The MNA, but not the DETERMINE, screening tool is a valid indicator of nutritional status in elderly Africans
Objectives: To compare the validity of existing nutrition screening tools for use in older South Africans. Design: A cross-sectional study in 283 free-living and institutionalized black South Africans aged 60+ years.Methods: Trained fieldworkers administered a 24-hour recall, the DETERMINE and Mini Nutritional Assessment (MNA) screening tools and performed anthropometrical measurements and physical function tests. Biochemical indicators assessed included serum albumin; haemoglobin, ferritin, vitamin B12, RBC folate, cholesterol and vitamin C. The 6-item Cognitive Impairment Test was used to assess cognitive function.Results: MNA score was positively and significantly associated with anthropometrical measurements, cognitive function, IADL and, in women only, % body fat, handgrip strength and ADL. Compared against 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 either malnourished, or at risk of malnutrition.