|BRIEF RESEARCH ARTICLE
|Year : 2018 | Volume
| Issue : 2 | Page : 159-162
Relationship between height and arm span of elderly persons in an urban colony of New Delhi
Anil Kumar Goswami1, Mani Kalaivani2, Sanjeev Kumar Gupta3, Baridalyne Nongkynrih3, Chandrakant S Pandav4
1 Assistant Professor, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
2 Scientist, Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
3 Professor, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
4 Professor and Head, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
|Date of Web Publication||14-Jun-2018|
Old O. T. Block, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Anthropometric changes take place with increasing age. Progressive loss of height makes it difficult to use height for calculation of body mass index in nutritional screening of elderly persons. There is a need to find other alternative methods which could be used as proxy measurements of height in them. To assess the relationship of height and arm span and among elderly persons. A community-based cross-sectional study was conducted among elderly persons in urban colony of Delhi. Height and arm span of persons aged 60 years and above (n = 711) were measured according to standard methods. Correlation between arm span and height was calculated. The mean arm span was seen to be more than the mean height in all age-groups and both sexes. There was a linear relationship between height and arm-span in all age-groups. There was a strong correlation between arm span and height in all age groups. Arm span could be used instead of height as an alternative in the conventional body mass index in elderly persons.
Keywords: Arm span, elderly, height, New Delhi
|How to cite this article:|
Goswami AK, Kalaivani M, Gupta SK, Nongkynrih B, Pandav CS. Relationship between height and arm span of elderly persons in an urban colony of New Delhi. Indian J Public Health 2018;62:159-62
|How to cite this URL:|
Goswami AK, Kalaivani M, Gupta SK, Nongkynrih B, Pandav CS. Relationship between height and arm span of elderly persons in an urban colony of New Delhi. Indian J Public Health [serial online] 2018 [cited 2019 Nov 18];62:159-62. Available from: http://www.ijph.in/text.asp?2018/62/2/159/234507
Nutrition status of elderly persons can be monitored through anthropometric surveys. However, in this population, degenerative and osteoporotic changes give rise to spine curvature, which makes it difficult to accurately measure height. Some studies have shown that arm span can be a good substitute for height in situ ations when the height cannot be measured, namely, bedridden patients, standardization of lung function tests in the elderly, and calculation of body mass index for nutritional assessment., Some studies in India from Darjeeling, West Bengal, and Karnataka, South India, have reported on the relationship between arm span and height. However, these were carried out in younger people. In India, there are limited published data in elderly persons to study this relationship. Hence, this study was conducted to assess the relationship between arm span and height among elderly persons in an urban colony of New Delhi.
A community-based cross-sectional study was done in Dakshinpuri Extension, Dr. Ambedkar Nagar, New Delhi, an urban colony, from January to June 2015. Ambulatory older persons who were residents of the study area for at least six months were included in the study. If participants were unable to communicate, we gathered proxy information from a family member/ caregiver. In case a reliable informant was not available, the participant was excluded. Sample size was calculated using the formula n = 4pq/d. Taking the prevalence of undernutrition to be 14%, relative error of 25%, design effect of 1.5, and 15% nonresponse, the sample size was calculated to be 693. The study population comprised a total of about 35,000 persons, spread across 11 blocks. Thus, each block had an average population of 3200 persons, including all ages. For the purpose of sampling, each block was taken as a cluster. Thus, there were a total of 11 clusters, and the average cluster size was 3200. Cluster random sampling was done. Three clusters were randomly selected from the sampling frame of 11. All elderly persons in these three clusters were recruited to the study. There were 851 elderly persons in these three clusters. House-to-house visits were made. If a person was not available after three visits, s\he was labeled as a nonresponder. Measurement of height and arm span was done using standard procedures as per the World Health Organization (1995) guidelines. Measurement of height and arm span was done using a flexible steel tape. Each measurement was taken twice, and the average was calculated. Height was measured with the participant standing without footwear and against a wall, with the scapula, buttocks, and heels touching the wall. With the participant standing upright and looking straight ahead at Frankfurt's plane, height was measured to the nearest 0.1 cm. Arm span was taken with the participant standing against a wall, looking straight at eye level, with arms extended laterally at shoulder level. Then, the steel tape was extended from the tip of the middle finger of one hand straight across the chest to the tip of the middle finger of the other hand and recorded to the nearest 0.1 cm.
