Original Article

Development of Estimate Formulas for Appendicular Lean Mass Using Forearm Circumference in Older Adults Requiring Care

Daisuke Takagi¹, Masatoshi Kageyama^2,3

1. Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Japan
2. Long-Term Care Health Facilities Sunrise Ohama, Japan
3. Graduate School, Hamamatsu University School of Medicine, Cooperative Major in Medical Photonics (Doctoral Course), Japan

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Keywords: Appendicular lean mass, Estimated formula, Forearm circumference, Long-term care, Older adults requiring care

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Abstract

Objectives: The use of forearm circumference (FC) in the estimation equation to predict appendicular lean mass (ALM) in older adults who require care remains unclear. Methods: This cross-sectional study targeted 132 participants aged ≥65 years requiring care. The ALM was measured with bioelectrical impedance analysis (BIA). Handgrip strength (HS) was measured with a digital hand dynamometer. FC was measured at the site of maximum swelling using a tape measure. Multiple regression analysis was conducted to develop an equation for estimating BIA-measured ALM using FC. Moreover, we investigated a systematic error by Bland–Altman analysis between BIA-measured ALM and ALM calculated by the estimation equation. Results: We developed the four estimation equations. The values of r, adjusted R², and SEE in the representative model (FC + HS + age) were 0.86, 0.73, and 2.01 (kg), respectively (p < 0.05). In contrast, a systematic error was identified between the BIA-measured ALM and ALM calculated by the estimation equations by the Bland–Altman analysis. Conclusions: This study developed the formula using FC, which can predict ALM with less influence of edema, but it may over- or underestimate ALM in older adults requiring care

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