Cross-cultural adaptation and psychometric evaluation of the long-form mini nutritional assessment (MNA-LF) among older Moroccan patients with cancer - 06/11/26

Doi : 10.1016/j.jarlif.2026.100089

Salma Chbanat ^a, Raja Arif ^a, Elhoussein Hamni ^a, Jawad Bouzid ^a, Youssef Babakhouya ^a, Naoufal Himmouche ^a, Hassane Loukili ^b, Mouna Khouchani ^c,^d, Zineb Serhier ^e,^f, Anis Sfendla ^g, Fatine Hadrya ^a,^h,^⁎

^a Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco

^b Alaoui Polyclinic, Meknès, Morocco

^c Oncology – Radiotherapy Department, Mohammed VI University Hospital, Marrakech, Morocco

^d Morpho-science Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco

^e Clinical Neuroscience and Mental Health Laboratory, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco

^f Medical Informatic Department, Ibn Rochd University Hospital Center, Casablanca, Morocco

^g High Institute of Nursing Professions and Health Techniques, Fez, Morocco

^h Laboratory of Biology and Health, Faculty of Science, Ibn Tofail University, Kenitra, Morocco

^⁎ Corresponding author at: Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, BP 555, 26000, Settat, Morocco. Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies BP 555 Settat 26000 Morocco

Highlights

•	First Moroccan Arabic adaptation of the MNA-LF for older adults with cancer.
•	The MNA-LF showed acceptable internal consistency (α = 0.757; ω = 0.776).
•	Test-retest reliability was excellent in a small subsample (ICC = 0.928; n = 19).
•	An exploratory six-component solution explained 60.5% of total variance.
•	Concurrent discrimination of low MAMC and low grip strength was acceptable.

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Abstract

Background

Malnutrition is common among older adults with cancer and independently predicts treatment-related toxicity, functional decline, and mortality. Despite the widespread international use of the Mini Nutritional Assessment Long Form (MNA-LF), no Moroccan Arabic version had previously been available.

Objectives

To adapt the MNA-LF into Moroccan Arabic and evaluate its reliability, exploratory component structure, convergent validity, and concurrent discriminative validity against selected anthropometric and functional muscle-related criteria among older Moroccan patients with cancer.

Methodology

A cross-sectional psychometric evaluation study was conducted following a five-stage cross-cultural adaptation process.

Setting

Three public Moroccan hospital centers.

Participants

A total of 387 patients aged ≥60 years with histologically confirmed cancer were included. Test-retest reliability was assessed in a subsample of 19 participants.

Measures

Internal consistency, test-retest reliability, exploratory principal component analysis, convergent validity, and concurrent discriminative validity against selected muscle-related criteria were evaluated.

Results

Principal component analysis identified an exploratory six-component solution explaining 60.5% of the total variance. Internal consistency was acceptable (Cronbach’s alpha = 0.757; McDonald’s omega = 0.776; bootstrap 95% CI, 0.734–0.804), and test-retest reliability was excellent in a small subsample (ICC = 0.928; 95% CI, 0.825–0.971; n = 19). Convergent validity was supported by significant correlations with calf circumference (rho = 0.566) and body mass index (rho = 0.501), although these measures overlap with MNA-LF content. Concurrent discriminative validity against the low-MAMC and low-handgrip-strength criteria was acceptable (AUC = 0.767 and 0.702, respectively); at the ≤17 threshold, specificity exceeded sensitivity for both criteria (82.4%vs. 57.3% and 90.6% vs. 40.4%, respectively).

Conclusions

The Moroccan Arabic MNA-LF showed acceptable internal consistency, excellent short-term test-retest reliability in a small subsample (n = 19), and evidence of convergent validity and concurrent discriminative validity against selected muscle-related criteria. Its exploratory component structure requires confirmation in an independent sample. The instrument may support initial nutritional assessment in geriatric oncology and prompt more comprehensive evaluation in accordance with local practice; it is not a diagnostic tool for malnutrition or sarcopenia.

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