Anthropometric norms in the elderly

Abstract

1 . Anthropometric indices are presented for representative samples of elderly people in South Wales, based on over 1500 subjects seen during community surveys.2. Body mass index declined with age after 70 years in both men and women. Estimates of fat and muscle volume based on upper arm measurements also showed a decline with age, which was particularly steep for triceps skinfold thickness in women.3. These indices are in general similar to results that have been reported from other surveys within the UK; they suggest that Welsh old people have less fat and muscle than elderly Americans.Anthropometric percentiles have long been used in the diagnosis and surveillance of malnutrition in children. During recent years various anthropometric indices have been published for adults, including results from large surveys in the USA (Bishop et al. 1981; Frisancho, 198 1). In general, the information available for the elderly has been rather sparse, especially for persons aged over 75 years. Information has been collected from over 1500 old people in South Wales during community surveys, and these findings are presented here in the form of percentiles to provide a frame of reference for elderly people in Britain. SUBJECTS AND METHODSThe surveys were conducted in three areas of South Wales, two of which have an industrial history of coal mining. Names and addresses of the subjects were obtained from the lists of local general practitioners. In the largest of the three surveys, the sample was stratified by age to provide more subjects over 75 years of age. This survey also included residents of old people's homes (4%) and long-stay hospital wards (3%) whereas, in the other two areas, only people living at home were included. The values of the sampling ratios and other details of the surveys have already been published (Burr et al. 1974(Burr et al. , 1975.The heights and weights of the subjects were measured in indoor clothes without shoes. In the largest of the three surveys, the triceps skinfold thickness was measured with Harpenden callipers over the left triceps muscle midway between the acromion and the olecranon process; three measurements were made and the median reading taken. The mid-arm circumference was measured twice at the same point and the mean taken as the true value. The arm measurements were all made by the same observer (M. L. B.).Body mass index (Quetelet index) was calculated as weight (kg) divided by the square of the height (m". The arm muscle area (mm2) and arm muscle circumference (mm) were calculated using the following formulas derived from Gurney & Jelliffe (1973) :arm muscle circumference = arm circumference -7r (triceps skinfold thickness) (arm muscle circumference)2 4n arm muscle area = These formulas assume that the upper arm is cylindrical, and they ignore the contribution to arm volume made by the humerus. Nevertheless, the indices derived from them seem to be serviceable and are widely used.

Anthropometric measurements from a cross-sectional survey of community dwelling subjects aged over 90 years of age

“…Recent nutritional surveys emphasize the wide range of BMI values amongst older populations across Europe and world-wide (Euronut SENECA, 1991;Launer and Harris, 1996). Despite these reservations, BMI values for this study are within the upper normal range and somewhat higher than for a comparable Welsh, 85 y old, free-living group (Burr and Phillips, 1984). A smaller percent of females (10%) showed BMI values consistent with under nutrition compared with recent large studies iǹ younger' older groups (Euronut SENECA, 1991;Launer and Harris, 1996), though cut-off points for BMI are not always comparable.…”

“…The average weight for height tables, produced by Masters in the 1960s, still represent the best source of comparative sex-related information and show heavier weights for taller 90±94 y old American subjects compared to this study. There are no values for b 90 y old subjects in comparable community surveys in Northern Europe (Euronut SENECA, 1991;Lehmann et al, 1996;Burr and Phillips, 1984;Delarue et al, 1994;Visser et al, 1994), but weights for 70±80 y old subjects were heavier than for these b 90 y old subjects, though genetic and environmental in¯uences preclude direct comparisons.…”

“…In this study, these dif®culties were minimised by attention to measurement techniques and subject recruitment. Percentiles for triceps skin fold have been developed for ages 55±74 y in America (Frisancho, 1984), in Canada (Nutrition, Canada, 1980, in Britain to age 85 y (Burr and Phillips, 1984) but not the b 90 y group. The SENECA study demonstrated the wide range of sex-related TSF values possible within genetically and economically diverse 75 y old European groups.…”

Pre-operative nutritional assessment

“…In the UK and the Republic of Ireland, the standards used are derived from measurements in the early 1970s of healthy Causasian Americans (Bishop et al 1981;Frisancho, 1981). Reference data derived from people in south Wales, published in 1984, are normally used for defining the nutritional status of those aged 65 years or more (Burr & Phillips, 1984). A major problem occurs when the patient started out well above the normal range, and therefore has been in a negative nutritional state for some time, although measurements now classify the patient as normal (Smith & Mullen, 1991).…”

Relationship Between Nutritional Status and the Clinical Outcomes of Patients With and Without Neoplasms According to Multiple Correspondence Analysis

“…The body composition indicators (MUAC, TST, and MUAMC) were classified according to their percentile distribution as recommended by Frisancho (15) and Burr & Phillips (6) for adults and older adults aged >65 years, respectively. Lean mass depletion (LMD) was defined as MUAC and MUAMC equal to or lower than the 15th percentile (≤P15); a percentile above the reference percentile for lean mass was defined as MUAC and MUAMC above the 85th percentile (>P85); and lean mass preservation (LMP) was defined as MUAC and MUAMC between the 15th and 85th percentiles (P15-P85).…”