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POLISH ARCHIVES OF INTERNAL MEDICINE 2018; 128 (9) Fatyga et al1 studied a population of 106 geriat‐ ric patients (aged >60 years) who were followed in a geriatric outpatient clinic. Patients had multiple chronic conditions (mean number, 5.6) and were polymedicated (mean number, 7 medications). The mean Instrumental Activities of Daily Living (IADL) score was 23.65, and more than 50% of pa‐ tients were classified as New York Heart Associa‐ tion class III. Three ‐quarters of the sample had HF (systolic and diastolic function not mentioned). In terms of nutritional assessment, the authors re‐ ported only the number of patients at risk of mal‐ nutrition (MNA <24, n = 30) because of the low number of malnourished patients. However, ex‐ amining this number would have been very in‐ formative. The population could have been ana‐ lyzed by grouping patients according to the pres‐ ence of HF. Instead, the authors pursued the ob‐ jective of identifying higher ‐risk patients ac‐ cording to NT ‐proBNP levels. The NT ‐proBNP level was categorized according to tertiles (cutoff points, 268 pg/ml and 1339 pg/ml). As expect‐ ed, the higher the tertile, the greater the percent‐ age of patients with chronic HF—this was 100% in the highest NT ‐proBNP tertile. In addition, the proportions of patients at risk of malnutrition were similar in the first and second tertiles and tripled in the third tertile, so patients in the third tertile (NT ‐proBNP >1339 pg/ml) were identified as being at higher risk of malnutrition. The above hypothesis was further analyzed by the authors. The risk of malnutrition (MNA <24) was associated with body mass index (odds ratio [OR], 0.86; P = 0.01), Mini Mental State Examination score (OR, 0.84; P = 0.02), IADL score (OR, 0.9; P = 0.08), and NT ‐proBNP (OR for the third tertile, 4.72; P = 0.006). For each 100‐pg/ml increase in NT ‐proBNP levels, the risk of malnutrition increased by 2%. In the multi‐ ple logistic regression analysis, the third tertile of NT ‐proBNP continued to be associated with In the present issue of Polish Archives of Internal Medicine, Fatyga et al1 address a simple question with enormous clinical and social impact: should malnutrition risk be assessed among all geriatric patients or should this assessment be reserved for particular subsets of high ‐risk patients? Us‐ ing a multivariable logistic analysis, the authors of this study conclude that patients with elevat‐ ed N ‐terminal fragment of the prohormone brain natriuretic peptide (NT ‐proBNP); greater than 1339 pg/ml, the third tertile) are at higher risk of malnutrition. Malnutrition refers to an imbalance between anabolic and catabolic metabolism, and it may be associated with multiple chronic conditions.2 There are many screening tools for malnutrition, but there is no consensus on which of these to use among specific subsets of patients,3 such as pa‐ tients with heart failure (HF). The optimal screen‐ ing test should be easy to apply, time ‐efficient, and quantifiable. Additionally, the test should be an independent predictor of outcomes in the rel‐ evant population and add predictive value to the classic model for this population. The Mini Nutritional Assessment (MNA) is a short, validated screening tool for use among older people, and it has been recommended for routine geriatric assessment.3,4 It has been vali‐ dated in several countries for the assessment of chronic conditions. Full and short versions of the MNA have been used among geriatric patients with HF.3,5,6 It classifies patients into 3 groups by score: ≥24, normal nutrition; 17 to 23.5, at risk of malnutrition; and <17, malnutrition. A previous study reported a correlation between MNA score and NT ‐proBNP levels5 among patients with sys‐ tolic HF: patients with a worse status and worse prognosis (higher NT ‐proBNP levels) had a great‐ er chance of malnutrition. This association makes it possible to identify a subgroup at higher risk of malnutrition among patients with HF. EDITORIAL