Optimal Calf Circumference Cutoff Values in the Mini Nutritional Assessment Short-Form Based on Usual Walking Speed Decline in Older Adults Requiring Long-Term Care/Support.

AIM: Different calf circumference (CC) cutoff values have been established in the Mini Nutritional Assessment short-form (MNA-SF), Global Leadership Initiative on Malnutrition (GLIM) criteria, and Asian Working Group for Sarcopenia (AWGS). We used these different cutoff values and examined the impact of nutritional classification on functional decline based on the MNA-SF.

METHODS

This longitudinal study (2018-2024) included 169 daycare rehabilitation users (80.4 ± 7.2 years; 97 males, 72 females) who underwent usual walking speed measurement at baseline and after 6 months. At baseline, nutritional status was assessed using the MNA-SF based on body mass index (MNA-SF-BMI) and calf circumference cutoff values, including the conventional cutoff (MNA-SF-CC), GLIM criteria (MNA-SF-CC (GLIM)), and AWGS (MNA-SF-CC (AWGS)). Binomial logistic regression was applied and odds ratios (ORs) calculated, with a decline in usual walking speed ≥ 0.18 m/s as the dependent variable and nutritional categories as independent variables.

RESULTS

Twenty-four participants (14.2%) showed a decline in usual walking speed of 0.18 m/s or more. Using the combined "normal nutrition" and "at risk" categories as the reference, a decline in usual walking speed was significantly associated with MNA-SF-BMI (malnourished; OR = 2.93, p = 0.042), MNA-SF-CC (GLIM) (malnourished; OR = 2.79, p = 0.046), and MNA-SF-CC (AWGS) (malnourished; OR = 3.31, p = 0.018). In contrast, the MNA-SF-CC showed no significant association.

CONCLUSIONS

When assessing the MNA-SF using CC, the recently proposed cutoff values from the GLIM criteria and AWGS provided a clearer association with functional decline.