Neck circumference is associated with nutritional status in elderly nursing home residents

Neck circumference is a highly reliable anthropometric measure in older adults requiring long-term care

The reliability of neck circumference measurement as an assessment tool for older adults requiring long-term care remains unknown. This study aimed to evaluate the reliability of neck circumference measurement in older adults requiring long-term care, and the effect of edema on measurement error. Two physical therapists measured the neck circumference. Intraclass correlation coefficient (ICC) and Bland-Altman analyses were performed to examine the reliability of neck circumference measurement. Correlation analysis was used to evaluate the relationship between edema values (extracellular water/total body water) and neck circumference measurement difference. For inter-rater reliability of neck circumference measurement, the overall ICC (2,1) was 0.98. The upper and lower limits of the difference between examiners ranged from -0.9 to 1.2 cm. There was no association between edema values and neck circumference measurement error. Thus, measurement of the neck circumference in older adults requiring long-term care is a reliable assessment tool, with a low error rate, even in older adults with edema.

Association between decreased neck circumference and impaired activities of daily living among older adults in long-term care

AIM

Assessment interventions for the decline of activities of daily living (ADLs) in older adults are crucial, as ADL decline increases hospitalization duration and mortality risk. Decreased neck circumference may result in various physical dysfunctions, including malnutrition. However, the association between neck circumference and ADLs has not been fully clarified. This study aimed to determine the association between decreased neck circumference and ADLs in older adults requiring long-term care.

METHODS

The study included 152 older adults deemed to require support or care under Japan's long-term care insurance system. Neck circumference was measured just below the thyroid cartilage with a measuring tape. The Barthel index was used to evaluate ADLs, and skeletal muscle mass and nutritional status were assessed by bioelectrical impedance analysis instruments. A multivariate analysis was conducted to investigate the association between neck circumference and ADLs.

RESULTS

Neck circumference demonstrated a significant inverse correlation with age and a significant positive correlation with body mass index, skeletal muscle mass index, phase angle, and Barthel index. In the multivariate analysis, ADLs was significantly associated with neck circumference (odds ratio [OR] = 0.51, P = 0.002) and phase angle (OR = 0.04, P < 0.001).

CONCLUSIONS

Neck circumference is associated with age, skeletal muscle mass, and nutritional status. Furthermore, a decrease in neck circumference is suggested as an independent risk factor for ADL decline in older adults requiring long-term care. Geriatr Gerontol Int 2023; 23: 906-911.

Neck circumference may predict sarcopenia in Japanese older adults requiring long-term care

Several studies have established the advantage of using anthropometric measurements as indicators of sarcopenia. Nevertheless, no study has explored the association between sarcopenia and neck circumference. In this cross-sectional study, we examined the data of 90 older adults requiring long-term care to evaluate this association and establish cut-off points for individuals at risk of sarcopenia as defined by the Asian Working Group for Sarcopenia (AWGS) 2019. A significant association was found between sarcopenia and neck circumference using binomial logistic regression and receiver operating characteristic analyses. The optimal cut-off value for neck circumference associated with increased risk for sarcopenia among older adults was 32.8 cm for females and 38.0 cm for males. Given the potential of declining neck circumference as an anthropometric marker of sarcopenia, it has clinical applications in screening for sarcopenia in older adults requiring long-term care.