The MNA, but not the DETERMINE, screening tool is a valid indicator of nutritional status in elderly Africans

Objectives We compared the validity of existing nutrition screening tools for use in older South Africans. Methods This was a cross-sectional study in 283 free-living and institutionalized black South Africans ≥60 y of age. Trained fieldworkers administered a 24-h recall, the DETERMINE and Mini-Nutritional Assessment (MNA) screening tools, and performed anthropometric measurements and physical function tests. Biochemical indicators assessed included serum albumin, hemoglobin, ferritin, vitamin B12, red blood cell folate, cholesterol, and vitamin C. The six-item Cognitive Impairment Test was used to assess cognitive function. Results The MNA score was positively and significantly associated with anthropometric measurements, cognitive function, instrumental activities of daily living and, in women only, percentage of body fat, handgrip strength, and activities of daily living. Compared with the MNA, the DETERMINE instrument had a low positive predictive value (55.6%) and specificity (11.2%), resulting in a high rate of false positives classified as being malnourished. Conclusion The MNA, but not the DETERMINE, screening tool is appropriate for use in identifying older black South Africans who are malnourished or at risk of malnutrition.