The Use of the Arm Circumference as a Measure to Detect Underweight in Individuals Aged 60 Years or Older Living in Costa Rica

Authors

DOI:

https://doi.org/10.15359/ru.37-1.24

Keywords:

Body mass index, elderly, nutritional status, sensitivity, specificity

Abstract

[Objective]: This investigation focuses on the association between arm circumference and body mass index, and the estimation of cutoff values of this arm measurement for identifying low weight in Costa Rican residents aged 60 years and over. [Methods]: The study included a total of 2514 persons 60 years old or older who participated in the project “Costa Rica: Study of Longevity and Healthy Aging.” The analysis included calculation of Spearman’s correlation coefficient between arm circumference and the body mass index, the area under the Receiver Operating Characteristic (ROC) curve, and sensitivity and specificity values for measurements of arm circumference corresponding to a body mass index lower than 22 kg/m2. [Results]: The Spearman’s correlation coefficient between the body mass index and the arm circumference was 0.794 (0.774 for men and 0.806 for women). The optimum cutoff point was estimated at 26.5 cm, with a Youden’s Index of 0.7256, a sensitivity of 87.79 %, and a specificity of 84.77 %. Specific cutoff points for men and women were 26.5 cm and 25.9 cm, respectively. [Conclusions]: There is a strong relationship between arm circumference and body mass index in Costa Rican residents aged 60 years and over. A first approach was established to determine an adequate cutoff point in the measurement of arm circumference that will allow the detection of persons with low weight and greater nutritional risk in this population.

References

Abizanda, P., Sinclair, A., Barcons, N., Lizán, L., & Rodríguez-Mañas, L. (2016). Costs of malnutrition in institutionalized and community-dwelling older adults: A systematic review. Journal of the American Medical Directors Association, 17(1), 17-23. https://doi.org/10.1016/j.jamda.2015.07.005

Balcombe, N., & Saweirs, W. (2001). Nutritional status and well-being. Is there a relationship between body mass index and the well-being of older people? Current Medical Research and Opinion, 17(1), 1-7. https://www.proquest.com/docview/207969893?pq-origsite=gscholar&fromopenview=true

Barosa, R., Ramos, L. R., Santos, C. A., Pereira, M., & Fonseca, J. (2018). Mid upper arm circumference and Powell-tuck and Hennessey’s equation correlate with body mass index and can be used sequentially in gastrostomy fed patients. Clinical Nutrition, 37(5), 1584-1588. https://doi.org/10.1016/j.clnu.2017.08.011

Benítez Brito, N., Suárez Llanos, J. P., Fuentes Ferrer, M., Oliva García, J. G., Delgado Brito, I., Pereyra-García Castro, F., Caracena Castellanos, N., Acevedo Rodríguez, C. X., & Palacio Abizanda, E. (2016). Relationship between mid-upper arm circumference and body mass index inpatients. PloS One, 11(8), e0160480. https://doi.org/10.1371/journal.pone.0160480

Chakraborty, R., Bose, K., & Koziel, S. (2011). Use of mid-upper arm circumference in determining undernutrition and illness in rural adult Oraon men of Gumla district, Jharkhand, India. Rural and Remote Health, 11(3), 118-129. https://doi.org/10.22605/RRH1754

Chen, C., Schilling, L. S., & Lyder, C. H. (2001). A concept analysis of malnutrition in the elderly. Journal of Advanced Nursing, 36(1), 131-142. https://doi.org/10.1046/j.1365-2648.2001.01950.x

Chen, Y., Ge, W., Parvez, F., Bangalore, S., Eunus, M., Ahmed, A., Islam, T., Rakibuz-Zaman, M., Hasan, R., Argos, M., Levy, D., Sarwar, G., & Ahsan, H. (2014). A prospective study of arm circumference and risk of death in Bangladesh. International Journal of Epidemiology, 43(4), 1187-1196. https://doi.org/10.1093/ije/dyu082

Das, A., Saimala, G., Reddy, N., Mishra, P., Giri, R., Kumar, A., Raj, A., Kumar, G., Chaturvedi, S., Babu, S., Srikantiah, S., & Mahapatra, T. (2020). Mid-upper arm circumference as a substitute of the body mass index for assessment of nutritional status among adult and adolescent females: Learning from an impoverished Indian state. Public Health, 179, 68-75. https://doi.org/10.1016/j.puhe.2019.09.010

Das, P., Khatun, A., Bose, K., & Chakraborty, R. (2018). The validity of mid-upper arm circumference as an indicator of low BMI in population screening for undernutrition: A study among adult slum dwellers in eastern India. Public Health Nutrition, 21(14), 2575-2583. https://doi.org/10.1017/S1368980018001301

