Comparative evaluation of body composition in medically stable elderly

Evaluation of an alternative skeletal muscle index for skeletal muscle mass assessment in a group of Australian women

Background

Sarcopenia is assessed by several methods, including dual energy X-ray absorptiometry (DEXA), which provide a height-adjusted skeletal muscle index (H-SMI). A SMI 2 standard deviation below the young adult reference [1] combined with low muscle strength or performance is used to identify sarcopenia. As height declines with age, H-SMI may underestimate low skeletal muscle mass in the older population. Our study aims to evaluate an alternative SMI and to examine its relationship to grip strength in a group of Australian women.

Methods

Women from two cohorts were analysed. 2041 women had body composition data (112 had calf circumference, 137 had leg length measurements) without grip strength, and 49 women had grip strength measured (40 had body composition data).The relationship between leg length-adjusted SMI (LL-SMI) to grip strength and anthropometric variables to skeletal muscle mass by DEXA were examined by linear regression analysis.

Results

Cohort 1: Older women were compared to younger women. Older women were shorter but leg length did not differ between different age groups. H-SMI was not different between groups (P = 0.528). LL-SMI was lower in older women (P = 0.002). Cohort 2: LL-SMI was significantly associated with grip strength (P = 0.048) after adjustment for age.

Conclusion

Older women were shorter, while leg length did not differ from the younger group. H-SMI may obscure and may underestimate low muscle mass in older individuals. LL-SMI may be a better measure of skeletal muscle mass in older individuals. These alternate SMI would benefit from further exploration in older individuals.

Estimation of Stature from Percutaneous Hand Length Among the Students of A Medical College

INTRODUCTION

Anthropometry is commonly used technique for the measurement of bone and soft parts in Anatomy and other fields of science. It has practical implications mainly in the field of anatomy and forensic medicine. The present study is aimed to determine the average hand length with stature among the students of a medical college.

METHODS

A cross sectional study was done among 185 students including 98 females and 87 males of Devdaha Medical College and Research Institute. Hand length and stature were measured and collected data was entered and analyzed in SPSS 21. The differences in measurements of hand bone length and stature among males and females were calculated. The regression equation for the estimation of stature from hand length was calculated.

RESULTS

The mean hand length among the total population was 17.80±1.04 cm and stature was 160.50±6.73 cm. The mean hand length and stature were higher among males as compared to females. The range of hand length and stature among the total population is 16.00-21.20 and 146.00-176.50 respectively. The regression equation for the estimation of stature from hand length revealed statistically significant value among the males and females.

CONCLUSIONS

Our study reveals higher value of hand length and stature for males as compared to females. Also there is significant correlation between the hand length and the stature. The present values are obtained from the small population of an institute. Further studies have to be carried out to develop the regression formula for the Nepalese population with larger sample size.

Anthropometric Indices and Their Correlates in Cognitively-Intact and Elderly Canadians with Dementia

Les mesures anthropométriques reflètent l'état nutritionnel. Cette recherche a examiné les données provenant de Canadien(ne)s âgé(e)s ayant participé à la première phase de l'Étude sur la santé et le vieillissement au Canada (CSHA-1). Le poids et la taille furent mesurés chez 1 464 personnes vivant dans la communauté et 963 individus en institution. Les sujets institutionnalisés avaient un poids corporel inférieur à ceux vivant en communauté (59,1 ± 13,8 kg. vs. 65,1 ± 14,1 kg.); ils étaient plus petits (160,4 ± 10.1 cm vs. 162,6 ± 10 cm), et leur IMC étaient plus bas (23,3 ± 5,0 vs. 24,6 ± 4,5) (p< .001). Les valeurs anthropométriques furent plus basses chez les femmes, et diminuaient progressivement avec l'âge. Les Québécois avaient une taille plus petite et un poids corporel inférieur à ceux des Canadiens vivant ailleurs. Les mesures anthropométriques ont diminué suivant le diagnostic cognitif, en allant de normal, à «deficit cognitif sans démence» (CIND), à dément; les participants atteints de la démence de type Alzheimer avaient les poids corporels les plus bas. Les facteurs associés au poids corporel étaient différents parmi les participants vivant dans la communauté et en institution.

Estimation of Height and Body Mass Index from Demi-Span in Elderly Individuals

BACKGROUND

Obtaining accurate height and, consequently, body mass index (BMI) measurements in elderly subjects can be difficult due to changes in posture and loss of height during ageing. Measurements of other body segments can be used as an alternative to estimate standing height, but population- and age-specific equations are necessary.

OBJECTIVE

Our objectives were to validate existing equations, to develop new simple equations to predict height in an elderly Spanish population and to assess the accuracy of the BMI calculated by estimated height from the new equations.

