MALNUTRITION IDENTIFIED BY COMPREHENSIVE NUTRITIONAL ASSESSMENT AS A DETERMINANT OF BONE MINERAL DENSITY IN OLDER WOMEN: A RETROSPECTIVE STUDY

Objective: This study investigates how malnutrition, assessed by Mini Nutritional Assessment (MNA), Controlling Nutritional Status (CONUT), and Geriatric Nutritional Risk Index (GNRI), affects bone mineral density (BMD) in older women. Materials and Methods: A retrospective analysis was conducted on 196 women aged 65 years and older who underwent comprehensive geriatric assessment and dual-energy X-ray absorptiometry. Nutritional status was evaluated using the MNA, CONUT, and GNRI tools. BMD was measured at the lumbar spine and femoral neck, while body mass index and body fat percentage (BF%) were assessed via bioelectrical impedance analysis. Results: Among the participants, 14.43% were newly diagnosed with osteoporosis and 40.72% with osteopenia. The prevalence of malnutrition varied depending on the assessment tool used: 50.32% according to the MNA, 15.64% based on the CONUT score, and 10.31% using the GNRI. Lower femoral neck T-scores and femoral BMD were significantly associated with undernutrition as determined by the CONUT score. In univariate analysis, MNA, GNRI, hemoglobin, albumin, handgrip strength, BF%, and obesity were all significantly and inversely associated with low BMD (osteopenia and osteoporosis) (p=0.007, p=0.018, p=0.004, p=0.004, p<0.001, p <0.001, p=0.011, respectively). After adjustment for related variables, only the MNA remained significantly associated with low BMD (OR: 0.78, 95% CI: 0.64–0.96), whereas no significant associations were observed for the GNRI or CONUT scores. Conclusion: Our findings underscore the significance of the MNA as a comprehensive indicator that not only evaluates nutritional status but also incorporates functional and psychological components, thereby providing a more holistic perspective on bone health. Additionally, serum albumin, handgrip strength, and hemoglobin levels may further serve as valuable indicators in assessing bone health. A multidimensional evaluation of nutritional status is essential to accurately assess osteoporosis risk in older adults.