Screening Performance of Anthropometric Indices and Determination of Optimal Cut-Off Values for Identifying Low...

Background: Sarcopenia, characterized by age-related loss of muscle mass and strength, is a growing public health concern requiring early detection; this exploratory study evaluated a range of anthropometric measurements and indices to identify those most suitable for screening low muscle strength in hospitalized geriatric patients and to determine preliminary cut-off values that may support screening in settings with limited access to specialized equipment or trained personnel. Materials and Methods: In this cross-sectional study, 390 hospitalized geriatric-ward patients aged ≥ 60 years were included. The median age was 77.00 years (72.00, 82.00), and 258 participants (66.2%) were women. Anthropometric and body composition measurements were performed, and handgrip strength was assessed. Low muscle strength was defined according to The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Logistic regression analyses were used to assess associations between anthropometric measurements and low muscle strength, and receiver operating characteristic (ROC) curve analysis was used to evaluate their screening performance. Results: Among 390 participants, 67 (17.2%) had low muscle strength. Low muscle strength was associated with older age, lower body weight, BMI (Body Mass Index), fat-free mass, and smaller arm and calf circumferences. Higher arm and calf circumferences were significantly associated with a lower risk of low muscle strength in both women (OR = 0.913 and 0.884) and men (OR = 0.793 and 0.769; all p < 0.05). ROC analysis identified optimal screening cut-offs: arm 26.5 cm and calf 31.5 cm in women, and arm 29.5 cm and calf 33 cm in men, showing moderate screening performance, with an area under the ROC curve (AUC) of 0.63-0.78. Conclusions: Calf and arm circumferences are simple, quick, and non-invasive measurements that may be useful for screening low muscle strength in hospitalized geriatric patients, particularly in settings with limited access to specialized equipment. These measurements may help identify individuals who require further assessment for sarcopenia according to current clinical guidelines, with age being an important factor to consider. The proposed cut-off values should be considered hypothesis-generating rather than diagnostic thresholds for sarcopenia and require external validation in independent populations before they can be recommended for routine clinical use.