Assessment of nutritional status with modified Mini Nutritional assessment (MNA) of adults with Intellectual Disabilities in a long-term care institution in Taiwan
Background: Nutritional abnormalities in individuals with mental disability can affect their susceptibility to diseases and infections, hospitalization, cognition status, activities of daily living (ADL) and even the quality of life. Routine monitoring of their nutritional status is important for avoiding these extra risks.
Objective: This study was aimed to examine the possibility of using the Mini Nutritional Assessment (MNA) for monitoring the nutritional status of adults with mental disability.
Design: Purposive sampling.
Setting: A religious group-managed living center for mentally disabled persons in Central Taiwan Methods: 104 (59 male & 45 female) adult residents of the center were recruited to participate in the study after each of their guardians signed an informed consent. Each subject was interviewed and anthropometrically measured. Their interview dates were arranged to correspond with their annual physical check-up covered under the Universal Healthcare Insurance Program of Taiwan. The interview included personal data and questions in the MNA. The nutritional status of each subject was assessed with three versions of the MNA, the original, MNA-T1 which adopted population-specific anthropometric cut- points, and MNA-T2 which had the BMI in the scale replaced with calf-circumference (CC).
Results: Results showed the original MNA rated 7 (6.7%) subjects malnourished and 29 (27.9%) at risk of malnutrition; MNA-T1 rated 7 (6.7%) and 15 (14.4%), and MNA-T2 rated 6 (5.8%) and 18 (17.3%),
respectively. Analysis of these results with Friedman Test suggested significant differences existed among the versions. Post hoc analysis with Wilcoxon signed-Rank test revealed that the pattern of nutritional status predicted with the original MNA was significantly different from that predicted with the MNA-T1 and T2, but the patterns predicted with the two modified versions were not different from each other. MNA scores of the three versions were also significantly correlated with hemoglobin, ADL, hospital length of stay, number of emergency visit, number of chronic diseases and number of prescribed medicine.
Regression analysis indicated that ADL, emergency visit and hospital length of stay were the major associated factors of the nutritional status.
Conclusions: Results of this study indicate that the MNA, especially version T2, can be an effective tool for routine monitoring the nutritional risk status of Taiwanese adults with mental disabilities. The tool can enhance the efficiency of the primary healthcare workers. Routine monitoring of the nutritional risk status coupled with timely intervention can reduce the risk associated with malnutrition and can also help to enhance the quality of life of the mentally disabled individuals.
