The effectiveness of BMI, calf circumference and mid-arm circumference in predicting subsequent mortality risk in elderly Taiwanese

Abstract

BMI, mid-arm circumference (MAC) and calf circumference (CC) are anthropometric indicators often included in geriatric health measurement scales. However, their relative effectiveness in predicting long-term mortality risk has not been extensively examined. The present study aimed to evaluate the relative effectiveness of these anthropometrics in predicting long-term mortality risk in older adults. The study prospectively analysed the ability of these indicators in predicting 4-year follow-up mortality risk of a population-representative sample of 4191 men and women, 53 years of age or older in the 'Survey of Health and Living Status of the Elderly in Taiwan'. Cox regression analyses were performed to evaluate the association of follow-up mortality risk with low (, 21 kg/m 2 ) or high ($27 kg/m 2 ) BMI, low MAC (, 23·5/22 cm for men/women) and low CC (,30/27 cm) respectively, according to Taiwanese-specific cut-off points. Results showed that low CC and low MAC were more effective than low BMI in predicting follow-up mortality risk in 65 -74-year-old elderly. But low CC and low BMI were more effective than low MAC in $ 75-year-old elderly, and low BMI was more effective than low MAC or low CC in 53-64-year-old persons. High BMI was not effective in predicting mortality risk in any of these age ranges. These results suggest that in elderly adults, CC is more effective than BMI in predicting long-term mortality risk. Thus, more consideration to CC and MAC in designing geriatric health or nutritional measurement scales is recommended.

Calf circumference: clinical validation for evaluation of muscle mass in the elderly

“…In Taiwan, the decrease in CP (26) increased the risk of death in men by 1.30 (RR: 1.22-1.71) and in women by 1.38 (RR: 1.15-1.48) . Although studies (23)(24)(25)(26) have shown that decreased CP increases the likelihood of decreased muscle mass, a study with elderly in Mexico (24) showed that CP increase (> 38 cm) had an independent association with disability, suggesting that the fat tissue may still impact muscle function.…”

“…The possibility of identifying elderly patients with reduced muscle mass through CP is reinforced by studies that have evaluated their ability to predict mortality (23)(24) and disability (24)(25) and need for care (26) . In Taiwan, the decrease in CP (26) increased the risk of death in men by 1.30 (RR: 1.22-1.71) and in women by 1.38 (RR: 1.15-1.48) .…”

“…Among them, calf circumference (CC) (19) has been used in recent studies with the objective of measuring muscle mass and estimating the prevalence of sarcopenia (20)(21)(22) , predicting disability (23)(24) , mortality (24)(25) and need for care (26) , as well as for determining cut-off points of decreased muscle mass in the elderly population (27)(28)(29)(30)(31) .…”

Indicadores antropométricos como preditores na determinação da fragilidade em idosos

“…Neste contexto, indicadores antropométricos como Índice de Massa Corpó-rea (IMC) 8,9 , Peso 10 , Relação Cintura-Quadril (RCQ) 11,12 , Perímetro Braquial (PB) 13 , Perímetro da Panturrilha (PP) 14 e Circunferência da Cintura 15 são apontados como possíveis indicadores de alterações no estado nutricional e/ou capacidade física e/ou fragilidade.…”

Malnutrition risk and hospitalization in elderly assisted in Primary Care

“…Winter et al 27 observed that even in the community-dwelling older adults who have an annual health assessment, one in six is at risk of malnourishment, of whom one-third have a BMI of 25 kg/m 2 or higher. On the other hand, mid-arm circumference was found to be associated with risk of mortality in Taiwanese community-dwelling elderly (cut-off point of < 23.5 cm for men and < 22 cm for women) 28 . Ordoñez et al 29 observed that in hospitalized elderly, of the four assessment parameters of nutritional status (subjective global assessment, triceps skinfold thickness, BMI and mid-arm circumference), only mid-arm circumference showed an association with increased mortality.…”