nutr Health Aging 1997;1:23-27</td></tr><tr><td>Geriatric medicine Assessment on admission to hospital</td><td>166</td><td>&gt;70</td><td>15</td><td>33</td><td>52</td><td>1999</td><td>Switzerland</td><td>Quadri P et al. Nestle Nutr Workshop Ser Clin Perform Programme 1999;1:141-147</td></tr><tr><td>Acute care elderly patients</td><td>151</td><td>83.8 (70-99)</td><td>26</td><td>52</td><td>22</td><td>1999</td><td>Belgium</td><td>Joosten E et al. Aging (Milano) 1999;111:390-394</td></tr><tr><td>Acute care General surgery and neurosciences</td><td>152</td><td>&gt;65</td><td>15</td><td>44</td><td>41</td><td>1999</td><td>Canada</td><td>Azad N et al. CMAJ 1999;161:511-515</td></tr><tr><td>Acute care Elderly patients, not institutionalized, scheduled for elective surgery</td><td>419</td><td>72 (60 - 98)</td><td>7</td><td>25</td><td>68</td><td>1999</td><td>France</td><td>Cohendy R et al. Nestle Nutr Workshop Ser.Clin Perform.Programme 1999;1:117-121</td></tr><tr><td>Acute care</td><td>299</td><td>83± 8</td><td>24</td><td>45</td><td>31</td><td>1999</td><td>France</td><td></td></tr><tr><td>Sub-acute care</td><td>196</td><td></td><td>32</td><td>55</td><td>13</td><td></td><td></td><td>Compan B et al. J Nutr Health Aging 1999;3:146-151</td></tr><tr><td>Long-term care</td><td>423</td><td></td><td>25</td><td>50</td><td>25</td><td></td><td></td><td></td></tr><tr><td>Geriatric Medicine Elderly patients admitted to the regional university hospital</td><td>175</td><td>80+8</td><td>22</td><td>49</td><td>30</td><td>2000</td><td>Belgium</td><td>Gazzotti C et al. J Nutr Health Aging 2000;4:176-81</td></tr><tr><td>Acute care Orthopaedic ward patients admitted for emergency surgery</td><td>49</td><td>60 -103</td><td>16</td><td>47</td><td>37</td><td>2000</td><td>U.K.</td><td>Murphy MC et al. Eur J Clin Nutr 2000;54:555-562</td></tr><tr><td>Internal medicine</td><td>101</td><td>79.7 ± 6.3 (70-93)</td><td>8</td><td>46</td><td>47</td><td>2000</td><td>France</td><td>Clement A et al. Presse Med 2000;29:1207-1213</td></tr><tr><td>Geriatric medicine Assessment on admission to hospital</td><td>1145</td><td>84.2</td><td>19</td><td>60</td><td>21</td><td>2001</td><td>Switzerland</td><td>van Nes MC et al. Age and Ageing 2001;30:221-226</td></tr><tr><td>Hospital, general medicine</td><td>408</td><td>63 (&gt;60)</td><td>19</td><td>43</td><td>38</td><td>2001</td><td>France</td><td></td></tr><tr><td>Hospital, surgery</td><td>113</td><td></td><td>21</td><td>44</td><td>35</td><td></td><td></td><td>Gin H. et al. Cah Nutr Diét 2001;36:185-188</td></tr><tr><td>Hospital, geriatry</td><td>75</td><td></td><td>53</td><td>41</td><td>6</td><td></td><td></td><td></td></tr><tr><td>Geriatric ward of a general hospital</td><td>126</td><td></td><td>31</td><td>51</td><td>18</td><td>2002</td><td>Belgium</td><td>Pepersack T et al. J Nutr Health Aging 2002;6:306-310</td></tr><tr><td>Acute geriatric inpatient ward.</td><td>83</td><td>83+7</td><td>26</td><td>56</td><td>18</td><td>2002</td><td>Sweden</td><td>Persson M. et al. J Am Geriatr Soc 50:1996-2002, 2002</td></tr><tr><td>Sub-acute care</td><td>837</td><td>76 + 13</td><td>29</td><td>63</td><td>9</td><td>2002</td><td>USA</td><td>Thomas D.R. & al. Am J Clin Nutr 2002;75:308-313</td></tr><tr><td>Geriatric hospital admissions</td><td>486</td><td>81 ± 8</td><td>74</td><td>23</td><td>3</td><td>2002</td><td>Italy</td><td>Donini L.M. & al. J Nutr Health Aging 2002;6(2):141-146</td></tr><tr><td>Geriatric hospital</td><td>167</td><td>82 ± 8</td><td>2</td><td>30</td><td>68</td><td>2003</td><td>Italy</td><td>Donini L.M. & al. Journal of nutrition 2003;7(5):282-292</td></tr><tr><td>Demented patients admitted to an Alzheimer section</td><td>174</td><td>80.24 ± 8.09</td><td>36</td><td>48</td><td>17</td><td>2003</td><td>Italy</td><td>Magri F. & al. Aging Clin Exp Res 2003;15(2):148-153</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>**Table 8 (continued)**
MNA® Clinical practice- Hospital Settings - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 - 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Patients with various forms of advanced cancer about to start palliative chemotherapy</td><td>71</td><td>&gt; 65</td><td>13</td><td>63</td><td>24</td><td>2003</td><td>Australia</td><td>Slaviero KA. &amp; al. Nutrition and Cancer 2003;(46)2:148-157</td></tr><tr><td>Patients admitted to 5 regional hospital</td><td>43</td><td>78.6 (68 - 94)</td><td>21</td><td>29</td><td>50</td><td>2003</td><td>Australia</td><td>Barone L. et al. J Nutr Health Aging 2003;7(1):13-17</td></tr><tr><td>Patients over 60-year admitted in hematology department</td><td>123</td><td>74 (60 - 97)</td><td>13</td><td>36</td><td>51</td><td>2003</td><td>France</td><td>Bauduer F. et al. J Nutr Health Aging 2003;7(3):179-182</td></tr><tr><td>Inpatient geriatric service of an university hospital and a geriatric ward of a non-academic teaching hospital (MNA® -SF)</td><td>298</td><td>&gt; 60</td><td>61</td><td>32</td><td>7</td><td>2004</td><td>The Netherlands</td><td>Rypkema G. &amp; al. J Nutr Health Aging 2004;8(2):122-127</td></tr><tr><td>Older men with prostate cancer</td><td>total = 80</td><td>&gt; 65 (65-94)</td><td></td><td></td><td></td><td>2004</td><td>Lithuania</td><td>Toliusiene J. &amp; al. Medicina 2002;38:929-932</td></tr><tr><td>Group a: advanced</td><td>40</td><td></td><td>10</td><td>50</td><td>40</td><td></td><td></td><td></td></tr><tr><td>Group b: benign</td><td>40</td><td></td><td>0</td><td>8</td><td>37</td><td>2004</td><td>Spain</td><td>Support Care Cancer 2004(12):716-719</td></tr><tr><td>Geriatric convalescence unit (intermediate care facility)</td><td>118</td><td></td><td>46</td><td>47</td><td>8</td><td></td><td></td><td>Arellano Perez M. &amp; al. Rev Mult Gerontol 2004;14(5):258-261</td></tr><tr><td>First visit to a geriatric clinic for surgery</td><td>204</td><td>77.5 ± 6.1</td><td>8</td><td>37</td><td>56</td><td>2004</td><td>Spain</td><td>Esteban M. et al. Rev Esp Geriatr Gerontol 2004;39(1):25-28</td></tr><tr><td>Patients on discharge from surrounding acute hospitals. Hampstead Rehabilitation Centre in Adelaide, a sub-acute care facility</td><td>65</td><td>&gt;65</td><td>29</td><td>46</td><td>25</td><td>2004</td><td>Australia</td><td>Visvanathan R. &amp; al. Age Ageing 2004;33:260-265</td></tr><tr><td>Geriatric Oncology Program: Cancer patients</td><td>135</td><td>78 (66-92).</td><td>24</td><td>41</td><td>36</td><td>2004</td><td>France</td><td>Terret C. et al. J Clin Oncol 2004;22(14S):8167</td></tr><tr><td>Rehabilitation unit at the Repatriation General Hospital</td><td>133</td><td>81+6</td><td>6</td><td>47</td><td>47</td><td>2005</td><td>Australia</td><td>Neumann S.A. et al. J Hum Nutr Dietet 2005;18:129-136</td></tr><tr><td>Patients attending the medical oncology day centers</td><td>157</td><td>65 (32-81)</td><td>9</td><td>57</td><td>34</td><td>2005</td><td>Australia</td><td>Read J.A. et al. Nutr Cancer 2005;53:51-56</td></tr><tr><td>Acute care geriatric wards</td><td>80</td><td>80.2 + 7.7</td><td>33</td><td>38</td><td>30</td><td>2005</td><td>Germany</td><td>Bauer J.M. et al. Z. Gerontol Geriatr 2005;38:322-327 ClinNutr 2005;34(4):557 (Abstr P046)</td></tr><tr><td>Patients admitted to hospital</td><td>200</td><td>81±7</td><td>50</td><td>38</td><td>13</td><td>2005</td><td>Spain</td><td>Gomez Ramos et al. Nutr Hosp 2005;20(4):286-292 Arch Latinoam Nutr 2005;55(1)71-76</td></tr><tr><td>Patients admitted to hospital</td><td>145</td><td></td><td>68</td><td>30</td><td>2</td><td>2005</td><td>Spain</td><td>Izaola O. et al. An Med Interna 2005;22(7):313-316</td></tr><tr><td>Elderly hospitalized for different medical and/or surgical reasons</td><td>207</td><td>74.3 ± 7.0</td><td>9</td><td>30</td><td>61</td><td>2005</td><td>Portugal</td><td>Martins C.P.A.L. et al. J Nutr Elderly 2005;25:5-21</td></tr><tr><td>Prospective cohort study of patients from a geriatric hospital</td><td>414</td><td>&gt;75</td><td>49</td><td>33</td><td>17</td><td>2005</td><td>Israel</td><td>Kagansky N. et al. Am J Clin Nutr 2005;82:784-791</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 8 (continued)**
MNA® Clinical practice- Hospital Settings - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Elderly institutionalized in geriatric units</td><td>126</td><td>60 - 96</td><td>6</td><td>48</td><td>46</td><td>2005</td><td>Venezuela</td><td>Rodriguez N. et al. Invet Clin 2005;46(3):219-228</td></tr><tr><td>Patients aged ≥ 65 at the time of admission</td><td>108</td><td>73.1 ± 5.8</td><td>22</td><td>41</td><td>37</td><td>2005</td><td>Korea</td><td>Chung S.H. &amp; Sohn C.M. Korean J Community Nutr 2005;10:645-653</td></tr><tr><td>Patients referred to hospital</td><td>120</td><td>80 ± 7</td><td>17</td><td>44</td><td>39</td><td>2005</td><td>China (Hong Kong)</td><td>Shum N.C. et al. Hong Kong Med J 2005;11(4):234-242</td></tr><tr><td>Acute care</td><td>204</td><td>73.8 ± 5.6</td><td>1</td><td>39</td><td>60</td><td>2006</td><td>Israel</td><td>Castel H. et al. J Am Coll Nutr 2006;25:128-134</td></tr><tr><td>Patient who underwent major elective surgery</td><td>202</td><td>55.3 ± 14.9</td><td>17</td><td>73</td><td>10</td><td>2006</td><td>Turkey</td><td>Kuzu M.A. et al. World J Surg 2006;30:378-390</td></tr><tr><td>Hemodialysis Patients with CRP&lt;10mg/dl</td><td>137</td><td>41 ± 12</td><td>13</td><td>77</td><td>47</td><td>2006</td><td>Turkey</td><td>Afsar B. et al. J Renal Nutr 2006;16(3):277-282</td></tr><tr><td>All consecutive patients admitted into the clinic</td><td>102</td><td>62 ± 19 (16-91)</td><td>12</td><td>38</td><td>50</td><td>2006</td><td>Switzerland</td><td>Gehring N. et al. Swiss Med Wkly 2006;136:664-669</td></tr><tr><td>Elderly non-diabetic patients on admission to hospital</td><td>29</td><td>86 ± 5.8</td><td>21</td><td>59</td><td>21</td><td>2006</td><td>Switzerland</td><td>Bonin-Guillaume S. et al. Diabetes Metab 2006;32:236-243</td></tr><tr><td>Hospitalized patients</td><td>41</td><td>63 ± 22</td><td>51</td><td>42</td><td>7</td><td>2006</td><td>Spain</td><td>Villamayor Blanco L. et al. Nutr Hosp 2006;21(2):163-172</td></tr><tr><td>Admission to surgery unit</td><td>133</td><td>22 - 93</td><td>7</td><td>31</td><td>62</td><td>2006</td><td>Spain</td><td>Agalés M. et al. Nutr Hosp 2006;21(Supl 1):28(Abstr)</td></tr><tr><td>Hospitalized patients (Surgery &amp; Internal Medicine)</td><td>400</td><td>67 ± 16 (20 - 102)</td><td>15</td><td>44</td><td>42</td><td>2006</td><td>Spain</td><td>Velasco Gimeno C. et al. Nutr Hosp 2006;21(Supl 1):21(Abstr)</td></tr><tr><td>Hospitalized elderly from nine hospitals</td><td>213</td><td>73.5 ± 15</td><td>24</td><td>50</td><td>26</td><td>2006</td><td>Spain</td><td>de Luis D. et al. Eur J Intern Med 2006;17(8):556-560</td></tr><tr><td>Geriatric hospital population</td><td>100</td><td>65 - 89</td><td>29</td><td>52</td><td>19</td><td>2006</td><td>India</td><td>Manral M. Abstr 6th Intern Conf on Dietary Assessment Methods, Copenhagen, April 27-29, 2006</td></tr><tr><td>Hospital older patients</td><td>114</td><td>75.22 ± 6.29</td><td>4</td><td>43</td><td>53</td><td>2007</td><td>Taiwan</td><td>Chen C.C-H. et al. J Clin Nursing 2007;16(11):2015-2026</td></tr><tr><td>Hospital geriatric service</td><td>197</td><td>60 (60-75: 55%; 75-85: 35%; &gt;85: 10%)</td><td>32</td><td>49</td><td>19</td><td>2007</td><td>Cuba</td><td>Cuyac L. M. &amp; Santana P. S. Arch Latinoam Nutr 2007;57(3):255-265</td></tr><tr><td>Older patients admitted to the internal medicine department</td><td>589</td><td>&gt; 65</td><td>19</td><td>36</td><td>57</td><td>2007</td><td>Israel</td><td>Feldblum I. et al. Nutr J 2007;6:37</td></tr><tr><td>Multimorbid geriatric patients in acute care with Pressure Ulcere</td><td>81</td><td>79.3 ± 7.4</td><td>40</td><td>58</td><td>3</td><td>2007</td><td>Germany</td><td>Hengstermann S. et al. J parenter Enteral Nutr 2007; 31:288-294</td></tr><tr><td>Idem, without Pressure Ulcer</td><td>403</td><td>79.7 ± 7.7</td><td>17</td><td>60</td><td>24</td><td></td><td></td><td></td></tr><tr><td>Rehabilitation ward</td><td>38</td><td></td><td>4</td><td>42</td><td>54</td><td>2007</td><td>Australia</td><td>Neumann S.A. et al. Nutr Dietetics 2007;64:179-185</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<caption>Table 8 (continued)</caption>

