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

Introduction: Major proportion of the elderly with under nutrition is undetected in the community. One of the feasible ways to detect under nutrition among elderly would be screening in the field settings. in this study, we aimed to identify the utility of alternate anthropometric measures such as mid-upper arm circumference (MUAC), calf circumference, and skin fold thickness in identifying under nutrition among elderly.

Materials and methods: A community-based cross-sectional survey was done among elderly in one of the randomly selected subcenters. Anthropometric measures such as weight, arm span, MUAC, and triceps skinfold thickness were measured as per the standard measurement guidelines by a trained medical graduate. The elderly were identified as undernourished if body mass index (BMI) is <18.5 kg/m². Utility of alternate anthropometric markers against BMI is represented by area under the curve (AUC) value from receiver operating characteristic curve and correlation coefficient (r).

Results: Mean MUAC, calf circumference, and triceps skinfold thickness measured among 271 elderly were 25.6 cm ± 3.7 cm, 27.6 cm ± 3.7 cm, and 3.0 mm ± 1.3 mm, respectively. Among all three proxy anthropometric measures, MUAC had the highest AUC value (AUC = 0.88) Triceps skinfold thickness had the least AUC (AUC = 0.61). The correlation of anthropometric measurements such as MUAC, calf circumference, and triceps skinfold thickness with BMI was 0.74, -0.04, and 0.64, respectively.

Conclusion: As MUAC and calf circumference are easy to measure and they are highly correlating with BMI, they can be used routinely by peripheral field workers to assess undernutrition in elderly during their regular house visits.