METHODS

We measured height and demi-span in a representative sample of 592 individuals, 271 men and 321 women, 65 years and older (mean +/- SD, 73.8 +/- 6.3 years). We suggested equations to predict height from demi-span by multiple regression analyses and performed an agreement analysis between measured and estimated indices.

RESULTS

Height estimated from demi-span correlated significantly (p < 0.001) with measured height (men: r = 0.708, women: r = 0.625). The best prediction equations were as follows: men, height (in cm) = 77.821 + (1.132 x demi-span in cm) + (-0.215 x 5-year age category); women: height (in cm) = 88.854 + (0.899 x demi-span in cm) + (-0.692 x 5-year age category). No significant differences between the mean values of estimated and measured heights were found for men (-0.03 +/- 4.6 cm) or women (-0.02 +/- 4.1 cm). The BMI derived from measured height did not differ significantly from the BMI derived from estimated height either.

CONCLUSION

Predicted height values from equations based on demi-span and age may be acceptable surrogates to derive accurate nutritional indices such as the BMI, particularly in elderly populations, where height may be difficult to measure accurately.

Nutritional risk and body composition in free-living elderly participating in congregate meal-site programs

Early detection of nutritional risk in free-living elderly is critical in healthcare, yet comprehensive measurements are time consuming and can be frustrating to both health professionals and elderly. In addition, body composition measurements provide information regarding fat and fat-free mass that have been linked to morbidity and mortality in elderly. In this study, nutritional risk was assessed in 69 elderly, aged 50-90 years, attending congregate meal-site programs, using Mini Nutritional Assessment, and body composition was assessed by bioelectric impedance. Analysis revealed that 31.9% of the elderly were at risk for malnutrition and 2.9% were malnourished. Males had significantly greater body weight, height and fat-free mass, and females had significantly greater body fat as percentage of body weight, but there was no gender difference in nutritional risk. Of elderly, 36.2% had body mass index > 85th percentile and 8.7% < 15th percentile using national population reference standards. Age-related decline in fat-free mass was an early indicator of changes in body composition.

Equations for predicting height for elderly Mexican Americans are not applicable for elderly Mexicans

Common indices for the assessment of nutritional status take height into account. Elderly individuals are frequently unable to assume the position needed for this measurement. Therefore, equations have been developed for predicting height in elderly American Whites, American Blacks, and Mexican Americans using knee height as a predictor. These equations may not be applicable for the elderly in other populations. A sample of 736 individuals was studied (186 males, 550 females) with a mean age of 74.7 +/- 8 years. Height and knee height (without shoes) were measured in millimeters. Multiple regression and cross-validation was performed. The correlation between knee height and standing height was similar in women (r = 0.86; P < 0.0001) and men (r = 0.83; P < 0.0001). The equations obtained were as follows: men (height in cm) = 52.6 + (2.17 x knee height in cm) and women (height in cm) = 73.7 + (1.99 x knee height in cm) - (0.23 x age in years). Cross-validation showed that the pure error was less than the root mean square error (RMSE) in both sexes. Mean heights, based on the equations of Chumlea et al. (1998) for Mexican Americans significantly differ from the reference values for females and males. Therefore, the equations developed by Chumlea et al. (1998) for elderly Mexican Americans do not appear to be applicable for elderly Mexicans.

Development of sex-specific equations for estimating stature of frail elderly Hispanics living in the northeastern United States

BACKGROUND

The accurate measurement of stature is not possible in many frail elderly persons because of problems affecting their ability to stand straight. In such cases, knee height may be used to estimate stature.

OBJECTIVE

This study was designed to explore the applicability of published regression equations to estimate stature of Puerto Rican and other Hispanic elderly persons living in the northeastern United States and to formulate ethnicity-specific equations for these persons.

DESIGN

The study subjects (60-92 y of age) included 569 Hispanics and a comparison group of 153 non-Hispanic whites. Equations to estimate stature of Hispanics and Puerto Ricans living in the northeastern United States were developed with regression models in a randomly selected subgroup of the Hispanics. These equations were tested with the remaining Hispanic subgroup.

RESULTS

The published equations significantly overestimated stature of our Hispanic subjects. Equations developed for Massachusetts Hispanics and Puerto Ricans provided estimates of stature that did not differ significantly from measured stature. We found further that equations for non-Hispanic whites published in 1985 predicted statures of our relatively low-income, non-Hispanic white subjects better than did newer 1998 equations developed from a national sample.

CONCLUSIONS

The stature of elderly Hispanics from the northeastern United States can be estimated by using equations derived from the same population. These, or similar equations, should be used to estimate stature of frail elderly persons for whom standing height cannot be taken accurately. Socioeconomic status as well as ethnicity may affect results when knee height equations are used.