This study aims to assess the agreement between the appendicular skeletal muscle index (ASMI) and dual-energy X-ray absorptiometry (DXA) using a single frequency bioelectrical impedance analysis (BIA) to assess criteria. Moreover, we used the European working group on sarcopenia in older people 1 (EWGSOP1), EWGSOP2, and the Tengvall equation to estimate a low prevalence in ASMI (under the cutoff criteria). We examined a sample of 765 elderly individuals (27.8% male and 72.2% female, aged 82 ± 8.2 years). Based on the cutoff identified by Tengvall, EWGSOP1, and EWGSOP2, the results showed that the prevalence of low ASMI in females was 10.1%, 11.4%, and 9.2%, respectively, and 98.1%, 30.5%, and 23.5% in males, respectively. Moreover, low ASMI prevalence under each diagnostic criterion and body mass index (BMI) was calculated. For BMI < 25 kg/m2, the ASMI prevalence was 39.9%, 25.9%, and 20.6%, as determined using Tengvall, EWGSOP1, and EWGSOP2, respectively, and for BMI > 25 kg/m2, the ASMI prevalence was 29.0%, 6.6%, and 5.2%. The percentage of agreement and Cohen's Kappa with the corresponding p-value between Tengvall and EWGSOP1 was 70.1% (p < 0.001). Between Tengvall and EWGSOP2, it was 69.4% (p < 0.001). Between EWGSOP1 and EWGSOP2, it was 96.5% (p < 0.001). Regarding gender, low ASMI prevalence in males was higher than in females. Moreover, in females, the prevalence was comparable among the three diagnostic criteria, while in males, it was significantly higher under Tengvall than the other two criteria. The application of the Tengvall formula with a single frequency BIA should be revised in terms of application for assessing low ASMI in elderly patients.
Keywords: appendicular skeletal muscle; appendicular skeletal muscle index; elderly; prevalence; sarcopenia.