Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan.
Arch Gerontol Geriatr. 2012 May-Jun;54(3):e405-10. doi: 10.1016/j.archger.2011.12.006. Epub 2012 Jan 3.
Nutritional status and functional ability are mutually dependent especially in the elderly. This study examined the functional status-predictive ability of the MNA in a cross-sectional study. We analyzed the dataset of the "Survey of Health and Living Status of the Elderly in Taiwan" (SHLSET). Subjects were 2948≥65 year-old persons who were rated with the long-form (LF) and short-form (SF) MNA with or without BMI for the risk of malnutrition, and with the Activities of Daily Living (ADL) and the Instrument Activities of Daily Living (IADL) for functional status. The ADL and IADL scores were calculated according to rated nutritional status. Receiver Operating Characteristic (ROC) curves were generated for ADL and IADL status predicted by the MNA. Logistic regression was performed to evaluate the association of rated MNA scores with ADL or IADL status. Results showed that both SF and LF of MNA-T1 and T2 were able to predict ADL and IADL disabilities. Those who were rated malnourished or at risk of malnutrition had drastically higher risk of ADL or IADL dependency compared to those who were rated normal. The SF versions performed well in rating nutritional status and predicting ADL and IADL status. Overall, MNA-T2-SF performed at least equally well as MNA-T1-SF in rating functional decline. These results suggest the MNA is able to predict functional decline of the elderly. MNA-T2, especially the SF, a version without BMI should be particularly useful in clinical, long-term care and community settings.
营养状况和功能能力是相互依存的，尤其是在老年人中。本研究通过横断面研究检验了 MNA 在预测功能状态方面的能力。我们分析了“台湾老年人健康与生活状况调查”（SHLSET）的数据。研究对象为 2948 名年龄≥65 岁的老年人，他们接受了长式（LF）和短式（SF）MNA 以及 BMI 评估的风险营养不良，以及日常生活活动（ADL）和日常生活活动工具（IADL）评估的功能状态。ADL 和 IADL 评分根据评定的营养状况计算。根据 MNA 预测的 ADL 和 IADL 状态生成了受试者工作特征（ROC）曲线。使用逻辑回归评估了评定的 MNA 评分与 ADL 或 IADL 状态的关联。结果表明，MNA-T1 和 T2 的 SF 和 LF 均能预测 ADL 和 IADL 残疾。与评定正常的人相比，评定为营养不良或有营养不良风险的人发生 ADL 或 IADL 依赖的风险大大增加。SF 版本在评定营养状况和预测 ADL 和 IADL 状态方面表现良好。总体而言，MNA-T2-SF 在评定功能下降方面的表现至少与 MNA-T1-SF 相当。这些结果表明 MNA 能够预测老年人的功能下降。MNA-T2，特别是无 BMI 的 SF 版本，在临床、长期护理和社区环境中应该特别有用。
