Nutritional Screening Tools as Predictors of Mortality, Functional Decline, and Move to Higher Level Care in Older People: A Systematic Review

Elsa Dent, Renuka Visvanathan, Cynthia Piantadosi, Ian Chapman

Research output: Contribution to journalReview article

50 Citations (Scopus)


This systematic review assessed whether nutritional screening tools (NSTs) predict mortality, functional decline, and move to higher level care in older adults residing in the community or in institutions. In total, 37 prospective studies published between 1999 and 2012 met inclusion criteria and were included in this review. The most commonly used NST in these studies was the Mini Nutritional Assessment (MNA). Comparison of NSTs was limited by variation in follow-up time, lack of uniform definition of functional decline, and biases in many studies. Results of MNA, MNA-Short Form (MNA-SF), and Geriatric Nutrition Risk Index (GNRI) assessments were significantly associated with subsequent mortality, with good negative predictive power (~0.83), but only modest positive predictive power (PPV~0.32). MNA-SF and MNA results had a low to moderate association with functional decline (PPV~0.34). Move to higher level care was less strongly associated with NST scores (PPV~0.25). Overall, there is evidence that NSTs can predict those at low risk of mortality, functional decline, and, to a lesser extent, move to higher level care in older people.

Original languageEnglish
Pages (from-to)97-145
Number of pages49
JournalJournal of Nutrition in Gerontology and Geriatrics
Issue number2
Publication statusPublished - 1 Apr 2012
Externally publishedYes



  • aged
  • functional decline
  • malnutrition
  • mortality
  • nutritional screening tools
  • nutritional status
  • older persons
  • residential care
  • sensitivity
  • specificity
  • systematic review

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