Arm length measurement as an alternative to height in nutritional assessment of the elderly

The use of long bone measurements as an alternative to height in nutritional assessment of the elderly was investigated in 100 young and 63 aged individuals. Highly significant correlations between height and total arm length, humerus length, forearm length, and proximal phalanx length were found. Compared to young subjects, values for the elderly were shifted significantly, demonstrating a reduction in height not paralleled by decreases in arm length measurements. In subsequent studies, lean body mass was evaluated by creatinine excretion in groups of young and elderly male and female volunteers. In both males and females, when creatinine excretion was related to height, ideal body weight, or total arm length, significantly lower values were found in the elderly as compared to the young. In all groups highly significant correlations between the use of arm length and the other two methods of expressing creatinine excretion were found. This validates the use of arm length measurement as an alternative to height for nutritional assessment. Since arm length is less affected than height by the aging process and more easily obtained in the bedfast patient, it should provide a more accurate reflection of stature when performing nutritional assessments of the elderly. These preliminary data emphasize the need for appropriate standards for subjects of different ages when evaluating lean body mass.