Exploring Factors Influencing Malnutrition and Establishing Mid-Arm Circumference Cut-Off Values in Indian Older Adult- A LASI DAD STUDY.

Background: Nutritional and anthropometric parameters play crucial roles as health and well-being indicators in the older persons. This study aims to investigate factors linked to malnutrition (both underand over-nutrition) and establish suitable cut-off values for mid-arm circumference (MAC) among community-dwelling Indian older adults using data from LASI DAD. Methods: This study utilized data from the first wave of the Longitudinal Ageing Study in India - Diagnostic Assessment of Dementia (LASIDAD), a nationally representative cohort study. The sample included 4,096 older adults aged over 60 years, drawn from the LASI-DAD dataset. The main outcome variable was BMI, categorized into low (<18.5 kg/m2), normal (18.5-22.9 kg/m2), and high (>23 kg/m2). To establish cut-off values for mid-arm circumference (MAC), ROC curves were employed, with BMI as the gold standard for comparison. This methodology allowed for the determination of sex-specific MAC cut-offs, enabling accurate nutritional assessment in Indian older adults. Results: 902 (weighted percentage 20.55%) had low BMI, 1,742 (44.25%) had high BMI. Undernutrition was associated with age, wealth-quintile, and impaired cognition, while over-nutrition was associated with higher education, urban living, and comorbidities such as hypertension, diabetes, and chronic heart disease. The optimal lower and upper cut-offs for MAC in males were 23.9 cm and >26.9 cm, and for females, they were 22.5 cm and >25 cm. Conclusion: The derivation of sex-specific cut-off values for midarm circumference (MAC) offers standardized criteria for assessing the nutritional status of older adults in India. These findings hold significant importance for healthcare professionals, policymakers, and researchers, enabling targeted interventions and policies to effectively address the issue of malnutrition. [ABSTRACT FROM AUTHOR]