Arm span and height of the participants are expressed as mean ± standard deviation. Gender-wise distribution of arm span and height across the age groups was also obtained. Associations were tested using Pearson's product moment correlation coefficient (r). Linear regression analysis was performed to estimate the change of height with one unit change of arm span. Statistical significance was set at 5% level.
Ethical clearance from the All India Institute of Medical Sciences Ethics Committee was obtained. Informed written consent was obtained from all the participants. Any participant with a medical condition was appropriately treated or referred as necessary.
Altogether, 851 elderly persons were approached to participate in the study. Of these, 111 were not available even after three visits, and 29 refused to participate in the study. Thus, a total of 711 elderly persons participated in the study, giving a response rate of 83%. There were 298 men (41%) and 413 (58%) women. Arm span and height showed normal distribution. The mean arm span (160.9 ± 11.3 cm) of the participants was more than the mean height (155.2 ± 9.1 cm). Men had a higher mean arm span (169.8 ± 8.2 cm) and height (162.8 ± 6.9 cm) as compared to women (arm span: 154.5 ± 8.4 cm; height: 149.7 ± 5.6 cm). [Table 1] shows gender-wise distribution of arm span and height across different age groups. The mean arm span in men was seen to be more than the mean height in all age groups. Similarly, in women, arm span was consistently more than the height in all age groups.
|Table 1: Gender-wise distribution of arm span and height among study participants across different age groups (n=711)|
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There was a strong correlation between arm span and height when analyzed by gender (P < 0.001) [Table 2]. Regression analysis was done for men and women separately, and variance (R-square) was calculated. R-square indicates the proportion of variability in height which can be explained by arm span. It was seen that R-square was higher in men than in women for all age groups. The overall regression coefficient was 0.73 (0.68, 0.79) for men which indicates that for every unit of increase in arm span of men, there was 0.73 cm significant increase in height (P < 0.0001). In women, height increased significantly by 0.70 cm per 1 cm increase in arm span (P < 0.0001) [Table 2].
|Table 2: Correlation and regression analysis between arm span and height in men and women|
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The present study has shown that there was a strong association between arm span and height among both men and women [Figure 1] and [Figure 2]. A similar study was conducted among rural population in Haryana, which also revealed that there is a high correlation between arm span and height among elderly persons.
|Figure 1: Scatter plot showing age-specific relation between arm span and height in men.|
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|Figure 2: Scatter plot showing age-specific relation between arm span and height in women.|
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A study among Japanese population examined anthropometric indicators to improve predictive ability of asymptomatic vertebral fracture screening models. It was seen that predictive accuracy of model for vertebral fracture including age, height, weight, postmenopausal status, and bone mineral density improved when arm span was added as an explanatory variable.
In this study, mean arm span was seen to be more than the mean height in all age groups. This was true for both men and women. A study from rural Haryana reported that the mean arm span (164.4 ± 11.1 cm) was higher than the mean height (156.1 ± 9.1 cm). Arm span was found to be consistently more than height in all the age groups, with an average difference in the mean arm span and height of 8–9 cm. Similar findings were also reported from studies by Chilima and Ismail  and de Lucia et al. Findings from regression analysis showed age- and gender-wise variations in height that could be predicted by arm span. Similar findings were also seen from a previous study among rural elderly population in Haryana. The overall regression coefficient in this study for men indicated that for every unit of increase in arm span of men, there was a 0.73-cm significant increase in height. This was similar to the findings from the rural study. In women, height increased significantly by 0.70 cm per 1 cm increase in arm span in this study which is also similar with that seen from the rural population. This indicates that irrespective of the difference in population groups, whether urban or rural, the rate of change of arm span and height is constant which is an important finding of the study. Joint stiffness and elbow joint contractures in elderly persons are factors to be considered while using arm span. Further similar studies need to be conducted across the country as anthropometric variations may exist across regions.
In India, the number of elderly persons in the population is expected to increase by more than double from 71 million in 2001 to 173 million in 2026. Many of them will be at an increased risk of malnutrition, be it underweight or obesity. Therefore, emphasis should be laid on developing proper methods for measuring basic indicators of nutrition. Due to the anthropometric changes that take place with increasing age, there is a progressive loss of height. Arm span could be used instead of height, as an alternative measurement in nutritional studies in elderly persons.
Financial support and sponsorship
This study was financially supported by the All India Institute of Medical Sciences Research Grant.
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2]
[Table 1], [Table 2]