A Comparison of the Different Anthropometric Indices for Assessing Malnutrition Among Older People in Turkey: a Large Population-based Screening

Overview

Journal J Health Popul Nutr

Publisher Biomed Central

Specialties Nutritional Sciences
Public Health

Date 2021 Mar 31

PMID 33785057

Citations 15

Authors

Gulusan Ozgun Basibuyuk

Parvin Ayremlou

Sakineh Nouri Saeidlou

Faruk Ay

Akgul Dalkiran

Wida Simzari

Gabor Aron Vitalyos

Yener Bektas

Affiliations

Soon will be listed here.

Abstract

Objective: Due to an increase in aging worldwide, assessment of the nutritional status of older people becomes an important matter. Malnutrition in older people increases the risk of infections, disease period and hospitalization rates. This study aimed to compare the different anthropometric indices for detecting malnutrition among older people and comparing these indices among males and females to explain the possible differences.

Methods: In this cross-sectional study, 2721 aged 65 years and older in Turkey were enrolled. Anthropometric measurements weight, height, hip circumference (HC), and waist circumference (WC), abdominal circumference (AC), mid-upper arm circumference (MUAC), triceps skinfold thickness (TST), calf circumference (CC)) were measured. Body mass index (BMI), abdominal volume index (AVI), body roundness index (BRI) and body adiposity index (BAI), and waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) indices were calculated using standardized formulas. The receiver operator characteristic curves (ROCs) were conducted in detecting the best anthropometric parameters. Adjusted odds ratios (OR) (stratified by sex) calculated for each anthropometric index.

Results: Participants with both BMI < 18.5 (1.1%) and BMI > 25 (80%) defined as the malnourished group and BMI of 18.5-24.99 (18.9%) defined as the normal group. In both sexes, the area under the curve (AUC) was > 0.7 for all anthropometric indices except WHR in females (AUC 0.66). BRI, WHR, WHtR, and AVI indices strongly predict the risk of malnutrition among both sexes. In males, the ORs were for BRI (6.83, 95% CI 5.39-8.66), WHR (6.43, 95% CI 5.9-6.9), AVI (2.02, 95% CI 1.86-2.12). In females, the ORs were for BRI (3.72, 95% CI 3.09-4.48), WtHR (2.63, 95% CI 1.3-3.5), and WHR (2.45, 95% CI 1.9-3.06).

Discussion: The presence of a large AUC in almost all anthropometric indices suggests that they can be used to assess the risk of malnutrition among older persons in both sexes.

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References

Yaxley A, Crotty M, Miller M . Identifying Malnutrition in an Elderly Ambulatory Rehabilitation Population: Agreement between Mini Nutritional Assessment and Validated Screening Tools. Healthcare (Basel). 2016; 3(3):822-9. PMC: 4939561. DOI: 10.3390/healthcare3030822. View

Quaye L, Owiredu W, Amidu N, Dapare P, Adams Y . Comparative Abilities of Body Mass Index, Waist Circumference, Abdominal Volume Index, Body Adiposity Index, and Conicity Index as Predictive Screening Tools for Metabolic Syndrome among Apparently Healthy Ghanaian Adults. J Obes. 2019; 2019:8143179. PMC: 6745169. DOI: 10.1155/2019/8143179. View

Wang Q, Xu L, Li J, Sun L, Qin W, Ding G . Association of Anthropometric Indices of Obesity with Hypertension in Chinese Elderly: An Analysis of Age and Gender Differences. Int J Environ Res Public Health. 2018; 15(4). PMC: 5923843. DOI: 10.3390/ijerph15040801. View

Kalaiselvi S, Arjumand Y, Jayalakshmy R, Gomathi R, Pruthu T, Palanivel C . Prevalence of under-nutrition, associated factors and perceived nutritional status among elderly in a rural area of Puducherry, South India. Arch Gerontol Geriatr. 2016; 65:156-60. DOI: 10.1016/j.archger.2016.03.003. View

Hu H, Wang J, Han X, Li Y, Wang F, Yuan J . BMI, Waist Circumference and All-Cause Mortality in a Middle-Aged and Elderly Chinese Population. J Nutr Health Aging. 2018; 22(8):975-981. DOI: 10.1007/s12603-018-1047-z. View

Dhana K, Kavousi M, Ikram M, Tiemeier H, Hofman A, Franco O . Body shape index in comparison with other anthropometric measures in prediction of total and cause-specific mortality. J Epidemiol Community Health. 2015; 70(1):90-6. DOI: 10.1136/jech-2014-205257. View