MNA® Clinical practice- Hospital Settings - Identifying the elderly/adults at risk of malnutrition

<table><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 - 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Hip fracture patients</td><td>157</td><td>&gt; 75</td><td>10</td><td>60</td><td>30</td><td>2007</td><td>Sweden</td><td>Olofsson B. et al. J Clin Nursing 2007;16:2027-2038</td></tr><tr><td>Admission to cardiac and orthopaedic services</td><td>114</td><td>75 ± 6</td><td>4.4</td><td>43</td><td>52.6</td><td>2007</td><td>Taiwan</td><td>Chen C.C-H. et al. J Clin Nursing 2007;16:2015-2026</td></tr><tr><td>Consecutively admitted patients</td><td>205</td><td>82 (75 - 95)</td><td>30</td><td>60</td><td>10</td><td>2007</td><td>Germany</td><td>Saeglitz C. PhD Thesis 2007, Hohen Landwirtschaftlichen Falkultät der Rheinischen Friedrich-Wil-hems-Universität Bonn</td></tr><tr><td>Consecutively admitted patients</td><td>97</td><td>71 ± 7.7</td><td>18</td><td>50</td><td>32</td><td>2007</td><td>Mexico</td><td>Gutiérrez Reyes J.G. et al. Nutr Hosp 2007;22(6):702-709</td></tr><tr><td>Hospitalized elderly</td><td>123</td><td>&gt;65</td><td>24</td><td>42</td><td>35</td><td>2007</td><td>Spain</td><td>Villar Taibo R. et al. Nutr Hosp 2007;22(Supl 1):68( Abstr)</td></tr><tr><td>Admission to orthopedic surgery</td><td>107</td><td>62 ± 20 (16 - 95)</td><td>12</td><td>22</td><td>66</td><td>2008</td><td>Spain</td><td>García Duque S. et al. Nutr Hosp 2008;23(5):493-499</td></tr><tr><td>Admission to hospital</td><td>41</td><td>83 ± 5</td><td>29</td><td>71</td><td>0</td><td>2008</td><td>Spain</td><td>Trabal J. et al. Clin Nutr 2008;Sup- pl3(1):61(P078)</td></tr><tr><td>Admission to hospital: elderly patients</td><td>531</td><td></td><td>32</td><td>51</td><td>17</td><td>2008</td><td>Portugal</td><td>Cansado P et al. Clin Nutr 2007; Suppl2(2):99(P032)</td></tr><tr><td>Elderly patients at a tertiary teaching hospital</td><td>100</td><td>81.9 ± 6.3</td><td>30</td><td>61</td><td>9</td><td>2008</td><td>Australia</td><td>Adams N.E. et al. Nutr Dietetics 2008;65:144-150</td></tr><tr><td>Multimorbid patients</td><td>808</td><td>77.1 ± 9.0</td><td>20</td><td>65</td><td>15</td><td>2008</td><td>Germany</td><td>Hengstermann S. et al. J Nutr Health Aging 2008;12(2):117-122</td></tr><tr><td>Mono-centre non-interventional trial hospitalised patients</td><td>102</td><td>62 ± 19</td><td>12</td><td>38</td><td>50</td><td>2006</td><td>Switzerland</td><td>Gehring N. et al. Swiss Med Wkly 2006;136(41- 42):664-669</td></tr><tr><td>Patients hospitalized for pneumonia in the Acute Geriatric Unit of Hospital de Mataró, Barcelona</td><td>117</td><td>84.7 ± 6.5</td><td>31</td><td>53</td><td>16</td><td>2008</td><td>Spain</td><td>Cabrè M. et al. Med Clin (Barc) 2008;131(5):167- 170</td></tr><tr><td>Patients with rheumatoid arthritis at inpatient ward</td><td>59</td><td>65 (55 - 75</td><td>22</td><td>51</td><td>27</td><td>2008</td><td>Sweden</td><td>Elkan A.C. et al. Eur J Clin Nutr 2008;62:1239-1247</td></tr><tr><td>COPD patients admitted to an acute care hospital ward</td><td>50</td><td>75.7 ± 6.9</td><td>48</td><td>48</td><td>2</td><td>2008</td><td>Sweden</td><td>Odencrants S. et al. J Clin Nursing 2008;17:1771-1778</td></tr><tr><td>Hospitalized medical patients</td><td>195</td><td>&gt;65</td><td>0</td><td>39</td><td>61</td><td>2008</td><td>Israel</td><td>German L. et al. J Nutr Health Aging 2008;12(5):313-318</td></tr><tr><td>180 persons, 65 males and 115 females (Rehabilitation unit)</td><td>180</td><td>79.5 (65-97)</td><td>19</td><td>67</td><td>14</td><td>2008</td><td>Italy</td><td>Amici A. et al. Arch Gerontol Geriatr 2008;46(3):327-334</td></tr><tr><td>Admission to medicine guard of a military hospital</td><td>113</td><td>78.3 ± 7.7 (65 - 98)</td><td>38</td><td>41</td><td>21</td><td>2008</td><td>Chile</td><td>Hirsch S. et al. Open Longevity Sci 2008;2:17-22</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 8 (continued)**
MNA® Clinical practice- Hospital Settings - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 - 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Unilateral lower-extremity amputees, Prosthetics clinic</td><td>58</td><td>66 (21 - 91)</td><td>2</td><td>28</td><td>71</td><td>2008</td><td>Australia</td><td>Miller M. et al. Arch Phys Med Re-habil 2008;89:2031-2033</td></tr><tr><td>Patients with metastatic lung cancer</td><td>163</td><td>65.4</td><td>26</td><td>46</td><td>28</td><td>2008</td><td>Greece</td><td>Gioulbasanis I. et al. J Clin Oncol 2008;26(15S Sup-pl):19062</td></tr><tr><td>Older hospitalised patients aged ≥ 65 years at hospitalization</td><td>306</td><td>71.8 (65 - 89)</td><td>9</td><td>64</td><td>28</td><td>2009</td><td>Taiwan</td><td>Chen C.C.H. et al. J Clin Nurs 2009;18:3299-3307</td></tr><tr><td>After 16 days hospitalisation/ Discharge</td><td></td><td></td><td>37</td><td>54</td><td>9</td><td></td><td></td><td></td></tr><tr><td>Elderly patients with hip fractures</td><td>32</td><td>66-95</td><td>44</td><td>53</td><td>3</td><td>2009</td><td>Sweden</td><td>Wengstrom Y. et al. J Nutr Health Aging 2009;13:632-638</td></tr><tr><td>Consecutively admitted patients</td><td>432</td><td>63 ± 19</td><td>10</td><td>20</td><td>70</td><td>2009</td><td>Switzerland</td><td>Venzin R.M. et al. Eur J Clin Nutr 2009;63:430-436</td></tr><tr><td>Elderly hospitalized in a hospital that provides care for the public and private healthcare systems</td><td>240</td><td>≥ 60</td><td>29</td><td>37</td><td>34</td><td>2009</td><td>Brazil</td><td>Oliveira M. et al. Nutr J 2009;8:54</td></tr><tr><td>Inpatients admitted to an acute geriatric ward</td><td>104</td><td>84 (78-89)</td><td>22</td><td>48</td><td>30</td><td>2010</td><td>Switzerland</td><td>Drescher T. et al. Eur J Clin Nutr 2010;64:887-893</td></tr><tr><td>Patients admitted to Internal Medicine</td><td>143</td><td>65.2 ± 16.5</td><td>10</td><td>53</td><td>37</td><td>2010</td><td>Spain</td><td>Bernabeu-Wittel M. et al. Arch Gerontol Geriatr. 2010;51(2):1851-1891</td></tr><tr><td>Patients admitted to the neurological and neurosurgical wards</td><td>196</td><td>66 ± 13</td><td>7</td><td>34</td><td>59</td><td>2010</td><td>The Netherlands</td><td>Hafsteinsdóttir T.B. et al. J Clin Nurs 2010;19:639-648</td></tr><tr><td>Elderly patients ≥ 75 from all Belgian general and teaching hospitals with elderly wards</td><td>2329</td><td>83.8 ± 5.2</td><td>33</td><td>43</td><td>24</td><td>2010</td><td>Belgium</td><td>Vanderwee K. et al. Clin Nutr 2010;29:469-476</td></tr><tr><td>Patients aged 65 + y admitted to two rehabilitation hospitals</td><td>2076</td><td>80.6 ± 27.7</td><td>33</td><td>52</td><td>16</td><td>2010</td><td>Australia</td><td>Charlton K.E. et al. J Nutr Health Aging 2010;4:622-628</td></tr><tr><td>Patients >18 years old, with newly diagnosed metastatic lung cancer, admitted to the Department of Medical Oncology, University Hospital of Heraklion</td><td>115</td><td>66 (32-86)</td><td>25</td><td>51</td><td>24</td><td>2011</td><td>Greece</td><td>Gioulbasanis I. et al. Lung Cancer 2011;74(3):516-520</td></tr><tr><td>Patients were randomly selected from the hospital admission register</td><td>400</td><td>67.4 ± 16.1</td><td>15</td><td>44</td><td>42</td><td>2011</td><td>Spain</td><td>Velasco C. et al. Eur J Clin Nutr. 2011;65:269-274</td></tr><tr><td>Patients with cancer >70years for whom chemotherapy was prescribed by their medical oncologist</td><td>202</td><td>77 ± 4.2</td><td>3</td><td>30</td><td>65</td><td>2011</td><td>The Netherlands</td><td>Aaldriks A.A. et al. Crit Rev Oncol Hematol 2011;79:205-212</td></tr><tr><td>Older non-diabetic and diabetic patients</td><td>164</td><td>85.2 ± 6.4</td><td>17</td><td>53</td><td>29</td><td>2012</td><td>Switzerland</td><td>Vischer U.M. et al. Clin Nutr 2012;31:113-117</td></tr><tr><td>Patients admitted to three different internal medicine units</td><td>106</td><td>79.4</td><td>22</td><td>55</td><td>24</td><td>2012</td><td>Spain</td><td>Calvo I. et al. Nutr Hosp 2012;27:1619-1625</td></tr><tr><td>Patients admitted in different medical or surgical wards</td><td>57</td><td>70.5 ± 16</td><td>14</td><td>35</td><td>51</td><td>2012</td><td>Spain</td><td>Ocón Bretón M.J. et al. Nutr Hosp 2012;27:701-706</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>**Table 8 (continued)**
MNA® Clinical practice- Hospital Settings - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Elderly at admission to the geriatric evaluation and management unit at The Queen Elizabeth Hospital in Adelaide</td><td>100</td><td>85.2 ± 6.1</td><td>40</td><td>44</td><td>16</td><td>2012</td><td>Australia</td><td>Dent E. et al. J Nutr Health Aging 2012;16:764-767</td></tr><tr><td>Older medical patients, large metropolitan public teaching hospital</td><td>134</td><td>80 ± 8</td><td>32</td><td>38</td><td>30</td><td>2013</td><td>Australia</td><td>Young A.M. et al. Nutrition 2013;29:101–106</td></tr><tr><td>People 65 years of age admitted to a medium-sized Swedish hospital</td><td>1767</td><td>78.1 ± 7.8</td><td>9</td><td>55</td><td>36</td><td>2013</td><td>Sweden</td><td>Söderström L. et al. Clin Nutr 2013;32:281-288</td></tr><tr><td>Elderly subjects admitted to either, the surgical and the medical ICU at a tertiary care hospital</td><td>250</td><td>74.2 ± 6.8</td><td>10</td><td>24</td><td>66</td><td>2013</td><td>U.S.A.</td><td>Sheean P.M. et al. Clin Nutr 2013;32:752-757</td></tr><tr><td>Older patients, older than 70, with cancers or lymphoma during chemotherapy</td><td>606</td><td>78.0 ± 4.9</td><td>13</td><td>52</td><td>35</td><td>2014</td><td>France</td><td>Bourdel-Marchasson I. et al. PLoS One 2014;9:e108687 PLoS One 2016;11:e0148523</td></tr><tr><td>Aged patients consecutively admitted to the acute geriatrics medical ward of Geriatrics and Gerontology department in Ain Shams University hospitals, Cairo</td><td>131</td><td>69.3 ± 8.2</td><td>41</td><td>53</td><td>7</td><td>2014</td><td>Egypt</td><td>Abd-El-Gawad W.M. et al. Clin Nutr 2014;33:1108-1116</td></tr><tr><td>Patients (&gt;18 years old) with advanced heart failure</td><td>162</td><td>&gt;18</td><td>25</td><td>65</td><td>10</td><td>2014</td><td>U.S.A.</td><td>Yost G. et al. Nutr Clin Pract. 2014;29(5):686-691</td></tr><tr><td>Consecutively admitted internal medicine patients at Sakarya Education and Research Hospital</td><td>130</td><td>76.2±7.2</td><td>37</td><td>31</td><td>32</td><td>2015</td><td>Turkey</td><td>Demir M.V. et al. Niger J Clin Pract. 2015;18(6):757-761</td></tr><tr><td>Elderly patients hospitalized at a geriatric care hospital</td><td>141</td><td>73.5 ± 5.2</td><td>26</td><td>40</td><td>34</td><td>2015</td><td>Korea</td><td>Baek M.-H. and Heo Y.-R. Nutr Res Pract 2015;9:637-643</td></tr><tr><td>Hospitalized patient of a tertiary hospital center</td><td>194</td><td>71.6 ± 21.4</td><td>23</td><td>46</td><td>31</td><td>2015</td><td>Spain</td><td>Calleja Fernández A. et al. Nutr Hosp 2015;31:2240-2246</td></tr><tr><td>Geriatric trauma patients</td><td>50</td><td>84.9 ± 5</td><td>28</td><td>42</td><td>30</td><td>2016</td><td>Germany</td><td>Goost H. et al. Technology and Health Care 2016;24: 225–239</td></tr><tr><td>Acute geriatric ward admission</td><td>120</td><td>82.5 ±8.0</td><td>27</td><td>48</td><td>25</td><td>2016</td><td>Norway</td><td>Jacobsen L. et al. BMJ Open 2016;6:e011512.</td></tr><tr><td>Patients with the age of 75 years or older and an indication for hip surgery</td><td>226</td><td>83 ± 5</td><td>5</td><td>27</td><td>68</td><td>2016</td><td>The Netherlands</td><td>van Wissen J. et al. J Nutr Health Aging 2016;20:964-968</td></tr><tr><td>Older adults admitted to rural rehabilitation facilities</td><td>57</td><td>79.1 ± 7.3</td><td>28</td><td>58</td><td>14</td><td>2016</td><td>Australia</td><td>Marshall S. et al. J Acad Nutr Diet 2016;116:785-794</td></tr><tr><td>Patients aged ≥70 years admitted to the Geriatric Evaluation and Management Unit following a brief acute hospital stay</td><td>100</td><td>85.2 ± 6.1</td><td>40</td><td>44</td><td>16</td><td>2017</td><td>Australia</td><td>Dent E. et al. Australas J Ageing 2017;36:E8-E13</td></tr><tr><td>Older patients (aged ≥ 60 years) from the acute geriatric wards of two hospitals in Chengdu</td><td>453</td><td>79.0 ± 7.8</td><td>10</td><td>41</td><td>48</td><td>2017</td><td>China</td><td>Hu X. et al. Sci Rep 2017;7:3171</td></tr><tr><td>Orthopedic and traumatology patient cohort</td><td>398</td><td>≥ 65</td><td>4</td><td>34</td><td>62</td><td>2017</td><td>Germany</td><td>Lambert C. et al. Nutrition 2017;37:60–67</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 8 (continued)**
