Ultrasound muscle geometry and malnutrition in community-dwelling older adults

The aim of the present research was to study whether muscle ultrasound (US) geometric parameters may be useful to detect malnutrition using Global Leadership Initiative on Malnutrition (GLIM) criteria in community-dwelling older adults.

Cross-sectional study.

Seven University Hospitals and three Primary Care settings from Spain.

424 adults ≥70 years old from outpatient clinics.

US measurements at the mid-thigh of participants, using a Clarius® L7 HD3 probe, included quadriceps rectus femoris thickness (QRFT) in mm and area (QRFA) in cm², subcutaneous adipose tissue thickness (SAT) in mm, total mid-thigh thickness (TTT) in mm, and pennation angle (PA) in grades. Nutritional data included the body mass index (BMI), and malnutrition assessed with the GLIM criteria.

367 participants presented valid data for the present study. US parameters presented significant correlation with BMI except for the PA, with TTT (r = 0.539; p < 0.001) and SAT (r = 0.453; p < 0.001) showing the higher figures. Every US parameter showed association with GLIM criteria, SAT (10.3 vs 14.9), QRFT (13.6 vs 15.3), QRFA (5.2 vs 5.9), TTT (34.7 vs 43.4), and PA (8.9 vs 10.4) for malnourished participants compared to those with normal nutritional status respectively (p < 0.001). TTT provided the best overall performance for malnutrition with an AUC 0.753 (95% CI 0.689-0.816; p < 0.001; overall model quality 0.69), with the best cutoff predictive value for both women and men of 41.4 mm and 35.4 mm respectively.

Ultrasonography may be a good tool to assess malnutrition in community-dwelling older adults, and total mid-thigh thickness may be the most promising single measurement.