Alkazemi Dalal U, Zadeh Maryam H, Zafar Tasleem A, Kubow Stan J
Department of Food Science and Nutrition, College of Life Sciences, Kuwait University, Adailiya, Kuwait.
School of Human Nutrition, McGill University, Montreal, Canada.
J Taibah Univ Med Sci. 2018 Feb 9;13(3):238-246. doi: 10.1016/j.jtumed.2018.01.002. eCollection 2018 Jun.
Adults with disabilities are at a higher risk of malnutrition than are their non-disabled counterparts owing to feeding problems and associated medical conditions. We evaluated the prevalence of malnutrition in a group of institutionalized women and investigated any feeding difficulties and nutrition-related medical problems.
This study used two versions of the Mini Nutritional Assessment-Short Form (MNA-SF) to screen malnutrition: the MNA-SF1 which uses the body mass index, and the MNA-SF2 which uses the calf circumference. Data were collected from 53 women with intellectual and physical disabilities in a cross-sectional survey of residents of the Kuwait Rehabilitation Centre.
Of all participants, 63.5% were found to be overweight or obese, while 11.5% were underweight. Using the MNA-SF1, 57.7% were found to be at risk of malnourishment while 11.5% were malnourished. More patients were identified to be at risk of malnutrition or to be actually malnourished using the MNA-SF2 (59.6% and 23.1%, respectively). Reported feeding problems included difficulties in maintaining a sitting position, manipulating food on a plate, conveying food to the mouth, and in swallowing. The presence of infections worsened the prognoses of malnourished women regardless of their weight status.
Our findings suggest that MNA-SF2 is a more sensitive tool for identifying malnourishment than MNA-SF1. Obesity can obscure the identification of malnourished patients if clinicians rely solely on the MNA-SF1, which uses the body mass index.
由于进食问题及相关疾病状况，残疾成年人比非残疾成年人面临更高的营养不良风险。我们评估了一组机构收容女性中营养不良的患病率，并调查了任何进食困难及与营养相关的医疗问题。
本研究使用两种简易营养评估量表简表（MNA-SF）版本筛查营养不良：使用体重指数的MNA-SF1和使用小腿围的MNA-SF2。在科威特康复中心居民的横断面调查中，收集了53名智力和身体残疾女性的数据。
在所有参与者中，63.5%被发现超重或肥胖，而11.5%体重过轻。使用MNA-SF1，57.7%被发现有营养不良风险，11.5%营养不良。使用MNA-SF2时，更多患者被确定有营养不良风险或实际营养不良（分别为59.6%和23.1%）。报告的进食问题包括难以保持坐姿、在盘子里摆弄食物、将食物送入口中和吞咽。无论体重状况如何，感染的存在都会使营养不良女性的预后恶化。
我们的研究结果表明，对于识别营养不良，MNA-SF2比MNA-SF1是更敏感的工具。如果临床医生仅依赖使用体重指数的MNA-SF1，肥胖可能会掩盖对营养不良患者的识别。