MNA® Clinical practice- Hospital Settings - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br>&lt;17</th><th>At risk<br>17 - 23.5</th><th>Well-nourished<br>≥24</th></tr></thead><tbody><tr><td>Hospitalized patients in an<br>internal medicine clinic: Adult</td><td>84</td><td>54 ± 7</td><td>7</td><td>33</td><td>60</td><td rowspan="2">2017</td><td rowspan="2">Turkey</td><td rowspan="2">Yürüçer, M. et al.<br>Turk J Med Sci<br>2017;47:1362-1369</td></tr><tr><td>Elderly</td><td>112</td><td>77 ± 8</td><td>17</td><td>68</td><td>15</td></tr><tr><td>Hospitalised trauma patients</td><td>521</td><td>54.0 ± 18.1</td><td>3</td><td>33</td><td>65</td><td rowspan="2">2017</td><td rowspan="2">Germany</td><td rowspan="2">Ihle c. et al.<br>Z Orthop Unfall<br>2017;155:184-193</td></tr><tr><td>Adult patients (&gt;18 years) with<br>solid tumor diagnosis and a life<br>expectancy &gt;3 months</td><td>1952</td><td>62.7 ± 12.9</td><td>9</td><td>42</td><td>49</td></tr><tr><td>Acutely ill patients admitted<br>to a geriatric ward of a tertiary<br>university hospital in São Paulo</td><td>1409</td><td>80 ± 9</td><td>43</td><td>42</td><td>15</td><td rowspan="2">2017</td><td rowspan="2">Brazil</td><td rowspan="2">Avelino-Silva T.J.et<br>al. PLoS medicine<br>2017;14:e1002264</td></tr><tr><td>Patients with end-stage renal<br>disease</td><td>47</td><td>69.7 ± 8.95</td><td>2</td><td>28</td><td>70</td></tr><tr><td>Patients staying on the internal<br>medicine ward<br>Women</td><td>76</td><td>65 ± 9.7</td><td>3</td><td>29</td><td>68</td><td rowspan="2">2018</td><td rowspan="2">Poland</td><td rowspan="2">Rogowski Ł. et al.<br>Adv Clin Exp Med<br>2018;27:1117-1123</td></tr><tr><td>Men</td><td>44</td><td>63 ± 8.4</td><td>0</td><td>18</td><td>82</td></tr><tr><td>Patients hospitalized for a hip<br>fracture</td><td>62</td><td>79.9 ± 7.7</td><td>9</td><td>46</td><td>44</td><td rowspan="2">2018</td><td rowspan="2">Italy</td><td rowspan="2">Valentini A. et al.<br>Clin Interv Aging<br>2018;13:1237-1244</td></tr><tr><td>Caucasian patients undergoing<br>major surgery</td><td>50</td><td>73.5 ± 7.76</td><td>10</td><td>44</td><td>46</td></tr><tr><td>Oncology patients.</td><td>296</td><td>58.3 ± 11.6</td><td>16</td><td>44</td><td>40</td><td rowspan="2">2018</td><td rowspan="2">Turkey</td><td rowspan="2">Koc E.M. et al.<br>Fam Pract Palliat<br>Care 2018;3:39-44</td></tr><tr><td>Patients with GIS cancer</td><td>153</td><td>70.5 ± 5.6</td><td>38</td><td>35</td><td>28</td></tr><tr><td>Elderly undergoing elective<br>total hip arthroplasty at hospital<br>admission</td><td>26</td><td>75 ± 1</td><td>0</td><td>0</td><td>100</td><td rowspan="2">2019</td><td rowspan="2">The<br>Nether-<br>lands</td><td rowspan="2">Kouw I.W.K. et al.<br>J Am Med Dir Assoc<br>2019;20(1):35-42</td></tr><tr><td>Consecutively admitted internal<br>medicine patients</td><td>425</td><td>81.2±5.9</td><td>23</td><td>35</td><td>41</td></tr><tr><td>Hospitalized elderly patients</td><td>134</td><td>68.9 ± 8.4</td><td>43</td><td>42</td><td>16</td><td rowspan="2">2019</td><td rowspan="2">China</td><td rowspan="2">Miao J.-P. et<br>al. BMJ Open.<br>2019;9(2):e022993</td></tr><tr><td>Very old patients admitted to<br>an Orthogeriatric Unit for the<br>treatment of a hip fracture</td><td>150</td><td>87.6 ± 4.9</td><td>13</td><td>49</td><td>38</td></tr><tr><td>Outpatients ≥70 years at the<br>Emergency Department of the<br>University Clinical Hospital of<br>Valladolid</td><td>288</td><td>81.1 ± 6.6</td><td>15</td><td>55</td><td>31</td><td rowspan="2">2019</td><td rowspan="2">Spain</td><td rowspan="2">Sánchez-Castellano<br>C. et al.<br>Bolado Jiménez C.<br>et al.<br>Bolado Jiménez C.<br>et al. Nutrition 2019<br>:66:142-1466</td></tr><tr><td>Hospitalized elderly</td><td>124</td><td>85.9±5.5</td><td>50</td><td>50</td><td>2</td></tr><tr><td>Patients hospitalised on<br>the geriatric wards of the<br>Department of Internal Medicine</td><td>240</td><td>83.4±8.1</td><td>37</td><td>61</td><td>2</td><td rowspan="2">2019</td><td rowspan="2">Germany</td><td rowspan="2">Becker L. et al.<br>Sci Rep 2019:9:9064</td></tr><tr><td>Consecutive patients with<br>end-stage kidney disease on<br>maintenance haemodialysis</td><td>113</td><td>67.0 ± 16.1</td><td>36</td><td>48</td><td>16</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>**Table 8 (continued)**
MNA® Clinical practice- Hospital Settings - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Hospitalized patients diagnosed with Heart Failure with reduced ejection fraction</td><td>120</td><td>55 ± 11</td><td>9</td><td>52</td><td>39</td><td>2020</td><td>Poland</td><td>Kaluzna-Oleksy M. et al. Nutrients 2020;12:2330</td></tr><tr><td rowspan="2">Hospitalized elderly</td><td></td><td></td><td>Under-nourished<br/>&lt;17</td><td>At risk of malnutrition<br/>17 – 23.5</td><td>Well-nourished<br/>≥24</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Total</td><td>33222</td><td>mean</td><td>22</td><td>44.5</td><td>34</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td>SE</td><td>0.2</td><td>0.3</td><td>0.3</td><td></td><td></td><td></td></tr></tbody></table>

<table><caption>**Table 9**
MNA® Clinical practice – Frail elderly (Outpatient/Home Care) - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Home care Elderly receiving home nursing care</td><td>80</td><td>84 ± 6</td><td>3</td><td>63</td><td>35</td><td>1999</td><td>Sweden</td><td>Saletti A et al J Hum.Nutr Diet 1999;12:381-387</td></tr><tr><td>Home care</td><td>529</td><td>78±9</td><td>6</td><td>46</td><td>48</td><td>1999</td><td>Belgium</td><td>Ridder D et al. Nestle Nutr Workshop Ser Clin Perform Programme 1999;1:162</td></tr><tr><td>Outpatient Elderly patients visiting the university teaching hospital outpatient clinic</td><td>53</td><td>80±7</td><td>2</td><td>23</td><td>75</td><td>1999</td><td>Switzerland</td><td>Decrey H et al. Nestle Nutr Workshop Ser Clin Perform Programme 1999;1:163</td></tr><tr><td>Community geriatric outpatient clinic</td><td>463</td><td>70</td><td>1</td><td>8</td><td>91</td><td>2000</td><td>Israel</td><td>Maaravi Y et al. Aging (Milano) 2000;12:173-179</td></tr><tr><td>Gerontological internal medicine service</td><td>71</td><td>>65</td><td>22</td><td>35</td><td>14</td><td>2000</td><td>France</td><td>Fanello et al. Sante Publique 2000 Mar;12(1):83-90</td></tr><tr><td>Patients >65 years in general practice, with no acute illness</td><td>61</td><td>75 (72-79)</td><td>0</td><td>38</td><td>62</td><td>2001</td><td>Denmark</td><td>Beck AM et al. Eur J Clin Nutr 2001;55:1028-33</td></tr><tr><td>Home Care, Patients with leg and foot ulcers</td><td>70</td><td>79</td><td>2</td><td>32</td><td>36</td><td>1999</td><td>Sweden</td><td>Wissing U. et al. Scand.J Caring Sci 1999;13:123-128 J Nutr Health Aging 2001;5:37-42</td></tr><tr><td>Follow-up for 4 years</td><td>43</td><td>+ 4 years</td><td>13</td><td>58</td><td>29</td><td>2001</td><td></td><td></td></tr><tr><td>Outpatient Elderly patients referred to a geriatric outpatient clinic</td><td>56</td><td></td><td>11</td><td>48</td><td>41</td><td>2001</td><td>U.K.</td><td>Cottee M et al. J Nutr Health Aging 2001;5(1):37-42</td></tr><tr><td>Outpatient Elderly lived at home in Tallinn</td><td>150</td><td>58-86</td><td>1</td><td>39</td><td>60</td><td>2002</td><td>Estonia</td><td>Saava M &amp; al. J Nutr Health Aging 2002;6:93-95</td></tr><tr><td>Elderly admitted to municipal care</td><td>261</td><td>83.8 + 7</td><td>23</td><td>56</td><td>21</td><td>2002</td><td>Sweden</td><td>Christensson et al Eur J Clin Nutr 2002;56:810-818</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 9 (continued)**
MNA® Clinical practice – Frail elderly (Outpatient/Home Care) - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Domiciliary care clients</td><td>173</td><td>67 - 99</td><td>5</td><td>38</td><td>57</td><td>2003</td><td>Australia</td><td>Visvanathan R & al. J Am Geriatr Soc 2003;51:1007-1011</td></tr><tr><td>Frail elderly receiving support services</td><td>51</td><td>83.7 ± 4.4<br/>(76-93)</td><td>1</td><td>47</td><td>52</td><td>2003</td><td>Finland</td><td>Soini H. & al. Spec Care Dentist 2003;23(6): 209-215</td></tr><tr><td>Elderly living at home, receiving Meals-on-Wheels (MOW)</td><td>324</td><td>60-90</td><td>24</td><td>65</td><td>11</td><td>2003</td><td>U.S.A.</td><td>Kretser AJ. & al J Am Diet Assoc 2003;103:329-336</td></tr><tr><td>Municipal home-care services in rural Finland.</td><td>178</td><td>&gt;75 [75-94)</td><td>3</td><td>48</td><td>49</td><td>2004</td><td>Finland</td><td>Soini H. & al. Eur J Clin Nutr 2004;58:64-70</td></tr><tr><td>Home living elderly Swedish women</td><td>351</td><td>~73</td><td>0</td><td>7</td><td>92</td><td>2004</td><td>Sweden</td><td>Salminen H. & al Osteoporos Int 2004;15(Suppl1):S52</td></tr><tr><td>Outpatients</td><td>215</td><td>&gt;60</td><td>4</td><td>31</td><td>65</td><td>2004</td><td>Turkei</td><td>Sakarya M. & al Anasthesiol Intensivmed Notfal 2004;39:400-405</td></tr><tr><td>Home-care Patients</td><td>104</td><td>&gt;65</td><td>20</td><td>52</td><td>28</td><td>2004</td><td>Spain</td><td>Ricart Casas J. Aten Primaria 2004;34:238-243</td></tr><tr><td>Elderly in various settings was carried out.</td><td>226</td><td>78.6 + 0.5</td><td>20</td><td>58</td><td>22</td><td>2005</td><td>Japan</td><td>Kuzuya M. et al. Nutrition 2005;21:498-503</td></tr><tr><td>Elderly living at home in 5 Swedish municipalities</td><td>353</td><td>82± 7</td><td>8</td><td>41</td><td>51</td><td>2005</td><td>Sweden</td><td>Saletti A. & al. Gerontology 2005;51:192-198</td></tr><tr><td>Patients living at home and receiving home health care services</td><td>51</td><td>76-93</td><td>0</td><td>47</td><td>53</td><td>2005</td><td>Finland</td><td>Soini H. & al. J Nutr health Aging 2005;9:249-253</td></tr><tr><td>Community-dwelling and frail elderly</td><td>187</td><td>&gt;60</td><td>5</td><td>50</td><td>44.4</td><td>2005</td><td>South Africa</td><td>Charlton K.E. et al. Public Health Nutr 2005;8:468-479</td></tr><tr><td>Apartment residents</td><td>67</td><td>70 ± 2.5</td><td>0</td><td>34</td><td>66</td><td>2005</td><td>Canada</td><td>Lawrence H.P. et al. Spec Care Dentist 2005;25(5):242-252</td></tr><tr><td>Elderly service flat residents</td><td>80</td><td>85.5 (79 - 90)</td><td>30</td><td>59</td><td>11</td><td>2005</td><td>Sweden</td><td>Ödlund Olin A. et al. Eur J Clin Nutr 2005;59:263-270</td></tr><tr><td>Residential homes</td><td>127</td><td>&gt;65</td><td>20</td><td>50</td><td>30</td><td>2006</td><td>Sweden</td><td>Wikby K. et al. J Nutr health Aging 2006;10:232-238</td></tr><tr><td>Day-care centers</td><td>281</td><td>81.9 ± 7.2</td><td>9</td><td>51</td><td>40</td><td>2006</td><td>Japan</td><td>Izawa S. et al. Clin Nutr 2006;25:962-967</td></tr><tr><td>Osteoporosis study women</td><td>120</td><td>69 (60-80)</td><td>34</td><td>4</td><td>62</td><td>2006</td><td>Lithuania</td><td>Ožeraitienė V. & Būtėnaitė V. Medicina (Kaunas) 2006;42(10):836-842</td></tr><tr><td>Home care patients</td><td>178</td><td>83.5 ±4.63</td><td>3</td><td>48</td><td>49</td><td>2006</td><td>Finland</td><td>Soini H. et al. J Gerontol Nurs 2006;32(4):12-17</td></tr><tr><td>11 Centers of Health</td><td>1605</td><td>65 - 100)</td><td>6</td><td>34</td><td>60</td><td>2007</td><td>Spain</td><td>Jiménez Sanz M. et al. Nutr Hosp 2007;22(Suppl 1):9(Abstr)</td></tr><tr><td>Elderly outpatients with and without venous ulcers</td><td>77</td><td>73.9 ± 8.5</td><td>9</td><td>39</td><td>52</td><td>2008</td><td>Poland</td><td>Szewczyk M.T. et al. Ostomy Wound Management 2008;54(9):34-6,38-40,42</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>**Table 9 (continued)**