Ferro-Luzzi, A., & James, W. (1996). Adult malnutrition: Simple assessment techniques for use in emergencies. British Journal of Nutrition, 75(1), 3-10. https://doi.org/10.1079/bjn19960105

Goswami, A. K., Kalaivani, M., Gupta, S. K., Nongkynrih, B., & Pandav, C. S. (2018). Usefulness of mid-upper arm circumference in assessment of nutritional status of elderly persons in urban India. International Journal of Medicine and Public Health, 8(1). https://doi.org/10.5530/ijmedph.2018.1.7

Ho, S. C., Wang, J. Y., Kuo, H. P., Huang, C. D., Lee, K. Y., Chuang, H. C., Feng, P. H., Chen, T. T., & Hsu, M. F. (2016). Mid-arm and calf circumferences are stronger mortality predictors than body mass index for patients with chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease, 11, 2075. https://doi.org/10.2147/COPD.S107326

Hollander, E. L. de, Bemelmans, W. J., & Groot, L. C. de. (2013). Associations between changes in anthropometric measures and mortality in old age: A role for mid-upper arm circumference? Journal of the American Medical Directors Association, 14(3), 187-193. https://doi.org/10.1016/j.jamda.2012.09.023

Kumar, P., Sinha, R., Patil, N., & Kumar, V. (2019). Relationship between mid-upper arm circumference and BMI for identifying maternal wasting and severe wasting: A cross-sectional assessment. Public Health Nutrition, 22(14), 2548-2552. https://doi.org/10.1017/S1368980019000727

Lipschitz, D. A. (1994). Screening for nutritional status in the elderly. Primary Care: Clinics in Office Practice, 21(1), 55-67. https://doi.org/10.1016/S0095-4543(21)00452-8

Mason, C., Craig, C. L., & Katzmarzyk, P. T. (2008). Influence of central and extremity circumferences on all-cause mortality in men and women. Obesity, 16(12), 2690-2695. https://doi.org/10.1038/oby.2008.438

Nube, M., Asenso-Okyere, W., & Van den Boom, G. (1998). Body mass index as indicator of standard of living in developing countries. European Journal of Clinical Nutrition, 52(2), 136-144. https://doi.org/10.1038/sj.ejcn.1600528

Okeh, U., & Okoro, C. (2012). Evaluating measures of indicators of diagnostic test performance: Fundamental meanings and formulations. Journal of Biometrics & Biostatistics, 3(1), 2. https://doi.org/10.4172/2155-6180.1000132

Payette, H., Coulombe, C., Boutier, V., & Gray-Donald, K. (1999). Weight loss and mortality among free-living frail elders: A prospective study. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 54(9), M440-M445. https://doi.org/10.1093/gerona/54.9.M440

Rosero-Bixby, L., Dow, W., & Fernández, X. (2013). CRELES: Costa Rican longevity and healthy aging study. Methods, wave 1. Berkeley, CA: Department of Demography, University of California. http://www.creles.berkeley.edu/pdf/Methods_w1.pdf

Sánchez-García, S., García-Peña, C., Duque-López, M. X., Juárez-Cedillo, T., Cortés-Núñez, A. R., & Reyes-Beaman, S. (2007). Anthropometric measures and nutritional status in a healthy elderly population. BMC Public Health, 7(1), 1-9. https://doi.org/10.1186/1471-2458-7-2

Schaap, L. A., Quirke, T., Wijnhoven, H. A., & Visser, M. (2018). Changes in body mass index and mid-upper arm circumference in relation to all-cause mortality in older adults. Clinical Nutrition, 37(6), 2252-2259. https://doi.org/10.1016/j.clnu.2017.11.004

Selvaraj, K., Jayalakshmy, R., Yousuf, A., Singh, A. K., Ramaswamy, G., & Palanivel, C. (2017). Can mid-upper arm circumference and calf circumference be the proxy measures to detect undernutrition among elderly? Findings of a community-based survey in rural Puducherry, India. Journal of Family Medicine and Primary Care, 6(2), 356-359. https://doi.org/10.4103/jfmpc.jfmpc_357_16

Shi, J., Yang, Z., Niu, Y., Zhang, W., Li, X., Zhang, H., Lin, N., Gu, H., Wen, J., Ning, G., Qin, L., & Su, Q. (2020). Large mid-upper arm circumference is associated with metabolic syndrome in middle-aged and elderly individuals: A community-based study. BMC Endocrine Disorders, 20(1), 1-8. https://doi.org/10.1186/s12902-020-00559-8

Spanish Society of Parental and Enteral Nutrition. (2007). Nutritional assessment in the elderly. Galenitas-Nigra Trea. https://senpe.com/documentacion/consenso/senpe_valoracion_nutricional_anciano.pdf

