Diagnostic performance of mini nutritional Assessment-Short form against the global leadership initiative on malnutrition criteria

In 2018, the Global Leadership Initiative on Malnutrition (GLIM) experts accepted screening for malnutrition with any validated tool. In gerontological dietetics, Mini Nutritional Assessment-Short Form (MNA-SF) remains the most frequently used one. We evaluated the diagnostic performance of MNA-SF against the GLIM criteria in a representative group of older adults (PolSenior2 study population). The complete dataset was available for 5614 participants. We compared two groups of respondents: fulfilling GLIM criteria (GLIM malnutrition, positive screening) and GLIM malnutrition, screening negative. At least one phenotypic and one etiological GLIM criterion was diagnosed in 1136 (20.2%) study participants, including 789 with positive screening results. Therefore, malnutrition would have been undiagnosed in one-third of the malnourished group (30.5% of the group was diagnosed based on the GLIM criterion). In comparison with participants with GLIM malnutrition, screening positive, those with GLIM malnutrition, screening negative were younger and more often had an acute or chronic inflammatory disease. They were less likely to report unintentional weight loss and reduced food intake, and they had higher body weight and BMI. The sensitivity of the MNA-SF in diagnosing malnutrition was estimated at 69.5%. Based on our findings, using a high clinical malnutrition risk profile as an alternative to screening tools for malnutrition in the GLIM diagnostic algorithm could be beneficial.