MNA® Clinical practice – Frail elderly (Outpatient/Home Care) - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Ambulatory rehabilitation</td><td>229</td><td>72 (70, 74)</td><td>5</td><td>58</td><td>37</td><td>2008</td><td>Australia</td><td>Kaur S. et al. Asia Pac J Clin Nutr 2008;17(2):199-207</td></tr><tr><td>Frail elderly service flat residents</td><td>49</td><td>84 (79 - 90)</td><td>27</td><td>63</td><td>10</td><td>2008</td><td>Sweden</td><td>Ödlund Olin A. et al. J Nutr Health Aging 2008;12(5)295-301</td></tr><tr><td>Patients with Parkinson's disease</td><td>61</td><td>72.1 ± 12.5</td><td>0</td><td>23</td><td>77</td><td>2008</td><td>Italy</td><td>Barichella M. et al. Nutr Neuroscience 2008;11(3):128-134</td></tr><tr><td>COPD patients attending outpatient clinic</td><td>32</td><td>72 ± 6</td><td>0</td><td>44</td><td>56</td><td>2008</td><td>Italy</td><td>Scichilone N. et al. Age Ageing 2008;37:214-217</td></tr><tr><td>Ambulatory patients, Geriatric day hospitals</td><td>182</td><td>79</td><td>3</td><td>53</td><td>44</td><td>2008</td><td>Canada</td><td>Chevalier S. et al. J Nutr Health Aging 2008;12 (10):721-726</td></tr><tr><td>Elderly patients admitted to the Geriatrics Outpatient Clinic</td><td>413</td><td>75 ± 7</td><td>13</td><td>31</td><td>56</td><td>2010</td><td>Turkey</td><td>Saka B. et al. Clin Nutr 2010;29:745-748</td></tr><tr><td>Patients aged 60 years and above who presented consecutively at the general outpatient department</td><td>500</td><td>66.7 ± 6.6</td><td>8</td><td>12</td><td>80</td><td>2011</td><td>Nigeria</td><td>Adebusoye L.A. et al. S Afr Fam Pract. 2011;53(4):355-360 J Nutr Gerontol Geriatr. 2012;31(1):71-85</td></tr><tr><td>Cancer patients aged ≥75 years seen at geriatric consultations for final therapeutic decision</td><td>161</td><td>82.4 (73–97)</td><td>25</td><td>40</td><td>35</td><td>2011</td><td>France</td><td>Chaïbi P. et al. Crit Rev Oncol Hematol 2011;79:302-307</td></tr><tr><td>Elderly meal recipients</td><td>31</td><td>?</td><td>6</td><td>65</td><td>29</td><td>2012</td><td>Albania</td><td>Gray A. et al. J Acad Nutr Diet 2016;112 :A95</td></tr><tr><td>Elderly people (from two Czech home care agencies and two Slovak home care agencies)</td><td>120</td><td>73.24</td><td>35</td><td>33</td><td>32</td><td>2012</td><td>Czech Republic</td><td>Kozakova, R. et al. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2012;156(4):371–376</td></tr><tr><td>Elderly from out-patient day hospital and short term rehabilitation</td><td>35</td><td>79.1 ± 6.8</td><td>3</td><td>26</td><td>71</td><td>2012</td><td>Ireland</td><td>Claesson M.J. et al. Nature 2012:488:178-184</td></tr><tr><td>Elderly women at four private care homes in Jakarta</td><td>100</td><td>72.4 ± 8.2</td><td>2</td><td>57</td><td>41</td><td>2013</td><td>Indonesia</td><td>Adiatman M. et al. Gerodontology 2013 :30:262-269</td></tr><tr><td>Outpatients with systolic heart failure</td><td>50</td><td>74.3 ± 6.2</td><td>6</td><td>10</td><td>84</td><td>2013</td><td>Portugal</td><td>Sargento L. et al. J Nutr Health Aging 2013 ;17:300-3044</td></tr><tr><td>Voluntary older home care receivers recruited in the areas of Paderborn, Bonn and Nuremberg</td><td>296</td><td>80.7 ± 7.7</td><td>12</td><td>57</td><td>31</td><td>2013</td><td>Germany</td><td>Kiesswetter E. et al. J Nutr Health Aging 2013;17:345-350</td></tr><tr><td>Patients visiting a geriatric outpatient department</td><td>448</td><td>80 ± 7</td><td>17</td><td>58</td><td>25</td><td>2013</td><td>The Netherlands</td><td>van Bokhorst-de van der Schueren M-A.E. et al. Clin Nutr 2013;32:1007-1011</td></tr><tr><td>Patients of the gastroenterology outpatient department of the Maastricht University Medical Center, a regional referral center for Chronic pancreatitis</td><td>50</td><td>57.1 (20–81 years)</td><td>10</td><td>40</td><td>50</td><td>2013</td><td>The Netherlands</td><td>Verhaegh B.P.M. et al. Eur J Clin Nutr 2013;67(12):1271-1276</td></tr><tr><td>Geriatric day hospital of a large community hospital</td><td>190</td><td>82 (80-86)</td><td>6</td><td>45</td><td>50</td><td>2014</td><td>Germany</td><td>Schrader E. et al. J Nutr Health Aging 2014;18(3):257-263</td></tr><tr><td>Community-dwelling older adults receiving home care</td><td>309</td><td>80.9 ± 7.9</td><td>14</td><td>58</td><td>29</td><td>2014</td><td>Germany</td><td>Kiesswetter E. et al. J Am Geriatr Soc 2014;62:512-517</td></tr><tr><td>Geriatric day hospital unit of the Toulouse Gérontopôle</td><td>1108</td><td>82.9 ± 6.1</td><td>8</td><td>40</td><td>53</td><td>2014</td><td>France</td><td>Tavassoli N. et al. Nutr Health Aging 2014;18(5):457-464</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 9 (continued)**
MNA® Clinical practice – Frail elderly (Outpatient/Home Care) - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Respondents who receive nursing care at home</td><td>470</td><td>77.3</td><td>19.2</td><td>38.5</td><td>42.3</td><td>2014</td><td>Czech Republic</td><td>Kozáková R. et al. Eur Geriatr Med 2014;5:377-381</td></tr><tr><td>Elderly of external consult in a Public Specialized Hospital of México City</td><td>96</td><td>80.4 ± .9</td><td>11.3</td><td>72.2</td><td>15.5</td><td>2014</td><td>Mexico</td><td>Perez Cruz E. et al. Nutr Hosp 2014;29:901-906</td></tr><tr><td>Internal medicine and geriatrics outpatient clinics</td><td>1030</td><td>&gt;65</td><td>19</td><td>29</td><td>52</td><td>2015</td><td>Turkey</td><td>Gündüz E. et al. Med Sci Monit 2015; 21: 2750-2756</td></tr><tr><td>Patients aged ≥65 years who were admitted to our geriatric medicine outpatient clinic</td><td>236</td><td>76.4 ± 7.2</td><td>15</td><td>30</td><td>55</td><td>2015</td><td>Turkey</td><td>Sarikaya D. et al. Arch Gerontol Geriatr 2015;61:56-60</td></tr><tr><td>Postmenopausal women, outpatient clinics in Ain Shams University hospital</td><td>200</td><td>45 - 64</td><td>11</td><td>27</td><td>62</td><td>2016</td><td>Egypt</td><td>Gabal H. et al. Eur J Public Health 2016;25:ckv176.300</td></tr><tr><td>Patients aged ≥65 years of a geriatric day hospital of a large community hospital in Nuremberg</td><td>190</td><td>80 (75-84)</td><td>6</td><td>45</td><td>50</td><td>2016</td><td>Germany</td><td>Schrader E. et al. J Nutr Health Aging 2016;20:918-926</td></tr><tr><td>Elderly, aged ≥65 years, being treated in community healthcare services in the Community of Madrid : DREAM + 65 Study</td><td>1103</td><td>79.5 ± 8.4</td><td>10</td><td>23</td><td>67</td><td>2016</td><td>Spain</td><td>Cuerda C. et al. Nutr Hosp 2016;33:263-269</td></tr><tr><td>Patients referred to the Geriatric Frailty Clinic.</td><td>1309</td><td>82.5 ± 6.3</td><td>5</td><td>35</td><td>61</td><td>2017</td><td>France</td><td>Rapp L. et al. J Frailty Aging 2017;6:154-60</td></tr><tr><td>Frail elderly, home care</td><td>80</td><td>83 ± 8</td><td>9</td><td>39</td><td>53</td><td>2017</td><td>Austria</td><td>Haider S. et al. PLoS One. 2017;12(1): e0169613</td></tr><tr><td>Aged-care facilities in metropolitan Melbourne and regional Victoria</td><td>215</td><td>85.8 ±7.5</td><td>11</td><td>57</td><td>32</td><td>2017</td><td>Australia</td><td>Iuliano S. et al. Br J Nutr 2017;117:142-147</td></tr><tr><td>Patients who visited the geriatric outpatient department of a Dutch hospital</td><td>404</td><td>80.2 ±7.1</td><td>15</td><td>56</td><td>29</td><td>2018</td><td>The Netherlands</td><td>Kurkcu M. et al. Clin Nutr ESPEN 2018;23:112-116</td></tr><tr><td>Elderly outpatients (≥65 years) admitted to a CGA center</td><td>473</td><td>80.9 ± 6.6</td><td>15</td><td>34</td><td>51</td><td>2018</td><td>Italy</td><td>Liguori I et al. Nutr Clin Pract 2018;33(6):879-886</td></tr><tr><td>Outpatients evaluated at the department of internal medicine</td><td>50</td><td>78.1 ± 6.0</td><td>0</td><td>22</td><td>78</td><td>2018</td><td>Italy</td><td>Valentini A. et al. Clin Interv Aging 2018;13:1237-1244</td></tr><tr><td>Elderly patients at a Geriatric Outpatient Clinic</td><td>159</td><td>76.9 ± 6.4</td><td>8</td><td>33</td><td>60</td><td>2018</td><td>Thailand</td><td>Pengsorn N. et al. J Med Assoc Thai 2018;101:869-874</td></tr><tr><td>Outpatients with chronic stroke</td><td>59</td><td>71 ±14.7</td><td>0</td><td>25</td><td>75</td><td>2019</td><td>Taiwan</td><td>Lin S-C. et al. PLoS One 2019;14:e0218749</td></tr><tr><td>Secondary outpatient clinic</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Non-Frail</td><td>39</td><td>73.6 ± 5.7</td><td>0</td><td>13</td><td>87</td><td>2019</td><td>Brazil</td><td>Zukeran M.S. et al. J Nutr Health Aging 2019;23(2):217-220</td></tr><tr><td>Pre-frail</td><td>76</td><td>75.3 ± 7.2</td><td>2</td><td>31</td><td>68</td><td></td><td></td><td></td></tr><tr><td>Frail</td><td>139</td><td>78.9 ± 7.6</td><td>8</td><td>54</td><td>38</td><td></td><td></td><td></td></tr><tr><td>Elderly over 65 years of age in 3 health centres and 3 residential care homes in Cordoba</td><td>248</td><td>81.3 (80 - 82)</td><td>9</td><td>29</td><td>62</td><td>2019</td><td>Spain</td><td>Muñoz Díaz B. et al. Family Practice 2019;36:172-178</td></tr><tr><td>Elderly home care patients</td><td>209</td><td>≥ 19</td><td>53</td><td>30</td><td>17</td><td>2019</td><td>Turkey</td><td>Adıgüzel E. &amp; Acar-Tek N. Exp Gerontol 2019;120:15-20</td></tr><tr><td>Older patients undergoing cancer care</td><td>454</td><td>78 (65 – 96)</td><td>30</td><td>35</td><td>35</td><td>2019</td><td>U.S.A.</td><td>Zhang X. et al. J Geriatr Oncol 2019;10:763-769<br/>BMJ Supportive &amp; Palliative Care 2020;10:363-368</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>**Table 9 (continued)**
