Calf circumference predicts mobility disability: A secondary analysis of the Mexican health and ageing study

Abstract

Introduction Calf circumference is a surrogate measurement of muscle mass. However, there is scarce evidence on its validity in predicting adverse outcomes such as mobility disability. The aim of this report is to determine if calf circumference could predict incident mobility disability in Mexican 60-year or older adults. Methods This is a secondary analysis of the Mexican Health and Aging Study and in particular of its two first waves. Sixty-year or older adults without mobility disability in the first assessment were included and followed-up for two years. Calf circumference quartile groups were compared to test the difference of incident mobility disability. Logistic regression models were fitted to test the independent association when including confounding variables. Results A total of 745 older adults were assessed, from which 24.4% of the older adults developed mobility disability at follow-up. A calf circumference > 38 cm was associated with a higher risk of developing mobility disability, even after adjustment in the multivariate model, with an odds ratio 0.55 (95% confidence interval 0.31–0.99, P = 0.049). Conclusions High calf circumference in Mexican older adults is independently associated with incident mobility disability. This could reflect the impact of adverse health conditions such as obesity (with high fat tissue) or edema. Further research should aim at testing these results in different populations.

Calf circumference: clinical validation for evaluation of muscle mass in the elderly

“…In Taiwan, the decrease in CP (26) increased the risk of death in men by 1.30 (RR: 1.22-1.71) and in women by 1.38 (RR: 1.15-1.48) . Although studies (23)(24)(25)(26) have shown that decreased CP increases the likelihood of decreased muscle mass, a study with elderly in Mexico (24) showed that CP increase (> 38 cm) had an independent association with disability, suggesting that the fat tissue may still impact muscle function.…”

“…The possibility of identifying elderly patients with reduced muscle mass through CP is reinforced by studies that have evaluated their ability to predict mortality (23)(24) and disability (24)(25) and need for care (26) . In Taiwan, the decrease in CP (26) increased the risk of death in men by 1.30 (RR: 1.22-1.71) and in women by 1.38 (RR: 1.15-1.48) .…”

“…Among them, calf circumference (CC) (19) has been used in recent studies with the objective of measuring muscle mass and estimating the prevalence of sarcopenia (20)(21)(22) , predicting disability (23)(24) , mortality (24)(25) and need for care (26) , as well as for determining cut-off points of decreased muscle mass in the elderly population (27)(28)(29)(30)(31) .…”

Estimation of appendicular skeletal muscle: Development and validation of anthropometric prediction equations in Chinese patients with knee osteoarthritis

“…MAC possibly represents the skeletal muscle mass; however, in patients with knee osteoarthritis, calf circumference may represent fat accumulation. Perez‐Zepeda and Gutierrez‐Robledo also found that high calf circumference could reflect a greater amount of subcutaneous fat in patients with high BMI. The introduction of handgrip strength in our study as a variable may increase the equation's complexity.…”

Impact of edema on length of calf circumference in older adults

“…Calf circumference has been proven to be positively correlated to skeletal muscle mass, and might thus be a potential indicator of decreased muscle mass in clinical practice as an alternative to imaging modalities and bioimpedance analysis. 12,13 However, although calf circumference has been endorsed in as a reliable indicator for evaluating muscle mass, 8,9,14 its use remains controversial. 10 Edema can develop from malnutrition, and renal, hepatic and cardiac diseases, and as a side-effect of medications that increase fluid accumulation in the body; 15,16 thus, edema can increase calf circumference.…”