Objective: The objective of this study was to examine the functionality of a
modified Mini Nutritional Assessment for assessing the nutritional status of stroke patients in Taiwan.
Design and sampling: The study employed a purposive sampling design by involving the patient pool of Wen-Hua Stroke Patient Homecare Services of Taipei City.
Subject criteria : To be eligible to participate in the study, the subject must be: (a) confirmed stroke patients, (b) 40 y or older, (c) cognitively functional and be able to communicate, (d) being admitted to the Center for at least one month and (e) willing to sign an informed study consent.
Measurements: An in-home in-person interview was conducted on each patient with a structured questionnaire which included personal information, and the MMSE, Barthel index and MNA scales. Each subject’s nutritional status was assessed according to the original or two modified version of the MNA. The first modification replaced population-specific BMI, Mid-arm circumference (MAC) and Calf circumference (CC) cut-points for values specified in the original MNA.
The second modification eliminated the question of BMI and distributed its scores to MAC and CC. Results were analkyzed by correlation analysis and linear
regression analysis to determine the association of the nutritional status with the major functional indicators.
Results: The study showed that 24.3% of patients were malnourished, 56.8% were at risk of malnutrition and18.9% were well nourished according to the original MNA; 13.5% of patients were malnourished, 63.5% were at risk of malnutrition and 23% were well nourished according to the modified MNA version I ; 18.9% of patients were malnourished, 56.8% were at risk of malnutrition and 24.3% were well nourished according to the modified MNA version II . MAC and CC showed significant correlations with all three versions the MNA score, other
anthropometric parameters such as BMI, waist circumference and waist to hip ratio showed no correlations with the MNA. The scores of MMSE and ADL showed
high correlations with the MNA-II scores. These results suggest that modified MNA, especially MNA-II which does not involve BMI can be effectively used to assess the nutritional risk status of stroke patients.
Conclusion: MNA-II, a modified version of the MNA without using BMI, can effectively predict nutritional risk status of Taiwanese stroke patients. This modified version can greatly improve the utility of the MNA since measuring
weight and height, especially for those living at home, is not an easy task for stroke patients. The tool can be used to detect individuals at risk of malnutrition, enabling timely intervention and healthcare cost.