MNA® Clinical practice – Frail elderly (Outpatient/Home Care) - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Patients ≥ 60 years followed in the Geriatric Outpatient Clinic</td><td>76</td><td>71 (67 - 77)</td><td>0</td><td>29</td><td>71</td><td>2020</td><td>Poland</td><td>Fatyga P. et al. Eur Geriatr Med 2020;11(3):383-391</td></tr><tr><td>Dialysis patients of the hemodialysis units</td><td>216</td><td>67±15</td><td>38</td><td>43</td><td>19</td><td>2020</td><td>Belgium</td><td>Holvoet E. et al. PLoS One 2020;15(3):e0229722</td></tr><tr><td>Patients admitted to dedicated rehabilitation wards</td><td>1430</td><td>79 (74 - 84)</td><td>21</td><td>53</td><td>26</td><td>2020</td><td>Australia</td><td>Lambert K. et al. J Nutr Gerontol Geriatr 2020;39:16-29</td></tr><tr><td>Elderly attending a Primary Care Community Health Center in Guayaquil</td><td>196</td><td>70.9 ± 7.1</td><td>6</td><td>52</td><td>42</td><td>2020</td><td>Ecuador</td><td>Álvarez Córdova L.R. et al. Nutr Hosp 2020;37:926-932</td></tr><tr><td>Outpatients, aged ≥65 years, who applied to a geriatric center between 2017 and 2018</td><td>1000</td><td>74.3 ± 8.3</td><td>7</td><td>32</td><td>62</td><td>2020</td><td>Turkey</td><td>Kalan U. et al. Aging Clin Exp Res 32:673-680</td></tr><tr><th rowspan="2">Frail elderly Outpatient/Home Care</th><th rowspan="2"></th><th>Under-nourished<br/>&lt;17</th><th>At risk of malnutrition<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th><th rowspan="2"></th><th rowspan="2"></th><th rowspan="2"></th><th rowspan="2"></th></tr><tr><th>11</th><th>40</th><th>48</th></tr><tr><td>Total</td><td>19910</td><td></td><td>0.2</td><td>0.3</td><td>0.4</td><td></td><td></td><td></td></tr></tbody></table>

<table><caption>**Table 10**
MNA® Clinical practice: elderly – Institution - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Medical nursing facility</td><td>77</td><td>86 + 9</td><td>32</td><td>43</td><td>25</td><td>1999</td><td>France</td><td>Menecier P et al. Age &amp; Nutrition 1999;10:3-6</td></tr><tr><td>Residential home residents</td><td>100</td><td>&gt; 65</td><td>5</td><td>41</td><td>54</td><td>1999</td><td>Slovakia</td><td>Hrabinská L. et al. Nestle Nutr Workshop Ser. Clin Perform Programme 1999;1:169</td></tr><tr><td>Retirement homes residents</td><td>107</td><td>65 - 104</td><td>21</td><td>62</td><td>17</td><td>1999</td><td>Poland</td><td>Adamska-Skula M &amp; Lutynsky R Nestle Nutr Workshop Ser. Clin Perform Programme 1999;1:169</td></tr><tr><td>Nursing home</td><td>100</td><td>85 + 9</td><td>21</td><td>60</td><td>19</td><td>1999</td><td>Italy</td><td>Molaschi M et al. Nestle Nutr Workshop Ser. Clin Perform Programme 1999;1:159</td></tr><tr><td>Nursing home elderly with dementia</td><td>51</td><td>86 ± 8</td><td>41</td><td>45</td><td>14</td><td>1999</td><td>France</td><td>Lauque S et al Revue Geriatr 1999;24:115-119</td></tr><tr><td>Nursing home elderly without dementia</td><td>24</td><td>90 ± 4</td><td>21</td><td>42</td><td>38</td><td></td><td></td><td></td></tr><tr><td>Community setting Elderly admitted from home</td><td>261</td><td>84 ± 7</td><td>23</td><td>56</td><td>21</td><td>1999</td><td>Sweden</td><td>Christensson L. et al. J Nutr Health Aging 1999;3:133-139</td></tr><tr><td>Nursing home</td><td>87</td><td>82 ± 8</td><td>6</td><td>47</td><td>47</td><td>1999</td><td>Spain</td><td>Salvà A et al. Nestle Nutr Workshop Ser.Clin Perform.Programme 1999;1:123-129</td></tr><tr><td>Retirement homes</td><td>81</td><td>83 + 7 (61-98)</td><td>2</td><td>37</td><td>61</td><td>2000</td><td>Belgium</td><td>Griep MI et al. J Gerontol A Biol Sci Med Sci 2000;55:M57-M63</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 10 (continued)**
MNA® Clinical practice: elderly – Institution - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Long term care</td><td>431</td><td>&gt;60</td><td>71</td><td>26</td><td>4</td><td>2000</td><td>Italy</td><td>Donini LM et al. Age &amp; Nutrition 2000;11:2-5</td></tr><tr><td>Long term care</td><td>77</td><td>85.6 ± 8.8</td><td>32</td><td>43</td><td>25</td><td>2000</td><td>France</td><td>Menecier-Ossia L. et al. Revue Geriatr 2000;25:65-70</td></tr><tr><td>Institution (all)</td><td>872</td><td>84.5 ± 8</td><td>36</td><td>48</td><td>16</td><td>2000</td><td>Sweden</td><td>Saletti A et al. Gerontology 2000;46:139-145</td></tr><tr><td>Rehabilitation unit</td><td>73</td><td>80.4 ± 7.6</td><td>23</td><td>67</td><td>10</td><td>2000</td><td>Switzerland</td><td>Liver C et al. Age &amp; Nutrition 2000;11:67-71</td></tr><tr><td>Institutionalized elderly Chinese</td><td>120</td><td>&gt;60</td><td>21</td><td>52</td><td>26</td><td>2001</td><td>China</td><td>Hui WH. et al. Hong Kong J Gerontol 2001;15:35-43</td></tr><tr><td>Nursing home</td><td>150</td><td>58 -96</td><td>1</td><td>27</td><td>73</td><td>2002</td><td>Estonia</td><td>Saava M. &amp; Kisper-Hint I.-R. J Nutr Health Aging 2002; 6:93-95</td></tr><tr><td>Spanish institution</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Women</td><td>134</td><td>&gt;65</td><td>5</td><td>38</td><td>58</td><td>2001</td><td>Spain</td><td>Ramon J.M. &amp; al Med Clin (Barc) 2001;117: 766-770</td></tr><tr><td>Men</td><td>255</td><td></td><td>9</td><td>46</td><td>45</td><td></td><td></td><td></td></tr><tr><td>Nursing home</td><td>66</td><td>&gt;65</td><td>32</td><td>55</td><td>9</td><td>2002</td><td>Denmark</td><td>Beck AM. &amp; al Aging Clin Exp Res. 14:212-215, 2002</td></tr><tr><td>Municipal care</td><td>261</td><td>65 -107</td><td>23</td><td>56</td><td>21</td><td>2002</td><td>Sweden</td><td>Christensson et al. Eur J Clin Nutr 2002;56:810-818</td></tr><tr><td>Long term geriatric unit Mataró</td><td>67</td><td>83 ± 8</td><td>24</td><td>37</td><td>39</td><td>2002</td><td>Spain</td><td>Bleda MN &amp; al J Nutr Health Aging 2002;6:134-37</td></tr><tr><td>Nursing homes</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Madrid</td><td>205</td><td>&gt;65</td><td>35</td><td>51</td><td>24</td><td>2002</td><td>Spain</td><td>Ribeira Casado J.M. J Nutr Health Aging 6:84-90, 2002 Sánchez, R. Residential 1999:9-21-30. Latorre C. et al. Rev Esp Geriatr Gerontol 2000;35(supl 1):74-75</td></tr><tr><td>Valencia</td><td>94</td><td>79.3</td><td>5</td><td>45</td><td>50</td><td></td><td></td><td></td></tr><tr><td>Institutionalized patients with a diagnosis of AD according with NINCDS/ADRDA criteria from 8 nursing-homes</td><td>99</td><td>86.5 ± 6.1</td><td>17</td><td>68</td><td>14</td><td>2003</td><td>Spain</td><td>Gregorio P.G. &amp; al J Nutr Health Aging 2003;7(5):304-308</td></tr><tr><td>Institutionalized older women</td><td>89</td><td>85 ± 6 (72-98)</td><td>8</td><td>82</td><td>30</td><td>2003</td><td>Spain</td><td>Ruiz-López M.D. et al. Nutrition 2003;19:767-771</td></tr><tr><td>Nursing homes residents</td><td>90</td><td>86 ± 6</td><td>13</td><td>63</td><td>23</td><td>2003</td><td>Switzerland</td><td>Gerber V. et al. J Nutr Health Aging 2003;7:140-145</td></tr><tr><td>Nursing Home elders with pressure ulcers</td><td>24</td><td>&gt;65</td><td>54</td><td>29</td><td>17</td><td>2004</td><td>USA</td><td>Hudgens JH &amp; al. JPEN J Parenter Enteral Nutr 2004;28(6):416-422</td></tr><tr><td>Elderly from a geriatric home</td><td>63</td><td>&gt;60</td><td>14</td><td>70</td><td>16</td><td>2004</td><td>Venezuela</td><td>Peña E. et al. Rev Esp Geriatr Gerontol 2004;39(6):360-366</td></tr><tr><td>Patients admitted at our subacute care nursing home</td><td>352</td><td>81.5 ± 8</td><td>38</td><td>55</td><td>7</td><td>2004</td><td>Italy</td><td>Baldelli M.V. et al. Arch Gerontol Geriatr Suppl 2004;(9):39-43</td></tr><tr><td>Nursing home residents</td><td>50</td><td>81.3</td><td>16</td><td>54</td><td>30</td><td>2004</td><td>Spain</td><td>Villaverde Gutierrez C. et al. Geriatria 2004;20(1):8-11</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>**Table 10 (continued)**
MNA® Clinical practice: elderly – Institution - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Two municipal service flat complexes</td><td>80</td><td>79.90</td><td>30</td><td>59</td><td>11</td><td>2005</td><td>Sweden</td><td>Odlund Olin A. et al. Eur J Clin Nutr 2005;59(2): 263-270</td></tr><tr><td>All nursing homes in Helsinki community Women</td><td>1696</td><td>84 ± 8.5</td><td>30</td><td>60</td><td>9</td><td>2005</td><td>Finland</td><td>Suominen M. & al. Eur J Clin Nutr 2005;59: 578-583 Eur J Clin Nutr 2009 :63 :292-296</td></tr><tr><td>Men</td><td>409</td><td>80 ± 8.5</td><td>23</td><td>61</td><td>17</td><td></td><td></td><td></td></tr><tr><td>Subjects from residential homes</td><td>237</td><td>83.2 ± 8.8</td><td>5</td><td>60</td><td>35</td><td>2005</td><td>Italy</td><td>Cairella G. et al Ann Ig 2005;17:35-46</td></tr><tr><td>Elderly institutionalized patients</td><td>153</td><td>76.9 ± 9.7</td><td>19</td><td>46</td><td>36</td><td>2005</td><td>Brazil</td><td>Alves de Rezende C.H. et al. Gerontol 2005;51:316-321</td></tr><tr><td>Nursing home & chronic care</td><td>31</td><td>65 ± 2.8</td><td>7</td><td>48</td><td>45</td><td>2005</td><td>Canada</td><td>Lawrence H.P. et al. Spec Care Dentist 2005;25(5):242-252</td></tr><tr><td>Institutionalized elders in different geriatric units of the metropolitan area Caracas</td><td>126</td><td>60 - 96</td><td>6</td><td>46</td><td>46</td><td>2005</td><td>Venezuela</td><td>Rodriguez N. et al. Invest Clin 2005;46:219-228</td></tr><tr><td>Nursing home</td><td>178</td><td>77</td><td>14</td><td>64</td><td>23</td><td>2006</td><td>The Netherlands</td><td>Nijs K.A.N.D. et al. J Gerontol 2006;61A(9):935-942</td></tr><tr><td>Older residents of the nursing home for the somatically ill adults in Bialystok</td><td>100</td><td>79.1 ±7.8</td><td>12</td><td>61</td><td>27</td><td>2006</td><td>Poland</td><td>Wojszel Z.B. Adv Med Sci. 2006;51:168-173</td></tr><tr><td>Elderly persons living in 5 nursing homes, Tyrol</td><td>272</td><td>84.4 ± 8.9</td><td>19</td><td>50</td><td>32</td><td>2006</td><td>Austria</td><td>Jeske M. et al. Journal fur Ernährungsmedizin 2006;8(1):13-20</td></tr><tr><td>100 institutions, rhône-alpes region</td><td>687</td><td>85 ± 8.16 (60-110)</td><td>18</td><td>41</td><td>41</td><td>2007</td><td>France</td><td>Dion N. et al. Nutrition 2007;23:301-307</td></tr><tr><td>Homes for the aged, Tygerberg Academic Hospital</td><td>210</td><td>76.8 ± 10.6</td><td>6</td><td>47</td><td>47</td><td>2007</td><td>South Africa</td><td>Marais M.L. et al. South Afr J Clin Nutr. 2007;20(3):102-108</td></tr><tr><td>Elderly nursing home</td><td>145</td><td>81 ± 7</td><td>3</td><td>35</td><td>61</td><td>2007</td><td>Japan</td><td>Shimizu T. et al. Ann Nutr Metab 2007;51:413 Abstr 11</td></tr><tr><td>Nursing home residents</td><td>112</td><td>85 (79 - 91)</td><td>9</td><td>71</td><td>20</td><td>2007</td><td>Germany</td><td>Norman K. et al. Nutrition 2007;23:564-569</td></tr><tr><td>Nursing home residents</td><td>83</td><td>85</td><td>0</td><td>29</td><td>71</td><td>2007</td><td>The Netherlands</td><td>Essed N.J. et al. Appetite 2007;48:29-36</td></tr><tr><td>Long-term residential care establishment High-level & Low-level Care facilities</td><td>75</td><td>&gt;65</td><td>16</td><td>37</td><td>47</td><td>2007</td><td>Australia</td><td>Grieger J.A. & Nowson C.A. Eur J Clin Nutr 2007;61:655-663</td></tr><tr><td>Patients admitted to internal medicine departments</td><td>589</td><td>&gt;65</td><td>8</td><td>36</td><td>56</td><td>2007</td><td>Israel</td><td>Feldblum I. et al. Nutrition J 2007;6:37</td></tr><tr><td>Institutionalized elderly, Nursing homes from the Granada province</td><td>82</td><td>83,1 ± 5.6</td><td>19</td><td>11</td><td>70</td><td>2007</td><td>Spain</td><td>Pérez Moreno A. et al. Nutr Hosp 2007;22(supl 1):92(Abstr)</td></tr><tr><td>Residents of long-term homes for the elderly, São Paulo</td><td>40</td><td>≥ 60</td><td>10</td><td>40</td><td>50</td><td>2007</td><td>Brazil</td><td>Santelle O. et al. Cad Saúde Publica 2007;23(12):3061-3067</td></tr><tr><td>Nursing home residents</td><td>106</td><td></td><td>50</td><td>45</td><td>5</td><td>2007</td><td>Cuba</td><td>González Hernández A. et al. Arch Latinoam Nutr 2007;57:266-272</td></tr><tr><td>Long term care centre in central Taiwan: Cognition-normal elderly</td><td>169</td><td>79.6 ± 7.6</td><td>22</td><td>59</td><td>19</td><td>2008</td><td>Taiwan</td><td>Tsai A.C. & Ku p-Y. Br J Nutr 2008;100(1):152-15</td></tr><tr><td>Institutionalized elderly in a nursing home</td><td>50</td><td>84 (66 - 97)</td><td>6</td><td>12</td><td>82</td><td>2008</td><td>Spain</td><td>Abajo del Alamo C. et al. Nutr Hosp 2008;23(2):100-104</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 10 (continued)**
