Cutoff points for calf circumference assessment in institutionalized older adults
Older adult; Calf Circumference; Sarcopenia screening; Nursing home
The calf circumference (CC) is a low-cost, easily applicable measure used to assess muscle mass loss in older adults, but various cutoff points exist in the literature. This cross-sectional study aimed to compare two different cutoff points for CC evaluation with the cutoff point established in the Older Adults Health Booklet (CSPI) and assess their agreement to identify the most suitable one for the institutionalized population. Conducted in eight Long-Term Care Facilities (LTCFs), the study included individuals aged ≥ 60 years present at the LTCFs during data collection. Sociodemographic and anthropometric data, including weight, height, and CC, were collected. CC was evaluated using three classifications: CSPI, Brazilian population (BP), and CC adjusted by BMI. Mann-Whitney U tests, Pearson's chi-square, Fisher's exact tests, Spearman's correlation coefficient (rho), and odds ratio (OR) with 95% confidence interval (CI) were used. The sample comprised 233 participants with a median age of 81 years. Statistically significant differences were identified between the CSPI low CC classification and the other cutoff points for the total sample and both sexes (p<0.001). CC was strongly correlated with CC adjusted by BMI (rho=0.771, p<0.001). The CSPI cutoff point seems to underestimate individuals with low CC, while BP's overestimates them. However, CC adjusted by BMI appears to be the most appropriate cutoff point, capable of identifying individuals not identified by the CSPI CC