Population-Specific Anthropometric Cut-Points Improve the Functionality of the Mini Nutritional Assessment (MNA) in Elderly Taiwanese

以族群代表性的體位指標切點修訂的「迷你營養評估」可改進其對臺灣老人的評估功能

Alan Chung-Hong Tsai ； Ching-Sung Ho ； Ming-Cheng Chang

《Asia Pacific Journal of Clinical Nutrition》 16卷4期 (2007/12) Pp. 656-662

https://doi.org/10.6133/apjcn.2007.16.4.10

摘要

本研究之目的在研訂臺灣老人族群代表性的身體質量指數（BMI）、上臂圍（MAC）、及小腿圍（CC）之分切點，以期能更有效的判別營養不良的老人；及評量這些新切點改進「迷你營養評估」（MNA）功能的程度。本研究分析了一個具族群代表性的全國性的調查研究，65歲以上的個案，男1582人及女1307人的資料。該調查包括問卷訪談及體位測量。結果顯示各指標累進百分位分佈曲線第五百分位之值分別為：BMI男女均為17 kg/m^2，MAC男22.5 cm女21 cm，CC男28 cm女25 cm。以這些新分切點分別取代MNA中原切點後，減低了該研究個案老人的營養不良率。被判定為營養不良者從男2.4%及女1.5%分別降為1.7%及1.4%。而被判定為具營養風險者，則從男16.8%及女12.8%分別降為10.1%及8.9%。本研究的結論是以老人營養評估而言，MNA是一套有價値的工具。但，當此工具被用來評估非白人族群老人時，則應採用具族群代表性的體位指標分切點。

關鍵字

迷你營養評估 ； 老人 ； 身體質量指數 ； 小腿圍 ； 臺灣

並列摘要

The objective of this study was to determine the population-specific cut-points of body mass index (BMI), mid-arm circumference (MAC) and calf circumference (CC) for identifying subnormal nutritional status in elderly Taiwanese, and to evaluate the possibility of improving the functionality of the Mini Nutritional Assessment (MNA) by adopting these cut-points. This study analyzed data from 1583 men and 1307 women, 65 years or older, of a national survey. The survey involved in-home, face-to-face, interviews and anthropometric measurements. Results showed that based on the cumulative percentile curves, the fifth percentile values were: BMI, 17 kg/m^2 for both men and women; MAC, 22.5 cm for men and 21 cm for women; and CC, 28 cm for men and 25 cm for women. Substitution of these population-specific cut-points for respective values in the MNA screen resulted in lowered proportions of elderly classified malnourished or at risk of malnutrition. The prevalence of malnutrition was reduced from 1.7% to 1.4% in men and from 2.4% to 1.5% in women. The proportions classified at risk of malnutrition were reduced from 10.1% to 8.9% for men and 16.8% to 12.8% for women. In conclusion, results suggest that the MNA is a valuable tool for geriatric nutritional risk assessment. However, in populations where significant differences exist in anthropometric measurements from the Caucasian populations, population-specific cut-points should be used.

並列關鍵字

Mini Nutritional Assessment ； elderly ； BMI ； calf circumference ； Taiwan