MNA® Clinical practice: elderly – Institution - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Elderly from long-term institution in southeast</td><td>89</td><td>73.7 ± 9.1</td><td>28</td><td>51</td><td>21</td><td>2008</td><td>Brazil</td><td>Ferreira L.S. et al. J Nutr Health Aging 2008;12(3):213-217</td></tr><tr><td>Large Vienna nursing home</td><td>245</td><td>86 ± 7</td><td>38</td><td>48</td><td>14</td><td>2008</td><td>Austria</td><td>Kulnik D. &amp; Elmadfa I. Ann Nutr Metab 52(Suppl 1):51-53, 2008</td></tr><tr><td>Community resident homes</td><td>127</td><td>women 86 ± 6.0 men 84 ± 6.8</td><td>16</td><td>53</td><td>31</td><td>2008</td><td>Sweden</td><td>Wikby K. et al. J Clin Nursing 2008;17:1211-1218</td></tr><tr><td>Long-term care resident elderly</td><td>172</td><td>85.3 ± 8.4</td><td>20</td><td>51</td><td>29</td><td>2008</td><td>Italy</td><td>Cereda E. et al. Clin Nutr 2008;27:700-705</td></tr><tr><td>Institutions South-West: Nursing-home residents</td><td>517</td><td>84.6 ± 9.0</td><td>13</td><td>42</td><td>45</td><td>2009</td><td>France</td><td>Bourdel-Marchasson I. et al. Nutrition 2009;25:155-164</td></tr><tr><td>Nstitutions South-West: Long-term care home residents</td><td>84</td><td>81.8 ± 10.4</td><td>43</td><td>48</td><td>10</td><td></td><td></td><td></td></tr><tr><td>Nursing home residents</td><td>43</td><td>82.5 (81;85)</td><td>10</td><td>72</td><td>19</td><td>2008</td><td>Malta</td><td>Koh G.C. Malta Med J 2008;17(01):28-42</td></tr><tr><td>Nursing home residents</td><td>50</td><td>84 (66 - 97)</td><td>6</td><td>12</td><td>82</td><td>2008</td><td>Spain</td><td>Abajo del Alamo C. et al. Nutr Hosp 2008;23(2):100-104</td></tr><tr><td>Long Term care stroke patients</td><td>74</td><td>&gt;40</td><td>24</td><td>57</td><td>19</td><td>2008</td><td>Taiwan</td><td>Tsai A.C. &amp; Shih C-L. J Clin Nursing 2008;18:82-88</td></tr><tr><td>Nursing home residents</td><td>199</td><td>83 ± 8</td><td>40</td><td>56</td><td>5</td><td>2009</td><td>Finland</td><td>Kuikka L.K. et al J Am Med Dir Assoc 2009;10:348-353</td></tr><tr><td>Geriatric homes in Cairo</td><td>100</td><td>&gt;60</td><td>28</td><td>22</td><td>50</td><td>2010</td><td>Egypt</td><td>Amer M.S. et al. J Am Geriatr Soc 2010;58(10):2036</td></tr><tr><td>Veterans' Administration Hospital-managed nursing home in Central Taiwan</td><td>160</td><td>81.1</td><td>19</td><td>54</td><td>26</td><td>2010</td><td>Taiwan</td><td>Tsai A.C. et al. Arch Gerontol Geriatr 2012;54(3):443-447</td></tr><tr><td>Kahrizak Charity Foundation (KCF) residents</td><td>221</td><td>78.1 ± 7.5</td><td>3</td><td>43</td><td>53</td><td>2010</td><td>Iran</td><td>Amirkalali B. et al. Public Health Nutr. 2010;13(9):1373-1379</td></tr><tr><td>Nstitutionalized elderly aged over 60 years</td><td>344</td><td>75.4 ± 9.4</td><td>8</td><td>56</td><td>36</td><td>2011</td><td>Brazil</td><td>Pereira Machado R &amp; Coelho M. J Nutr Health Aging 2011;15:532-535</td></tr><tr><td>Residents of three nursing homes in Cairo</td><td>120</td><td>71.4 ± 6.9</td><td>11</td><td>41</td><td>48</td><td>2011</td><td>Egypt</td><td>Khater M.S. et al. J Nutr Health Aging. 2011;15(2):104-108 J Clin Gerontol Geriatr. 2012;3(2):73-76</td></tr><tr><td>Residents from 3 municipal nursing homes in Bonn</td><td>350</td><td>84.8 ± 8.0</td><td>27</td><td>53</td><td>20</td><td>2011</td><td>Germany</td><td>Volkert D. et al. Gastroenterol Res Pract 2011;2011:247315</td></tr><tr><td>Elderly residing in long-term residential care</td><td>57</td><td>83.5 ± 7.6</td><td>47</td><td>49</td><td>4</td><td>2012</td><td>Ireland</td><td>Claesson M.J. et al. Nature 2012:488:178-184</td></tr><tr><td>Institutionalised elderly population in Mysore city,</td><td>141</td><td>72.2 ± 7.5</td><td>15.6</td><td>53</td><td>32</td><td>2013</td><td>India</td><td>Khetrimayum, N. et al. Gerodontology 2013;30:119-125</td></tr><tr><td>Residents of retirement homes in and around Prague</td><td></td><td></td><td></td><td></td><td></td><td>2013</td><td>Czech Republic</td><td></td></tr><tr><td>Women</td><td>659</td><td>86.1 ± 6.2</td><td>11</td><td>41</td><td>48</td><td></td><td></td><td></td></tr><tr><td>Men</td><td>156</td><td>81.5 ± 8.0</td><td>8</td><td>32</td><td>70</td><td></td><td></td><td>Rambousková J. et al. Ann Nutr Metab 2013;62:201-206</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>**Table 10 (continued)**
MNA® Clinical practice: elderly – Institution - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br>&lt;17</th><th>At risk<br>17 – 23.5</th><th>Well-nourished<br>≥24</th></tr></thead><tbody><tr><td>Resident patients in the nursing home facility</td><td>100</td><td>80.2 ± 10</td><td>36</td><td>46</td><td>18</td><td>2013</td><td>Italy</td><td>Donini L.M. et al. PLoS ONE 2013;8(2):e55804</td></tr><tr><td colspan="9">Subjects admitted in the nursing homes</td></tr><tr><td>women</td><td>195</td><td>81.6 ± 8</td><td>43</td><td>43</td><td>14</td><td>2013</td><td>Italy</td><td>Donini L.M. et al. J Nutr Health Aging 2013;17:332-328</td></tr><tr><td>Men</td><td>121</td><td>77.5 ± 8</td><td>31</td><td>35</td><td>35</td><td></td><td></td><td></td></tr><tr><td>Elderly ≥ 65 years, living consistently in the nursing home, and not in final stage of life (ernstes study)</td><td>650</td><td>85 (81, 91)</td><td>10</td><td>48</td><td>42</td><td>2013</td><td>Germany</td><td>Strathmann S. et al. J Nutr Health Aging 2013;17:271-276</td></tr><tr><td>Residents of 6 German nursing homes</td><td>286</td><td>86 ± 7</td><td>18</td><td>42</td><td>40</td><td>2013</td><td>Germany</td><td>Stange I. et al. J Nutr Health Aging 2013;17:357-363</td></tr><tr><td>Two municipal nursing homes in Nuremberg</td><td>188</td><td>85.5 ± 7.8</td><td>15</td><td>57</td><td>27</td><td>2013</td><td>Germany</td><td>Diekmann, R. et al. J Nutr Health Aging 2013;17:326-331</td></tr><tr><td colspan="9">Elders living in 34 nursing homes all over the province of Albacete</td></tr><tr><td>Women</td><td>523</td><td>82.9 ± 6.7</td><td>4</td><td>40</td><td>56</td><td>2013</td><td>Spain</td><td>Serrano-Urrea R. et al. Gerontology 2013;59:490-498</td></tr><tr><td>Men</td><td>372</td><td>81.3 ± 7.6</td><td>2</td><td>33</td><td>65</td><td></td><td></td><td></td></tr><tr><td>Elderly institutionalized in a nursing home</td><td>36</td><td>85.7</td><td>33</td><td>58</td><td>8</td><td>2013</td><td>Spain</td><td>Calvo M.E.D. Rev Esp Nutr Comunitaria 2013;19:20-28</td></tr><tr><td>Institutional environment (nursing homes)</td><td>859</td><td>79.0 ± 7.9</td><td>16</td><td>49</td><td>35</td><td>2014</td><td>Poland</td><td>Kostka J. et al. J Nutr Health Aging 2014;18:366-371 Eur J Clin Nutr 2014;68:1210-1215</td></tr><tr><td>15 Nursing Homes in the city of Salvador</td><td>359</td><td>74.3 ± 8.7</td><td>66</td><td></td><td>34</td><td>2014</td><td>Brazil</td><td>Amorim Sena Pereira M. et al. Nutr Hosp 2014;31:1198-1204</td></tr><tr><td>Public long term geriatric units</td><td>344</td><td>75.4 ± 9.4</td><td>8</td><td>56</td><td>36</td><td>2015</td><td>Brazil</td><td>Machado R.S.P. et al. BMC Geriatr. 2015;15:132</td></tr><tr><td>Residential homes for the elderly in Lattakia</td><td>103</td><td>70.9 ± 6.4</td><td>19</td><td>40</td><td>41</td><td>2015</td><td>Syria</td><td>Hallaj F.A. East Mediterr Health J. 2015;21(10):753-761</td></tr><tr><td>Institutionalized elderly, aged ≥ 65 years, in 25 institutions in 19 cities throughout Turkey.</td><td>554</td><td>76.1 ± 7.3</td><td>7</td><td>49</td><td>44</td><td>2015</td><td>Turkey</td><td>Ongan D. and Rakıcıoğlu N. Arch Gerontol Geriatr 2015;61:271-276</td></tr><tr><td colspan="9">Nursing home residents</td></tr><tr><td>Women</td><td>164</td><td>82.3 ± 9</td><td>22,6</td><td>57</td><td>21</td><td>2016</td><td>Italy</td><td>Donini L.M. et al. J Am Med Dir Assoc 2018;17(10):959. e11-959.e18</td></tr><tr><td>Men</td><td>82</td><td>76.5 ± 11</td><td>17</td><td>61</td><td>22</td><td></td><td></td><td></td></tr><tr><td>Senior citizens living at old age homes of Kathmandu valley</td><td>213</td><td>77.2 ± 8.7</td><td>16</td><td>61</td><td>24</td><td>2016</td><td>Nepal</td><td>Singh D.R. et al. Int J Community Med Public Health. 2016;3(7):1707-1715 Gait Posture 2017;54:56-61</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 10 (continued)**
MNA® Clinical practice: elderly – Institution - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Long-stay nursing home residents</td><td>123</td><td>82.7 ± 9.0</td><td>18</td><td>54</td><td>29</td><td>2016</td><td>Portugal</td><td>Pinho J. et al. Clin Nutr 2016;35(Suppl 1):S108</td></tr><tr><td>Older adults residing in care homes</td><td>97</td><td>82.2 ± 6.3</td><td>3</td><td>27</td><td>70</td><td>2016</td><td>Portugal</td><td>Araújo D.A. et al. Eur J Clin Nutr 2016;70:859-862</td></tr><tr><td colspan="9">Elderly residing in long-term care facilities from urban Bloemfontein</td></tr><tr><td>lower socio-economic area</td><td>62</td><td>78 (58–99)</td><td>11</td><td>74</td><td>15</td><td rowspan="2">2017</td><td rowspan="2">South Africa</td><td rowspan="2">Robb L. et al. South Afr J Clin Nutr 2017;30:34-40</td></tr><tr><td>Higher socio-economic area</td><td>62</td><td>85 (62–95)</td><td>3</td><td>37</td><td>60</td></tr><tr><td>Homes, shelters, and care centers for the elderly</td><td>144</td><td>75.3</td><td>11</td><td>82</td><td>7</td><td>2018</td><td>Ecuador</td><td>Espinosa Del Pozo PH: et al. Cureus 2018;10(9):e3269</td></tr><tr><td>Elderly denture-wearing patients above 60 years</td><td>200</td><td>&gt; 60</td><td>20</td><td>70</td><td>11</td><td>2018</td><td>India</td><td>Banerjee, R. et al. Indian J Dent Res. 2018;29:562567</td></tr><tr><td colspan="9">Institutionalized elderly from North Bohemia</td></tr><tr><td>Women</td><td>183</td><td>80.8 ± 8.1</td><td>12</td><td>52</td><td>36</td><td rowspan="2">2018</td><td rowspan="2">Czech Republic</td><td rowspan="2">Slavíková M. et al. Cent Eur J Public Health 2018; 26 (2):111–117</td></tr><tr><td>Men</td><td>71</td><td>75.9 ± 8.7</td><td>7</td><td>45</td><td>48</td></tr><tr><td>Frail elders, aged 75 years or ove,r from two nursing homes</td><td>81</td><td>≥75</td><td>0</td><td>40</td><td>61</td><td>2018</td><td>Spain</td><td>González I. et al. Proceedings 2018;2:1247</td></tr><tr><td>A socio-sanitary residence in the region of El Bierzo</td><td>164</td><td>85.6 ± 7.54</td><td>35</td><td>42</td><td>24</td><td>2019</td><td>Spain</td><td>Penacho Lázaro M.Á. Et al Nutr Hosp. 2019;36(2):296-302</td></tr><tr><td>Elderly ≥ 60 years in 4 homes for the elderly in Bogotá</td><td>152</td><td>81.5 ± 7.8</td><td>6</td><td>34</td><td>60</td><td>2019</td><td>Chile</td><td>Diaz-Muñoz G.A. and Calvera-Millán S.J. Rev Chil Nutr 2019;46:746-752</td></tr><tr><td>Malatya nursing home</td><td>65</td><td>77.4 ± 8.7</td><td>15</td><td>42</td><td>43</td><td>2019</td><td>Turkey</td><td>Bentli R. et al. Medecine Sci. 2029;8(2):430-435</td></tr><tr><td>Nationally representative sample of the Portuguese population aged 65 years or over living in nursing homes: PEN-3S-Study</td><td>1186</td><td>83.4</td><td>5</td><td>39</td><td>46</td><td>2019</td><td>Portugal</td><td>Madeira T. et al. Public Health Nutr 2019;22(3):486-497 Nutrition 2020;73:110660</td></tr><tr><td>Institutionalised elderly patients in a public nursing home</td><td>86</td><td>78.6 (53–101)</td><td>17</td><td>34</td><td>49</td><td>2020</td><td>Spain</td><td>Puivecino Moreno C. et al. Eur J Hosp Pharm Sci Pract 2020;27:A143</td></tr><tr><td colspan="9">3 nursing homes and 14 assisted living facilities in Helsinki</td></tr><tr><td>Prefrail</td><td>148</td><td>≥ 65</td><td>6</td><td>66</td><td>28</td><td rowspan="2">2020</td><td rowspan="2">Finland</td><td rowspan="2">Salminen, K. S. et al. J Nutr Health Aging 2020;24(3):319-324</td></tr><tr><td>Frail</td><td>228</td><td>≥ 65</td><td>20</td><td>68</td><td>12</td></tr><tr><td>Elderly population living in Old Homes of Jodhpur and Pali District, desert areas of Rajasthan</td><td>158</td><td>≥ 60</td><td>12</td><td>44.3</td><td>42.7</td><td>2020</td><td>India</td><td>Vyas K. & Singh M. Int J Res Anal Rev 2020;6 :i48-i50</td></tr><tr><td>Older People Living in the Community</td><td>100</td><td>74.9 ± 8.50</td><td>14</td><td>63</td><td>23.0</td><td>2020</td><td>Poland</td><td>Pigłowska M. et al. Nutrients 202; 12(7): 2042</td></tr><tr><td colspan="9">Institutionalized elderly</td></tr><tr><td></td><td></td><td></td><td>Under-nourished<br/>&lt;17</td><td>At risk of malnutrition<br/>17 – 23.5</td><td>Well-nourished<br/>≥24</td><td></td><td></td><td></td></tr><tr><td>Total</td><td>23119</td><td>Mean</td><td>18</td><td>48</td><td>34</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td>SE</td><td>0.3</td><td>0.3</td><td>0.3</td><td></td><td></td><td></td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>**Table 11**
