Population-specific anthropometric cutoff standards improve the functionality of the Mini Nutritional Assessment without BMI in institutionalized elderly in Taiwan

Objective: To assess the nutritional status of institutionalized Taiwanese elderly with the Mini Nutritional Assessment (MNA) without BMI and to determine whether the application of population-specific MAC and CC cutoff standards would improve the functionality of the tool.Design: Purposive sampling.Setting: A long-term care facility in central Taiwan.Participants: Two hundred and eight >65 y residents who were free of acute infection/diseases and were able to communicate.Measurements: A questionnaire survey to elicit personal data and administer the MNA and measurements of anthropometric and blood biochemical indicators.Results: The MNA, without BMI, predicted 22.1% of participants malnourished and 61.1% at risk of malnutrition among residents of a long-term care facility in Taiwan. Replacing the population-specific cutoff standards of MAC and CC for the original cutoff standards in the MNA and increasing the weighted score of MAC and CC to replace for the weighted score of BMI preserved and improved the predicting ability of the MNA. The improvement was evidenced by the increase in the correlationships between the MNA scores and the anthropometric, biochemical or health status indicators.Conclusion: The MNA predicted nutritional risk status of the institutionalized elderly Taiwanese. The study suggests that whenever possible population-specific anthropometric cutoff standards should be applied to improve the functionality of the MNA. It also appears possible to preserve or even improve the functionality of the MNA without BMI. The modifications indicate an improvement in the application of the MNA in long-term care patients.