2008, Volume 14 No. 2


Reliability and Technical Error of Calf Circumference and Mid-half Arm Span Measurements for Nutritional Status Assessment of Elderly Persons in Malaysia

Jamaiyah H1, Geeta A1, Safiza MN2, Wong NF2, Kee CC3, Ahmad AZ2, Suzana S4 , Rahmah R5 , Khor GL6 , Ruzita AT4, Chen WS1, Rajaah M1 & Faudzi A2
1 Clinical Research Centre, Hospital Kuala Lumpur, Malaysia
2 Institute for Public Health, Kuala Lumpur, Malaysia
3 Institute for Medical Research, Kuala Lumpur, Malaysia
4 Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
5 Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
6 Universiti Putra Malaysia, Serdang, Selangor, Malaysia

This study sought to examine the reliability of two measurements; Calf Circumference (CC) and Mid-half Arm Span (MHAS). A sample of 130 elderly persons aged 60 years and above seen consecutively in the Kuala Lumpur Hospital outpatient clinic during the period of December 2005 to January 2006, upon consent, were recruited to the study. There was a high degree of reliability for both inter- and intra-examiner (r close to 1). For inter-examiner, on average the CC measurements taken by the first examiner were 0.3 cm lower than that of the second examiner. The upper and lower limit of the differences were +0.4 to 0.9 cm respectively. Inter-examiner MHAS measurements on average by the first examiner were 0.2 cm lower than that of the second examiner. The limits were +1.7 to 2.1 cm. By comparison, the inter-examiner CC measurements were more reliable than the MHAS measurements. For intra-examiner, on average the CC measurements at Time 1 were consistent with Time 2 (mean difference=0) with limits of the difference at + 0.5 cm. MHAS measurements at Time 1 were on average 0.1 cm less than at Time 2 with limits at +1.7 and 1.8 cm. The technical error of measurement (TEM) and coefficient of variation of CC and MHAS for both interexaminer and intra-examiner measurements were within acceptable limits with the exception of MHAS TEM. This study suggests that CC and MHAS measured in elderly persons 60 years and above, using Seca Circumference Tape 206, Germany (0.05 cm) are reliable and can be used in a community survey.

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