MNA® Clinical practice: elderly – Cognitively impaired elderly - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 - 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Elderly subjects with dementia in a nursing home</td><td>51</td><td>86.2 ± 7.5</td><td>41</td><td>45</td><td>14</td><td>1999</td><td>France</td><td>Lauque S et al. Revue Gériatrie 1999;24:115-119</td></tr><tr><td>Psychogeriatric hospitalday hospital patients</td><td>133</td><td>75 ± 7</td><td>14</td><td>54</td><td>32</td><td>1999</td><td>Switzerland</td><td>De Mendonca Lima CA et al. Age Nutr 10:9-13, 2001</td></tr><tr><td>Non-institutionalized women with sarcopenia and Alzheimer's disease</td><td>32</td><td>81.5 ± 4.9</td><td>29</td><td>43</td><td>29</td><td>2000</td><td>France</td><td>Gillette-Guyonnet S et al. J Nutr Health Aging 200;4(3):165-169</td></tr><tr><td>Home living Alzheimer's disease elderly patients</td><td>100</td><td>76 ± 12</td><td>6</td><td>36</td><td>58</td><td>2001</td><td>France</td><td>Rivière S et al. J Nutr Health Aging 2001;5:295-299</td></tr><tr><td>Home living Alzheimer's disease patients (ELSA study)</td><td>318</td><td>75(45-89)</td><td>1</td><td>19</td><td>80</td><td>2001</td><td>France</td><td>Andrieu S et al. J Nutr Health Aging 2001;5:113-117<br>Dumont C. Et al. J Nutr Health Aging 2005;9:163-167</td></tr><tr><td>Memory Clinic Community dwelling subjects referred to a memory clinic</td><td>123</td><td>75 ± 7</td><td>2</td><td>33</td><td>64</td><td>2002</td><td>Ireland</td><td>Fallon C et al. J Nutr Health Aging 2002;6(Suppl):21</td></tr><tr><td>Demented patients admitted to an Alzheimer section</td><td>174</td><td>80.2 ± 8.1</td><td>36</td><td>48</td><td>17</td><td>2003</td><td>Italy</td><td>Magri F. & al Aging Clin Exp Res 2003;15(2):148-153</td></tr><tr><td>REAL.FR, Alzheimer's disease</td><td>479</td><td>77.4 ± 7.1</td><td>5</td><td>35</td><td>61</td><td>2003</td><td>France</td><td>Brocker P. & al Rev Med Interne 2003;24:314S-318S<br>Gillette-Guyonnet S. Et al. J Nutr Health Aging 2003;7(2):91-96</td></tr><tr><td>Elderly with perceived impaired memory</td><td>59</td><td>74.3 (52-86)</td><td>14</td><td>63</td><td>24</td><td>2003</td><td>Sweden</td><td>Holm B. & Söderholm O. Clin Nutr 2003;22(4):385-389</td></tr><tr><td>Nursing home residents with dementia</td><td>23</td><td>69 - 89</td><td>13</td><td>87</td><td>0</td><td>2004</td><td>Sweden</td><td>Suominen M. & al J Nutr Health Aging 2004;8(4):234-238</td></tr><tr><td>Cognitive impaired patients, geriatric convalescence unit</td><td>63</td><td>80.1+8.1</td><td>62</td><td>37</td><td>2</td><td>2004</td><td>Spain</td><td>Arellano M. & al Arch Gerontol. Geriatr. Suppl. 2004;9:27-31</td></tr><tr><td>AD patients living at home (REAL.FR Study)</td><td>561</td><td>76 ± 6</td><td>3</td><td>18</td><td>79</td><td>2005</td><td>France</td><td>Guérin O. Et al. J Nutr Health Aging 2005;9:75-80<br>Vellas B. Et al. J Nutr Health Aging 2005;9(2):81-84</td></tr><tr><td>Patients with Alzheimer's disease (ELSA Study)</td><td>312</td><td>75.4 ± 6.7</td><td>1</td><td>22</td><td>77</td><td>2005</td><td>France</td><td>Dumont Ch. Et al. J Nutr Health Aging 2005;9:163-167</td></tr><tr><td>Long term care centre in central Taiwan: Cognition-impaired elderly</td><td>139</td><td>82.2 ± 7.9</td><td>34</td><td>54</td><td>12</td><td>2007</td><td>Taiwan</td><td>Tsai A.C. & Ku p-Y. Br J Nutr 2008;100(1):152-158</td></tr><tr><td>Very mild Alzheimer disease patients</td><td>160</td><td>75.7 ± 5.8</td><td>0</td><td>28</td><td>72</td><td>2008</td><td>France</td><td>Ousset P-J et al. Alzheimer Dis Assoc Disord 2008;22:66-71</td></tr><tr><td>Elderly, diagnosed with probable or possible Alzheimer's disease, living at home with a well identified informal caregiver (PLASA study)</td><td>562</td><td>79.6 ± 5.7</td><td>0</td><td>36</td><td>64</td><td>2008</td><td>France</td><td>Nourhashemi F. Et al. J Nutr Health Aging 12(4):263-271, 2008</td></tr><tr><td>Patients entering the severe stage of AD in the longitudinal study of REAL.FR cohort</td><td>126</td><td>78.5 ± 8.1</td><td>9</td><td>60</td><td>32</td><td>2009</td><td>France</td><td>Gillioz A.S. et al. Dement Geriatr Cogn Disord 2009;28:427-32</td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 11 (continued)**
MNA® Clinical practice: elderly – Cognitively impaired elderly - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Hospitalized elderly patients with mild cognitive impairment</td><td>623</td><td></td><td>24</td><td>58</td><td>18</td><td>2009</td><td>Italy</td><td>Orsitto G. Et al. Clin Nutr 2009;28:100-102</td></tr><tr><td>Patients diagnosed with Alzheimer's disease with advanced cognitive impairment</td><td>52</td><td>84.5 ± 7.1</td><td>35</td><td>48</td><td>17</td><td>2009</td><td>Spain</td><td>Tarazona Santabalbina F. J. Et al. Nutr Hosp. 2009;24:724-731</td></tr><tr><td>Alzheimer's Disease Unit</td><td>49</td><td>73.9 ± 7.4</td><td>0</td><td>43</td><td>57</td><td>2010</td><td>Italy</td><td>Spaccavent S. Et al. Arch Gerontol Geriatr. 2009;48(3):356-360</td></tr><tr><td>Residents with mild cognitive impairment of three nursing homes in Cairo</td><td>46</td><td>74.5 ± 6.7</td><td>17</td><td>54</td><td>28</td><td>2011</td><td>Egypt</td><td>Khater M.S. et al. J Nutr Health Aging. 2011;15(2):104-108 J. Clin. Gerontol. Geriatr 212:3:73-76</td></tr><tr><td>Community-dwelling older people with dementia</td><td>56</td><td>80.7 (SD 6.5)</td><td>23</td><td>59</td><td>18</td><td>2013</td><td>France</td><td>Rullier L. Et al. Int J Geriatr Psychiatry. 2013;28(6):580-588</td></tr><tr><td>Community-dwelling elderly with newly diagnosed Alzheimer's disease</td><td>312</td><td>77.6 ± 5.7</td><td>0</td><td>14</td><td>86</td><td>2013</td><td>The Netherlands</td><td>Droogsma E. Et al. J Nutr Health Aging. 2013;17(7):606-610</td></tr><tr><td>Community-dwelling individuals attending dementia clinics (nutrialz Study)</td><td>940</td><td>79.1 ± 7.3</td><td>5.2</td><td>42.6</td><td>52.2</td><td>2013</td><td>Spain</td><td>Roqué M. Et al. J Nutr Health Aging. 2013;17(4):295-299 Salvà A. Et al. J Nutr Health Aging. 2009;13(6):529-537</td></tr><tr><td>Memory clinic patients with mild cognitive deficits</td><td>48</td><td>70.6 (61 - 87)</td><td>0</td><td>39</td><td>61</td><td>2013</td><td>Germany</td><td>Von Arnim C.A.F. et al. Nutr J 2013;12:148</td></tr><tr><td>Community-dwelling persons aged 60 years and above, prevalence of dementia 0.151 from 471 elderly</td><td>70</td><td>60+</td><td>40</td><td>54</td><td>6</td><td>2014</td><td>Bengladesh</td><td>Palmer K. Et al. Int Psychogeriatr 2014;26:1905-1915</td></tr><tr><td>Subjects diagnosed with probable Alzheimer's disease</td><td>189</td><td>82.3 (69-101)</td><td>9</td><td>55</td><td>36</td><td>2014</td><td>Spain</td><td>Sarabia-Cobo C.M. et al. J Aging Res Clin Practice 2014;3(3):178-181</td></tr><tr><td>Individuals of the geriatric outpatient department, with memory complaints, and with multiple problems in the somatic, psychological, social, or functional domain</td><td>359</td><td>80 ± 7</td><td>13</td><td>55</td><td>32</td><td>2016</td><td>The Netherlands</td><td>De van der Schueren M.A.E. et al. J Am Geriatr Soc 2016;64:2457-2463</td></tr><tr><td>Acutely ill patients admitted to a geriatric ward of a tertiary university hospital in São Paulo, subgroup with Dementia alone</td><td>182</td><td>82 ± 8</td><td>48</td><td>42</td><td>10</td><td>2017</td><td>Brazil</td><td>Avelino-Silva T.J.et al. Plos medicine 2017;14:e1002264</td></tr><tr><td>Elderly with mild, moderate and severe Alzheimer's disease, neurology outpatient clinic</td><td>43</td><td>80.6 ± 7.0</td><td>3</td><td>66</td><td>31</td><td>2018</td><td>Brazil</td><td>Santos T.N.B. et al. Nutr Hops 2018;35(6):1298-1304</td></tr><tr><td>Subjects who lived in their own homes and attended the Cognitive Disorders Unit</td><td>111</td><td>78.5 ± 6.4</td><td>19</td><td>68</td><td>14</td><td>2018</td><td>Spain</td><td>Rocaspana-García M. Et al. Peer 2018;6:e5150j</td></tr><tr><td>Older residents in institutional settings in Helsinki, assessed with a clinical dementia rating (CDR)</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>very mild/mild dementia (CDR 0.5-1),</td><td>150</td><td>85 ± 7</td><td>9</td><td>68</td><td>23</td><td>2019</td><td>Finland</td><td>Salminen K.S. et al. Nutrients 2019;11(10):2261</td></tr><tr><td>Moderate dementia (CDR 2)</td><td>206</td><td>84 ± 8</td><td>17</td><td>69</td><td>14</td><td></td><td></td><td></td></tr><tr><td>Severe dementia (CDR 3)</td><td>182</td><td>83 ± 7</td><td>28</td><td>67</td><td>5</td><td></td><td></td><td></td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

Table 11 (continued)

MNA® Clinical practice: elderly – Cognitively impaired elderly - Identifying the elderly/adults at risk of malnutrition

<table><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td colspan="9"><strong>NUDAD study</strong></td></tr><tr><td>Patients with clinical diagnosis of mild cognitive impairment</td><td>135</td><td>66.3 ± 7.7</td><td>1</td><td>19</td><td>80</td><td>2019</td><td>The Netherlands</td><td>Doorduijn A.S. et al. Nutrients 2019;11:1161</td></tr><tr><td>Alzheimer's disease</td><td>198</td><td>67.4 ± 7.9</td><td>3</td><td>28</td><td>69</td><td></td><td></td><td></td></tr><tr><td>Control group : subjects with subjective cognitive decline, with memory complaints but normal on all clinical examinations</td><td>219</td><td>60.6 ± 7.7</td><td>1</td><td>9</td><td>90</td><td></td><td></td><td></td></tr><tr><td>PEN-3S Study<br/>Cognitively impaired community-dwelling older adults</td><td>185</td><td>≥ 65</td><td>3</td><td>40</td><td>58</td><td>2020</td><td>Portugal</td><td>Madeira T. Et al. Nutrition 2020;73:110660</td></tr><tr><td>Cognitively impaired nursing home residents</td><td>608</td><td>≥ 65</td><td>5</td><td>49</td><td>47</td><td></td><td></td><td></td></tr><tr><td colspan="9"><strong>Cognitively impaired elderly</strong></td></tr><tr><td></td><td></td><td></td><td>Under-nourished<br/>&lt;17</td><td>At risk of malnutrition<br/>17 – 23.5</td><td>Well-nourished<br/>≥24</td><td></td><td></td><td></td></tr><tr><td>Total</td><td>8378</td><td>Mean</td><td>14</td><td>45</td><td>41</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td>SE</td><td>0.4</td><td>0.5</td><td>0.5</td><td></td><td></td><td></td></tr></tbody></table>

