Statistical & Clinical Analysis
Mini Nutritional Assessment Short-Form (MNA-SF 0–14) Formula: BMI & Calf Fallback
Calculate the revised 6-item Mini Nutritional Assessment Short-Form (MNA-SF, 0–14 points — Rubenstein et al., 2001 / Kaiser et al., 2009) with automatic Calf Circumference (>= 31 cm = 3 pts, < 31 cm = 0 pts) fallback when standing BMI is unavailable.
Why Kaiser et al.’s (2009) revised MNA-SF (0–14) works even in bedbound older adults without standing height/weight!
Originally derived by Laurence Z. Rubenstein et al. (2001) and revised with Calf Circumference substitution by Matthias J. Kaiser et al. (2009, Journal of Nutrition, Health & Aging), the 6-item Mini Nutritional Assessment Short-Form (MNA-SF, 0–14 points) is the gold-standard ESPEN geriatric nutrition screen across hospitals, nursing homes, and community clinics!
Items A–E score: (A) Food intake decline over 3 months (0 = severe, 1 = moderate, 2 = none), (B) Weight loss over 3 months (0 = >3 kg, 1 = unknown, 2 = 1–3 kg, 3 = none), (C) Mobility (0 = bed/chair bound, 1 = gets out of bed/chair but doesn’t go out, 2 = goes out), (D) Acute psychological stress or acute disease in past 3 months (0 = yes, 2 = no), and (E) Neuropsychological problems (0 = severe dementia/depression, 1 = mild dementia, 2 = none). Item F scores BMI (< 19 = 0, 19 to < 21 = 1, 21 to < 23 = 2, >= 23 = 3)—OR when BMI is 0/unavailable in bedbound patients, Item F2 Calf Circumference substitutes (>= 31 cm = 3 pts, < 31 cm = 0 pts)! Total 12–14 = Normal nutritional status, 8–11 = At risk of malnutrition, and 0–7 = Malnourished!
| MNA-SF Total Score (0–14 Points) | Kaiser et al. (2009) Nutritional Status | ESPEN Clinical Action |
|---|---|---|
| 12 to 14 Points | Normal Nutritional Status | Routine rescreening (every 3 mo institutional / annually community) |
| 8 to 11 Points | At Risk of Malnutrition | Protein-calorie fortification, oral supplements & weight monitoring |
| 0 to 7 Points | Malnourished | Comprehensive dietitian consult, etiology workup & targeted nutrition support |
Revised MNA-SF Total Score (0–14) with Automatic BMI-or-Calf-Circumference Item F Logic
Sums Items A–E (B2:B6) plus BMI tier points from B7 when BMI > 0—or automatically falls back to Calf Circumference B8 (>= 31 cm -> 3 pts, < 31 cm -> 0 pts) when BMI = 0.
=IF(OR(B2 < 0, B2 > 2, B3 < 0, B3 > 3, B4 < 0, B4 > 2, AND(B5 <> 0, B5 <> 2), B6 < 0, B6 > 2, AND(B7 <= 0, B8 <= 0)), "Invalid MNA-SF Item or Missing Both BMI & Calf Circumference", B2 + B3 + B4 + B5 + B6 + IF(B7 > 0, IF(B7 >= 23, 3, IF(B7 >= 21, 2, IF(B7 >= 19, 1, 0))), IF(B8 >= 31, 3, 0)))MNA-SF 3-Tier Geriatric Nutrition Triage Classifier (Normal 12–14 / At Risk 8–11 / Malnourished 0–7)
Classifies total MNA-SF score into Normal (12–14), At Risk of Malnutrition (8–11), or Malnourished (0–7).
=IF(OR(B2 < 0, B2 > 2, B3 < 0, B3 > 3, B4 < 0, B4 > 2, AND(B5 <> 0, B5 <> 2), B6 < 0, B6 > 2, AND(B7 <= 0, B8 <= 0)), "Invalid MNA-SF Item or Missing Both BMI & Calf Circumference", IF(B2 + B3 + B4 + B5 + B6 + IF(B7 > 0, IF(B7 >= 23, 3, IF(B7 >= 21, 2, IF(B7 >= 19, 1, 0))), IF(B8 >= 31, 3, 0)) >= 12, "Normal Nutritional Status (12–14)", IF(B2 + B3 + B4 + B5 + B6 + IF(B7 > 0, IF(B7 >= 23, 3, IF(B7 >= 21, 2, IF(B7 >= 19, 1, 0))), IF(B8 >= 31, 3, 0)) >= 8, "At Risk of Malnutrition (8–11)", "Malnourished (0–7)")))Try the example
Use the original values or change them to test your understanding.