Evidence map›Paper›PMID 41754103›Full record

Observational studyNutrients2026

Beyond the MNA: A Biological Vulnerability Phenotype Associated with Prolonged Hospitalization in Older Adults.

Virginia Boccardi, Francesca Mancinetti, Cesare Balducci, Valeria Labbozzetta, Elena Ercolanetti, Carmelinda Ruggiero, Sara Ercolani, Patrizia Mecocci

Abstract readObservational Study
In one paragraph

Observational study in Nutrients, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Virginia BoccardiDivision of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy.ORCID 0000-0003-2134-1122
Francesca MancinettiDivision of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy.
Cesare BalducciDivision of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy.
Valeria LabbozzettaDivision of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy.
Elena ErcolanettiDivision of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy.
Carmelinda RuggieroDivision of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy.ORCID 0000-0002-1245-1963
Sara ErcolaniDivision of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy.
Patrizia MecocciDivision of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy.ORCID 0000-0003-0729-5246

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesNutritional status in hospitalized older adults is usually evaluated using screening tools such as the Mini Nutritional Assessment (MNA). During acute illness, however, these tools may overlook biologically relevant vulnerability related to inflammation and metabolic stress, a condition often described as occult malnutrition. The clinical implications of applying a more stringent biological definition of this phenotype are still poorly defined.

methodsWe conducted an observational cohort study including 172 hospitalized older adults (mean age 86.7 ± 6.0 years) in an acute geriatric setting with complete data on MNA, serum albumin, hemoglobin, and C-reactive protein (CRP). Occult malnutrition was defined by the coexistence of at least two abnormal biological markers: hypoalbuminemia (albumin < 3.5 g/dL), anemia (Hb < 12 g/dL), and elevated CRP (>0.5 mg/dL). Prolonged length of stay (LOS) was defined as LOS above the 75th percentile. Associations between occult malnutrition, MNA categories, and prolonged LOS were examined using chi-square tests and multivariable logistic regression models adjusted for age ≥ 85 years, sex, primary reason for hospital admission and comorbidity burden.

resultsAmong 172 acutely hospitalized older adults (mean age 86.7 ± 6.0 years), hypoalbuminemia, anemia, and elevated CRP were observed in 42.4%, 46.5%, and 72.1% of patients, respectively. Occult malnutrition was identified in 54.7% of the cohort. Prolonged length of stay (LOS > 75th percentile) occurred in 50.0% of patients. Compared with patients without occult malnutrition, those with occult malnutrition were older, had significantly longer hospital stays, and a higher prevalence of prolonged LOS (59.6% vs. 38.5%,

conclusionsA stringent biological definition of occult malnutrition identifies a large subgroup of hospitalized older adults at increased risk of prolonged hospitalization, including patients considered nutritionally normal by standard screening. These findings underline the limitations of screening-based assessment alone and support the use of simple biological markers to refine risk stratification in acute geriatric care.

Indexed as

Geriatric AssessmentHospitalizationLength of StayMalnutritionNutritional StatusNutrition AssessmentAgedAged, 80 and overAnemiaBiomarkersCohort StudiesC-Reactive ProteinFemaleHumansHypoalbuminemiaLogistic ModelsBiomarkersC-Reactive ProteinSerum Albuminhospitalizationhypoalbuminemiainflammationmalnutrition screeningolder adults

Identifiers

PMID41754103
PMCPMC12943111

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.