Low mid-upper arm circumference, calf circumference, and body mass index and mortality in older persons.
BACKGROUND
Low body mass index is a general measure of thinness. However, its measurement can be cumbersome in older persons and other simple anthropometric measures may be more strongly associated with mortality. Therefore, associations of low mid-upper arm circumference, calf circumference, and body mass index with mortality were examined in older persons.


METHODS
Data of the Longitudinal Aging Study Amsterdam, a population-based cohort study in the Netherlands, were used. The present study included community-dwelling persons 65 years and older in 1992-1993 (n = 1,667), who were followed until 2007 for their vital status. Associations between anthropometric measures and 15-year mortality were examined by spline regression models and, below the nadir, Cox regression models, transforming all measures to sex-specific Z scores.


RESULTS
Mortality rates were 599 of 826 (73%) in men and 479 of 841 (57%) in women. Below the nadir, the hazard ratio of mortality per 1 standard deviation lower mid-upper arm circumference was 1.79 (95% confidence interval, 1.48-2.16) in men and 2.26 (1.71-3.00) in women. For calf circumference, the hazard ratio was 1.45 (1.22-1.71) in men and 1.30 (1.15-1.48) in women and for body mass index 1.38 (1.17-1.61) in men and 1.56 (1.10-2.21) in women. Excluding deaths within the first 3 years after baseline did not change these associations. Excluding those with a smoking history, obstructive lung disease, or cancer attenuated the associations of calf circumference (men) and body mass index (women).


CONCLUSIONS
Based on the stronger association with mortality and given a more easy assessment in older persons, mid-upper arm circumference seems a more feasible and valid anthropometric measure of thinness than body mass index in older men and women.
Wijnhoven
Hanneke A H
HA
Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands. hanneke.wijnhoven@falw.vu.nl
van Bokhorst-de van der Schueren
Marian A E
MA
Heymans
Martijn W
MW
de Vet
Henrica C W
HC
Kruizenga
Hinke M
HM
Twisk
Jos W
JW
Visser
Marjolein
M
D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001132:Arm / Q000033:anatomy & histology* / Q000502:physiology; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007866:Leg / Q000033:anatomy & histology* / Q000502:physiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009426:Netherlands; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012738:Sex Hormone-Binding Globulin
D012738:Sex Hormone-Binding Globulin