Calf circumference value for sarcopenia screening among older adults with stroke

Tatsuro Inoue; Keisuke Maeda; Akio Shimizu; Ayano Nagano; Junko Ueshima; Keisuke Sato; Kenta Murotani

doi:10.1016/j.archger.2020.104290

Calf circumference value for sarcopenia screening among older adults with stroke

Arch Gerontol Geriatr. 2021 Mar-Apr:93:104290. doi: 10.1016/j.archger.2020.104290. Epub 2020 Nov 3.

Authors

Tatsuro Inoue¹, Keisuke Maeda², Akio Shimizu³, Ayano Nagano⁴, Junko Ueshima⁵, Keisuke Sato⁶, Kenta Murotani⁷

Affiliations

¹ Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, 950-3198, Japan.
² Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan. Electronic address: kskmaeda1701@gmail.com.
³ Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan; Department of Nutrition, Hamamatsu City Rehabilitation Hospital, 1-6-1 Wagokita, Naka-ku, Hamamatsu, Shizuoka, 433-8127, Japan.
⁴ Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, 11-1 Imazuyamanaka-cho, Nishinomiya, Hyogo, 663-8211, Japan.
⁵ Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan; Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan.
⁶ Okinawa Chuzan Clinical Research Center, Chuzan Hospital, 6-2-1, Matsumoto, Okinawa, Okinawa, 904-2151, Japan.
⁷ Biostatistics Center, Kurume University, Asahi Machi, 67, Kurume, Fukuoka, 830-0011, Japan.

PMID: 33171328
DOI: 10.1016/j.archger.2020.104290

Abstract

Purpose: The Asia Working Group for Sarcopenia 2019 (AWGS) recommended using the calf circumference (CC) cut-off values to facilitate the case-finding of sarcopenia. However, the validity of the proposed cut-offs has not been examined in older patients with stroke. This study investigated the validity of the AWGS-recommended CC cut-off values for identifying sarcopenia among older patients with stroke.

Materials and methods: This cross-sectional study enrolled consecutive patients with stroke, aged 65 years and older, admitted to a convalescent rehabilitation ward. Sarcopenia was diagnosed based on the AWGS 2019 criteria. We drew a receiving operating characteristic curve to assess the ability of CC to predict sarcopenia diagnosis. Subsequently, we estimated the sensitivity, specificity, accuracy, F-value, and Matthews correlation coefficient (MCC) of the considered cut-off values.

Results: We enrolled 256 patients (43 % women) (mean age, 76.6 ± 7.5 years). The prevalence of sarcopenia was 63.7 %. Among men who presented with CC < 34 cm (the AWGS-recommended cut-off value), sensitivity and specificity were 85 % and 66 %, respectively. Concurrently, estimates of accuracy, F-value, and MCC were the highest at cut-off value <34 cm. Among women, at <33 cm of the AWGS-recommended cut-off value, the sensitivity and specificity were 91 % and 28 %, respectively. At cut-off value <32 cm, sensitivity was maintained at 80 %, while specificity increased to 56 %; suggesting that this cut-off value might be a useful indicator for the case-finding of sarcopenia.

Conclusions: The AWGS-recommended CC cut-off values are valid. The predictive characteristics of sarcopenia differed among men and women with stroke.

Keywords: Calf circumference; Cerebrovascular disorders; Sarcopenia; Screening.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Humans
Leg
Male
Mass Screening
Sarcopenia* / diagnosis
Sarcopenia* / epidemiology
Stroke* / complications
Stroke* / diagnosis