Objective: The study was conducted to determine whether a version of the MNA (Mini Nutritional Assessment) modified according to population-specific anthropometric cut-points have improved functionality in assessing the nutritional status of elderly residents in long-term care institutions in Taiwan.
Methods: Using a purposive sampling design, the study recruited 297 subjects (132 men and 165 women) from a large long-term care center in Central Taiwan as study subjects. To be qualified, subjects must be a resident for >30 days, without acute infection or disease and able to communicate. Each subject was interviewed with a structured questionnaire for personal data, health conditions and answers to the MNA, and also measured for anthropometric parameters. Biochemical data were obtained from their routine examinations carried out by the center. The nutritional status of each subject was evaluated with two modified versions of the MNA. Version I (MNA-TI) adopted population-specific anthropometric cut-points while version II (MNA-TII) further had the BMI question deleted from the scale and adjusted the scoring. The study protocol was approved by the IRB of Asia University.
Results: MNA-TI graded 8.1% malnourished, 52.9% at risk of malnutrition and 39% normal whereas MNA-TII graded 9.4, 55.2 and 35.4%, respectively. The results of the two versions were not different from each. The results of both versions were significantly correlated with the major nutritional indicators such as serum albumin, calf-circumference and mid-arm circumference. Regression analysis further indicated that serum albumin, calf-circumference, weight change during the past three months and hospital length of stay were the factors associated with the MNA scores.
Conclusion: Results of this study suggest that MNA which adopted population-specific anthropometric cut-points and a further modified version without BMI can effectively grade the nutritional status of elderly in long-term care institutions. MNA is a simple, easy-to-use and non-invasive tool. Removal of BMI from the scale further enhances its application in frail or disabled individuals.