Low calf circumference is associated with frailty in diabetic adults aged over 80 years

Abstract

Background Frailty is now seen as a significant factor in older people with diabetes, whose mortality and disability increased. This study aims to investigate the association between calf circumference (CC) with frailty in diabetic adults aged over 80 years. Methods A cross-sectional analysis was performed on the data of 426 diabetic adults aged over 80 years. On admission, demographic data and laboratory parameters were recorded. CC was measured on the lower right leg at the point of the maximal circumference. All participants accepted frailty assessments. Frailty was mainly defined using the Fried frailty phenotype criteria. Results The CC levels were significantly lower in the frail than the non-frail (26.7 ± 4.0 vs. 31.2 ± 4.0, P < 0.001). CC was negatively correlated with the Fried frailty phenotype index (P < 0.001). Logistic regression analysis of frailty revealed that age (Odds Ratio (OR), 1.368; 95% Confidential Interval (CI) 1.002–1.869; P = 0.049), CC (OR, 0.756; 95%CI 0.598–0.956; P = 0.019) were independent impact factors of frailty after adjusting all the potential confounders. Participants with low CC tertile had a significantly higher Fried frailty phenotype index than those with high CC tertiles. The best CC cut-off value for predicting frailty was 29.3 cm, its sensitivity was 75.0%, and the specificity was 78.6%, and areas under the curve (AUC) was 0.786 (P < 0.001). Conclusions CC was strongly related to frailty in diabetic adults aged over 80 years, suggesting that CC may be helpful for monitoring physical frailty in older adults in clinical and research settings.

Is Calf Circumference Associated With Clinical and Nutritional Outcome in Older Patients?

“…As observed in other studies 6 , 10 , 30 , 39 , 40 , different rates of malnutrition were verified by comparing the indicators and the nutritional assessment instruments used in the population examined 31 . The NRS was a sensitive tool for diagnosing patients at nutritional risk (48.4%); by clustering the malnourished patients with those at risk of malnutrition, according to the MNA, the total rate was 64.5%.…”

“…Our study found no association between CC and diseases. Other papers have pointed to CC as an easy measure capable of predicting falls in older adult patients on hemodialysis 27 , and as a valuable tool for predicting the risk of sarcopenia in OiP with hip fractures 4 ; also associated low CC values with frailty in diabetics older adult aged over 80 years 40 , and that CC showed good accuracy, sensitivity, and specificity for detecting malnutrition in both genders 3 . Another recent study that investigated the relationship between CC and AMC demonstrated that CC was associated with the risk of pneumonia 26 .…”

Calf circumference as a surrogate indicator for detecting low muscle mass in hospitalized geriatric patients

“…Although the radiological modalities for assessing muscle mass are convincing in terms of accuracy compared with CC determination, CC measurement in the elderly additionally impresses with its valuable predictability of fall events, frailty, malnutrition, morbidity and mortality [ 16 , 21 – 25 ] . The anthropometric method for recording CC provides a viable and cost-effective option for diagnosing “confirmed sarcopenia” in the elderly according to the diagnostic algorithm of the EWGSOP-2 guidelines.…”

Low calf circumference can predict nutritional risk and mortality in adults with metabolic syndrome aged over 80 years

“…In our study, we suggested that decreasing CC and increasing FPG were all independent risk factors for nutritional risk. Our previous study identified that CC is strongly related to frailty in diabetic adults aged over 80 years [ 23 ]. As geriatrics are shifting towards identifying early stages of disability, understanding frailty and sarcopenia is essential and is still developing in the quest to prevent physical dependence.…”