Table 12

MNA® Clinical practice: elderly/adults with Parkinson's disease – Institution - Identifying the elderly/adults at risk of malnutrition

<table><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation [% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;17</th><th>At risk<br/>17 – 23.5</th><th>Well-nourished<br/>≥24</th></tr></thead><tbody><tr><td>Patients with Parkinson's disease</td><td>61</td><td>70.5 ± 5.5</td><td>0</td><td>23</td><td>77</td><td>2008</td><td>Italy</td><td>Barichella M. Et al. Nutr Neuroscience 2008;11(3):128-134</td></tr><tr><td>Outpatients with Parkinson's disease and their respective caregivers</td><td>117</td><td>65 ± 9.4</td><td>2</td><td>20</td><td>79</td><td>2010</td><td>China</td><td>Wang, G. Et al. Parkinsonism Relat Disord 2010;16:119-123</td></tr><tr><td>Community-dwelling adults with Parkinson's disease, aged &gt;18 years</td><td>125</td><td>70.0 (35–92)</td><td>2</td><td>22</td><td>76</td><td>2013</td><td>Australia</td><td>Sheard J.M. et al. E-SPEN Journal 2013;8:e187-e92</td></tr><tr><td>Consecutive patients with idiopathic Parkinson's disease, single referral Movement Disorders Clinic in Tehran</td><td>150</td><td>61 ± 10.8</td><td>2</td><td>25</td><td>73</td><td>2014</td><td>Iran</td><td>Fereshtehejad S-M. Et al. Plos One 2014;9:e91153 J Parkinsons Dis 2014;4:473-481</td></tr><tr><td>Parkinson's disease (PD) patients</td><td>114</td><td>66 ± 9.8</td><td>7</td><td>28</td><td>65</td><td>2017</td><td>Argentina</td><td>Bril A. Et al. NPJ Parkinsons Dis 2017;3:17</td></tr><tr><td>Patients with idiopathic PD, recruited from an outpatient referral movement disorder clinic</td><td>96</td><td>64 ± 6.4</td><td>25</td><td>43</td><td>32</td><td>2018</td><td>Turkey</td><td>Ongun N. Plos One 2018;13(10): e0205100</td></tr><tr><td>Hospitalized elderly patients with Parkinson's disease [MNA® -SF]</td><td>92</td><td>74 ± 6.7</td><td>7</td><td>39</td><td>54</td><td>2020</td><td>Germany</td><td>Gruber M.T. et al. Plos One 2020;15:e0232764</td></tr><tr><td colspan="9"><strong>Elderly/adults with Parkinson's disease</strong></td></tr><tr><td></td><td></td><td></td><td>Under-nourished<br/>&lt;17</td><td>At risk of malnutrition<br/>17 – 23.5</td><td>Well-nourished<br/>≥24</td><td></td><td></td><td></td></tr><tr><td>Total</td><td>755</td><td>Mean</td><td>6</td><td>29</td><td>65</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td>SE</td><td>0.9</td><td>1.6</td><td>1.7</td><td></td><td></td><td></td></tr></tbody></table>
NUTRITIONAL ASSESSMENT IN OLDER ADULTS

<table><caption>**Table 13**
Self-MNA® Clinical practice: elderly - Identifying the elderly/adults at risk of malnutrition</caption><thead><tr><th rowspan="2">Setting</th><th rowspan="2">n</th><th rowspan="2">Age<br/>[year]</th><th colspan="3">Nutritional status evaluation[% of subjects]</th><th rowspan="2">Pub Year</th><th rowspan="2">Country</th><th rowspan="2">Reference</th></tr><tr><th>Under-nourished<br/>&lt;8</th><th>At risk<br/>8 - 11</th><th>Well-nourished<br/>≥12</th></tr></thead><tbody><tr><td>Community-dwelling older adults</td><td>463</td><td>76.8 ± 6.8</td><td>27</td><td>38</td><td>35</td><td>2013</td><td>U.S.A.</td><td>Huhmann M.<br/>Et al.<br/>J Nutr Health<br/>Aging<br/>2013;17:339-344</td></tr><tr><td>Older who came for care to the Rutgers<br/>School of Dental Medicine (RSDM)<br/>clinics</td><td>75</td><td>71.9 ± 5.5</td><td>9</td><td>28</td><td>63</td><td>2016</td><td>U.S.A.</td><td>Stump M. Et al.<br/>J Acad Nutr Diet<br/>2016;116:A94</td></tr><tr><td>Patients referring to the GP offices<br/>Women</td><td>125</td><td>75.1 ± 8</td><td>9</td><td>33</td><td>58</td><td>2018</td><td>Italy</td><td>Donini L. Et al.<br/>J Nutr Health<br/>Aging<br/>2018;22:44-52</td></tr><tr><td>Men</td><td>101</td><td>75.3 ± 8</td><td>8</td><td>21</td><td>70</td><td></td><td></td><td></td></tr><tr><td>Community-dwelling older adults</td><td>107</td><td>72.6 ± 5.6</td><td>5</td><td>21</td><td>75</td><td>2018</td><td>U.S.A.</td><td>Zelig R. Et al.<br/>J Aging Res<br/>Clin Pract 2018<br/>:7:107-114</td></tr></tbody><tfoot><tr><td>N</td><td>871</td><td>Mean</td><td>11.7</td><td>28.2</td><td>60.1</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td>SE</td><td>1.1</td><td>1.5</td><td>1.7</td><td></td><td></td><td></td></tr></tfoot></table>

<table><caption>**Table 14**
Prevalence of malnutrition and risk of malnutrition in different settings MNA®</caption><thead><tr><th rowspan="2"># of studies</th><th rowspan="2">Setting</th><th colspan="3">Mean ± SD in %</th><th rowspan="2">N</th></tr><tr><th>Malnutrition</th><th>Risk of malnutrition</th><th>Well nourished</th></tr></thead><tbody><tr><td>88</td><td>Community</td><td>5</td><td>31</td><td>64</td><td>75396</td></tr><tr><td></td><td></td><td>0.1</td><td>0.2</td><td>0.2</td><td></td></tr><tr><td>73</td><td>Home care / Out patient</td><td>11</td><td>40</td><td>48</td><td>20701</td></tr><tr><td></td><td></td><td>0.2</td><td>0.3</td><td>0.3</td><td></td></tr><tr><td>120</td><td>Hospital</td><td>22</td><td>45</td><td>34</td><td>33222</td></tr><tr><td></td><td></td><td>0.2</td><td>0.3</td><td>0.3</td><td></td></tr><tr><td>94</td><td>Institutions</td><td>18</td><td>48</td><td>34</td><td>23246</td></tr><tr><td></td><td></td><td>0.3</td><td>0.3</td><td>0.3</td><td></td></tr><tr><td>34</td><td>Cognitive impaired</td><td>14</td><td>45</td><td>41</td><td>8378</td></tr><tr><td></td><td></td><td>0.8</td><td>0.5</td><td>0.5</td><td></td></tr><tr><td>7</td><td>Elderly/adult with Parkinson's disease</td><td>6</td><td>29</td><td>65</td><td>755</td></tr><tr><td></td><td></td><td>0.9</td><td>1.6</td><td>1.7</td><td></td></tr><tr><td>416</td><td>Total n of studies</td><td></td><td></td><td>Total n of elderly</td><td>161698</td></tr><tr><td>32</td><td>Community</td><td>4</td><td>27</td><td>69</td><td>53617</td></tr><tr><td></td><td></td><td>0.1</td><td>0.0</td><td>0.2</td><td></td></tr><tr><td>20</td><td>Outpatient</td><td>12</td><td>33</td><td>55</td><td>8508</td></tr><tr><td></td><td></td><td>0.3</td><td>0.1</td><td>0.5</td><td></td></tr><tr><td>62</td><td>Hospital</td><td>29</td><td>45</td><td>27</td><td>31068</td></tr><tr><td></td><td></td><td>0.3</td><td>0.0</td><td>0.3</td><td></td></tr><tr><td>16</td><td>Institution</td><td>22</td><td>50</td><td>28</td><td>12618</td></tr><tr><td></td><td></td><td>0.4</td><td>0.1</td><td>0.4</td><td></td></tr><tr><td>3</td><td>Cognitively impaired elderly</td><td>20</td><td>54</td><td>26</td><td>1980</td></tr><tr><td>2</td><td>Elderly/adult with Parkinson's disease</td><td>4</td><td>35</td><td>61</td><td>217</td></tr><tr><td>133</td><td>Total n of studies</td><td></td><td></td><td>Total # of elderly</td><td>108008</td></tr></tbody></table>
THE JOURNAL OF NUTRITION, HEALTH & AGING

<table><caption>**Table 15**
MNA® Sensitivity/Specificity against Nutritional assessment parameters & other parameters</caption><thead><tr><td>Reference</td><td>Sensitivity</td><td>Specificity</td><td>References</td></tr></thead><tbody><tr><td>Clinical Status (extensive evaluation by 2 clinicians)</td><td>96</td><td>98</td><td>Guigoz Y. Et al. Med Hyg 1995; 53:1965-1969.</td></tr><tr><td>Detailed nutritional assessment</td><td>54</td><td>61</td><td>Azad N. Et al. CMAJ 1999;161:511-515</td></tr><tr><td>Albumin (&lt;35 g/l)</td><td>75</td><td>50</td><td></td></tr><tr><td>Energy intake (&lt;1 SD mean)</td><td></td><td></td><td></td></tr><tr><td>720 kcal/day</td><td>100</td><td>37</td><td>Murphy M.C. et al. Eur J Clin Nutr 2000;54:555-562</td></tr><tr><td>970 kcal/day</td><td>72</td><td>32</td><td></td></tr><tr><td>Mindex (&lt;50%tile 81.7 kg/m)</td><td>81</td><td>47</td><td></td></tr><tr><td>Detailed nutritional assessment (albumin, BMI, diet history, clinical data)</td><td>72</td><td>88</td><td>Hui W.H. et al. Hong Kong J Gerontol 2001;15:35-43</td></tr><tr><td>BMI 19</td><td>41</td><td>86</td><td></td></tr><tr><td>BMI 21</td><td>59</td><td>78</td><td>Thomas D.R. et al. Am J Clin Nutr 2002;75:308-313</td></tr><tr><td>BMI 22</td><td>70</td><td>71</td><td></td></tr><tr><td>Protein energy malnutrition (weight, triceps skin fold, arm circumference, albumin &amp; transthyretin)</td><td>96</td><td>26</td><td>Christensson L. Et al. Eur J Clin Nutr 2002;56(9):810-818.</td></tr><tr><td>Nutritional assessment (anthropometry, serum proteins)</td><td>98</td><td>13</td><td>Donini L.M. et al. J Nutr Health Aging 2002;6:141-146.</td></tr><tr><td>Detailed nutritional assessment</td><td>90</td><td>88</td><td>Visvanathan R. Et al. Age Ageing 2004;33:260-265</td></tr><tr><td>Nutritional diagnosis (BMI &amp; laboratory testing)</td><td>100</td><td>74</td><td>Delacorte R.R. et al. J Nutr Health Aging 2004; 8:531-534</td></tr><tr><td>Full nutritional assessment</td><td>77</td><td>36</td><td>Thorsdottir I. Et al. J Hum Nutr Diet 2005;18:53-60.</td></tr><tr><td>PS SGA baseline</td><td>97</td><td>54</td><td>Read J.A. et al. Nutr Cancer 2005;53:51-56.</td></tr><tr><td>PG-SGA 4-6 wk</td><td>79</td><td>69</td><td></td></tr><tr><td>PG-SGA 8-12 wk</td><td>82</td><td>66</td><td></td></tr><tr><td>Albumin &lt;3.5 g/dl</td><td>86</td><td>82</td><td>Kuzuya M et al. Nutrition 2005;21:498-503.</td></tr><tr><td>NRS-2002</td><td>81.7</td><td>84.6</td><td>Martins C.P.A.L. et al. J Nutr Elderly. 2005;25:5-21</td></tr><tr><td>PEM (anthrop., Alb, Prealb)</td><td>73</td><td>31</td><td>Wikby K. Et al. J Nutr Health Aging 2006;10:232-238</td></tr><tr><td>Criteria of Edington, Clin Nutr 2000;19:191-195</td><td>93</td><td>67</td><td>Gehring N. Et al. Swis Med Wkly 2006;136:664-669</td></tr><tr><td>Fat-free mass index (FFMI; kg/m²)</td><td>85</td><td>39</td><td>Elkan A.C. et al. EJCN 2007;62:1239-1247</td></tr><tr><td>SGA</td><td>77</td><td>82</td><td>Capra S. Nutrition 2007;23:356-357</td></tr><tr><td>Well nourished</td><td></td><td></td><td></td></tr><tr><td>with following nutritional indicators: BMI ≥ 21, Arm Circumference ≥ 22, Calf circumference ≥ 31, albumin ≥ 35</td><td>87.1</td><td>50</td><td>Cuyac L.M. and Santana P.S. (2007)</td></tr><tr><td>Arch Latinoam Nutr 2007;57:255-265</td><td></td><td></td><td></td></tr><tr><td>Criteria of the American Institute of Nutrition (AIN): BMI ≤ 20, Arm-circumference ≤ 21 cm, albumin ≤ 3.5 g/dl and cholesterol ≤ 150 mg/dl</td><td>60</td><td>94.7</td><td>Tarazona Santabalbina F.J. et al. Nutr Hosp. 2009;24:724-731</td></tr><tr><td>BMI &lt;24 kg/m²</td><td>82</td><td>63</td><td>Amirkalali B. Et al. Public Health Nutr 2010;13:1373-9</td></tr><tr><td>Serum albumin &lt;3.5 g/dl</td><td></td><td></td><td></td></tr><tr><td>SBMI and/or Weight loss: severely undernourished and moderately undernourished versus not undernourished</td><td>90</td><td>36</td><td>Kruizenga H.M. et al. J Nutr Health Aging 2010;14:83-89</td></tr><tr><td>Accuracy for MNA® &lt;23.5</td><td></td><td></td><td></td></tr><tr><td>BMI and/or Weight loss: severely undernourished versus moderately and not undernourished</td><td>56</td><td>58</td><td></td></tr><tr><td>Accuracy for MNA® &lt;17</td><td></td><td></td><td></td></tr><tr><td>CONUT (controlling nutritional status): albumin, total cholesterol and total lymphocyte count</td><td>77</td><td>70</td><td>Jürschik Jiménez P. Et al. Arch Latinoam Nutr 2009;59(1):38-46</td></tr></tbody></table>