Harris D, Davies C, Ward H, Haboubi N . An observational study of screening for malnutrition in elderly people living in sheltered accommodation. J Hum Nutr Diet. 2008; 21(1):3-9. DOI: 10.1111/j.1365-277X.2007.00845.x. View

Slee A, Birch D, Stokoe D . A comparison of the malnutrition screening tools, MUST, MNA and bioelectrical impedance assessment in frail older hospital patients. Clin Nutr. 2014; 34(2):296-301. DOI: 10.1016/j.clnu.2014.04.013. View

Zhang J, Zhu W, Qiu L, Huang L, Fang L . Sex- and Age-Specific Optimal Anthropometric Indices as Screening Tools for Metabolic Syndrome in Chinese Adults. Int J Endocrinol. 2018; 2018:1067603. PMC: 6166375. DOI: 10.1155/2018/1067603. View

10.

Perissinotto E, Pisent C, Sergi G, Grigoletto F . Anthropometric measurements in the elderly: age and gender differences. Br J Nutr. 2002; 87(2):177-86. DOI: 10.1079/bjn2001487. View

11.

Chao P, Chuang H, Tsao L, Chen P, Hsu C, Lin H . The Malnutrition Universal Screening Tool (MUST) and a nutrition education program for high risk cancer patients: strategies to improve dietary intake in cancer patients. Biomedicine (Taipei). 2015; 5(3):17. PMC: 4532677. DOI: 10.7603/s40681-015-0017-6. View

12.

Tian S, Zhang X, Xu Y, Dong H . Feasibility of body roundness index for identifying a clustering of cardiometabolic abnormalities compared to BMI, waist circumference and other anthropometric indices: the China Health and Nutrition Survey, 2008 to 2009. Medicine (Baltimore). 2016; 95(34):e4642. PMC: 5400331. DOI: 10.1097/MD.0000000000004642. View

13.

Zuo M, Huang Y, Ma W, Xue Z, Zhang J, Gong Y . Expert Recommendations for Tracheal Intubation in Critically ill Patients with Noval Coronavirus Disease 2019. Chin Med Sci J. 2020; . PMC: 7367670. DOI: 10.24920/003724. View

14.

Montazeri A, Harirchi A, Shariati M, Garmaroudi G, Ebadi M, Fateh A . The 12-item General Health Questionnaire (GHQ-12): translation and validation study of the Iranian version. Health Qual Life Outcomes. 2003; 1:66. PMC: 280704. DOI: 10.1186/1477-7525-1-66. View

15.

Cascio B, Logomarsino J . Evaluating the effectiveness of five screening tools used to identify malnutrition risk in hospitalized elderly: A systematic review. Geriatr Nurs. 2017; 39(1):95-102. DOI: 10.1016/j.gerinurse.2017.07.006. View

16.

Krakauer N, Krakauer J . An Anthropometric Risk Index Based on Combining Height, Weight, Waist, and Hip Measurements. J Obes. 2016; 2016:8094275. PMC: 5088335. DOI: 10.1155/2016/8094275. View

17.

Sanchez-Garcia S, Garcia-Pena C, Duque-Lopez M, Juarez-Cedillo T, Cortes-Nunez A, Reyes-Beaman S . Anthropometric measures and nutritional status in a healthy elderly population. BMC Public Health. 2007; 7:2. PMC: 1769489. DOI: 10.1186/1471-2458-7-2. View

18.

Miao J, Quan X, Zhang C, Zhu H, Ye M, Shen L . Comparison of two malnutrition risk screening tools with nutritional biochemical parameters, BMI and length of stay in Chinese geriatric inpatients: a multicenter, cross-sectional study. BMJ Open. 2019; 9(2):e022993. PMC: 6411257. DOI: 10.1136/bmjopen-2018-022993. View

19.

Setiati S, Istanti R, Andayani R, Kuswardhani R, Aryana I, Putu I . Cut-off of anthropometry measurement and nutritional status among elderly outpatient in Indonesia: multi-centre study. Acta Med Indones. 2010; 42(4):224-30. View

20.

Gavriilidou N, Pihlsgard M, Elmstahl S . Anthropometric reference data for elderly Swedes and its disease-related pattern. Eur J Clin Nutr. 2015; 69(9):1066-75. PMC: 4559758. DOI: 10.1038/ejcn.2015.73. View