Defining anthropometric thresholds (mid-arm circumference and calf circumference) in older adults residing in the community: a cross-sectional analysis using data from the population representative Longitudinal Aging Study in India (LASI DAD)

Abstract

Objectives: To identify factors associated with malnutrition (undernutrition and overnutrition) and determine appropriate cut-off values for mid-arm circumference (MAC) and calf circumference (CC) among community-dwelling Indian older adults.

Design: Data from the first wave of harmonised diagnostic assessment of dementia for Longitudinal Ageing Study in India (LASI-DAD) were used. Various sociodemographic factors, comorbidities, geriatric syndromes, childhood financial and health status were included. Anthropometric measurements included body mass index (BMI), MAC and CC.

Setting: Nationally representative cohort study including 36 Indian states and union territories.

Participants: 4096 older adults aged >60 years from LASI DAD.

Outcome measures: The outcome variable was BMI, categorised as low (<18.5 kg/m²), normal (18.5-22.9 kg/m²) and high (>23 kg/m²). The cut-off values of MAC and CC were derived using ROC curve with BMI as the gold standard.

Results: 902 (weighted percentage 20.55%) had low BMI, 1742 (44.25%) had high BMI. Undernutrition was associated with age, wealth-quintile and impaired cognition, while overnutrition was associated with higher education, urban living and comorbidities such as hypertension, diabetes and chronic heart disease. For CC, the optimal lower and upper cut-offs for males were 28.1 cm and >31.5 cm, respectively, while for females, the corresponding values were 26 cm and >29 cm. Similarly, the optimal lower and upper cut-offs for MAC in males were 23.9 cm and >26.9 cm, and for females, they were 22.5 cm and >25 cm.

Conclusion: Our study identifies a high BMI prevalence, especially among females, individuals with higher education, urban residents and those with comorbidities. We establish gender-specific MAC and CC cut-off values with significant implications for healthcare, policy and research. Tailored interventions can address undernutrition and overnutrition in older adults, enhancing standardised nutritional assessment and well-being.

Keywords: Aging; GERIATRIC MEDICINE; Nutrition.

Figure 1

Scatter plot of BMI by mid-arm circumference (MAC) (A) and by calf circumference (CC) (B) of males and females. BMI, body mass index.

Figure 2

Receiver operating characteristics (ROC) curve to determine optimum cut-offs for mid-arm circumference (MAC) of males (A, B) and females (E, F) and calf circumference (CC) of males (C, D) and females (G, H) to screen for undernutrition (BMI<18.5 kg/m²) and overnutrition (BMI>23 kg/m²). BMI, body mass index.