Spanish Society of Parental and Enteral Nutrition. (2011). Multidisciplinary consensus on the approach to hospital malnutrition in Spain. Editorial Glosa SL. https://senpe.com/documentacion/consenso/SENPE_Consenso_Multidisciplinar_Abordaje_Desnutricion_ESP.pdf

Sousa, O. V. de, Mendes, J., & Amaral, T. (2020). Nutritional and functional indicators and their association with mortality among older adults with Alzheimer’s disease. American Journal of Alzheimer’s Disease & Other Dementias, 35, 1533317520907168. https://doi.org/10.1177/1533317520907168

StataCorp. (2013). Stata statistical software: Release 13. College Station.

Sultana, T., Karim, M. N., Ahmed, T., & Hossain, M. I. (2015). Assessment of under nutrition of Bangladeshi adults using anthropometry: Can body mass index be replaced by mid-upper-arm-circumference? PloS One, 10(4), e0121456. https://doi.org/10.1371/journal.pone.0121456

Tang, A. M., Chung, M., Dong, K. R., Bahwere, P., Bose, K., Chakraborty, R., Charlton, K., Das, P., Ghosh, M., Hossain, M., Nguyen, P., Patsche, C. B., Sultana, T., Deitchler, M., & Maalouf-Manasseh, Z. (2020). Determining a global mid-upper arm circumference cut-off to assess underweight in adults (men and non-pregnant women). Public Health Nutrition, 23(17), 3104-3113. https://doi.org/10.1017/S1368980020000397

Thorup, L., Hamann, S. A., Kallestrup, P., Hjortdal, V. E., Tripathee, A., Neupane, D., & Patsche, C. B. (2020). Mid-upper arm circumference as an indicator of underweight in adults: A cross-sectional study from Nepal. BMC Public Health, 20(1), 1-7. https://doi.org/10.1186/s12889-020-09294-0

Tsai, A. C., & Chang, T. L. (2011). The effectiveness of BMI, calf circumference and mid-arm circumference in predicting subsequent mortality risk in elderly Taiwanese. British Journal of Nutrition, 105(2), 275-281. https://doi.org/10.1017/S0007114510003429

Weng, C. H., Tien, C. P., Li, C. I., L’Heureux, A., Liu, C. S., Lin, C. H., Lin, C. C., C. C., Lai, S. W., Lai, M. M., & Lin, W. Y. (2018). Mid-upper arm circumference, calf circumference and mortality in Chinese long-term care facility residents: A prospective cohort study. BMJ Open, 8(5), e020485. https://doi.org/10.1136/bmjopen-2017-020485

Wijnhoven, H., Bokhorst-de van der Schueren, M. van, Heymans, M., Vet, H. de, Kruizenga, H. M., Twisk, J. W., & Visser, M. (2010). Low Mid-Upper Arm Circumference, Calf Circumference, and Body Mass Index and Mortality in Older Persons. The Journals of Gerontology: Series A, 65A(10), 1107-1114. https://doi.org/10.1093/gerona/glq100

Wijnhoven, H., Schilp, J., Vet, H. C. de, Kruizenga, H. M., Deeg, D. J., Ferrucci, L., & Visser, M. (2012). Development and validation of criteria for determining undernutrition in community-dwelling older men and women: The short nutritional assessment questionnaire 65+. Clinical Nutrition, 31(3), 351-358. https://doi.org/10.1016/j.clnu.2011.10.013

World Health Organization. (1985). Physical status: The use of and interpretation of anthropometry, report of a WHO expert committee. World Health Organization. https://apps.who.int/iris/handle/10665/37003

World Health Organization. (2000). Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization. https://apps.who.int/iris/handle/10665/42330

Wu, L. W., Lin, Y. Y., Kao, T. W., Lin, C. M., Wang, C. C., Wang, G. C., Peng, T. C., & Chen, W. L. (2017). Mid-arm circumference and all-cause, cardiovascular, and cancer mortality among obese and non-obese US adults: The national health and nutrition examination survey III. Scientific Reports, 7(1), 1-8. https://doi.org/10.1038/s41598-017-02663-7

Youden, W. J. (1950). Index for rating diagnostic tests. Cancer, 3(1), 32-35. https://doi.org/10.1002/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3

Zhen, L., Pang, S. J., Man, Q. Q., Wang, J. Z., Zhao, W. H., & Zhang, J. (2018). Prevalence of undernutrition and related dietary factors among people aged 75 years or older in China during 2010-2012. Biomedical and Environmental Sciences, 31(6), 425-437. https://doi.org/10.3967/bes2018.056

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2023-09-01

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