|Year : 2022 | Volume
| Issue : 2 | Page : 101-104
Relationship between height and arm-span of elderly persons in a rural area of Ballabgarh, Haryana
Sunanda Gupta1, Rakesh Kumar1, Mani Kalaivani2, Baridalyne Nongkynrih1, Shashi Kant1, Sanjeev Kumar Gupta1
1 Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
2 Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
|Date of Submission||28-Sep-2021|
|Date of Decision||19-Oct-2021|
|Date of Acceptance||21-Oct-2021|
|Date of Web Publication||21-Mar-2022|
Dr. Sanjeev Kumar Gupta
Centre for Community Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
Source of Support: None, Conflict of Interest: None
Background: Progression in age causes gradual loss in height due to degenerative osteoporotic changes in bones and decrease in the disc space. Hence, proxy measures of height are required in elderly persons. Objective: The objective of the study is to study the relationship between height and arm-span of elderly persons. Materials and Methods: This community-based study was conducted in a rural area of Ballabgarh, Haryana, among elderly persons (age ≥60 years). Four hundred and twenty participants were selected by simple random sampling method. House-to-house visits were made. Height and arm-span were measured. Association between height and arm-span was assessed by Pearson's product-moment correlation coefficient and linear regression analysis. Scatter plot was also made to show the association by age and sex. Results: In both sexes and all age groups, arm-span was seen to be more than height. Linear relationship between height and arm-span was observed. There was strong correlation between height and arm-span in both sexes (correlation coefficient = 0.97, P < 0.001 in both sexes). Conclusion: Arm-span can be measured as an alternative to height in elderly population. Arm-span can be used as a substitute for height for calculation of body mass index, creatinine height index, basal energy expenditure, and pulmonary function test.
Keywords: Anthropometry, arm-span, elderly, height, rural
|How to cite this article:|
Gupta S, Kumar R, Kalaivani M, Nongkynrih B, Kant S, Gupta SK. Relationship between height and arm-span of elderly persons in a rural area of Ballabgarh, Haryana. Indian J Med Spec 2022;13:101-4
|How to cite this URL:|
Gupta S, Kumar R, Kalaivani M, Nongkynrih B, Kant S, Gupta SK. Relationship between height and arm-span of elderly persons in a rural area of Ballabgarh, Haryana. Indian J Med Spec [serial online] 2022 [cited 2022 May 24];13:101-4. Available from: http://www.ijms.in/text.asp?2022/13/2/101/339994
| Introduction|| |
Anthropometry is one of the indicators of health of an individual. Anthropometry is used for identification of individuals or population at risk of malnutrition and related diseases and for selection of population or individuals for interventions. It also helps in the evaluation of effects of changing nutrition, health, socioeconomic influences, and interventions and hence achieving normal standards. Anthropometry has proved to be a noninvasive, cheap, and practical method for assessment of nutrition.
Measurement of height is required for calculating body mass index, creatinine height index, basal energy expenditure, and pulmonary function test. Decrease in height of elderly persons occurs due to vertebral compression, change in shape and height of vertebral disc, loss of muscle tone, postural change, etc.
Globally, as well as in Indian scenario, both absolute number and proportion of elderly persons are growing fast. In India, from 1971 to 2011, the proportion of elderly persons has increased from 5.3% to 8.6%. Hence, identification of elderly persons at risk of diseases and following them up after interventions has assumed greater public health importance.
Some Indian studies from Darjeeling, West Bengal, and Karnataka have reported on the correlation between arm-span and height., However, these were done in younger people. The objective of the present study was to assess the relationship between arm-span and height in elderly persons, aged 60 years and above, in a rural area of Haryana.
| Materials and Methods|| |
The Comprehensive Rural Health Services Project (CRHSP) Ballabgarh, Haryana, is a collaborative project of the All India Institute of Medical Sciences, New Delhi and the Government of Haryana. This was a cross-sectional study conducted in 28 villages of the CRHSP. A computerized health management information system (HMIS) contained the demographic details of every individual residing in these villages. The HMIS was updated by the health workers every month. The total population in the year 2018 was 99,756, which included 7470 elderly persons (aged ≥60 years). This was the sampling frame of the study. The reported prevalence of underweight among elderly persons was 24.8%. With absolute precision of 4.5, z = 1.96, and alpha of 5%, the required sample size was 354. With 5% allowance for death and migration, and 10% for nonresponse, the final sample was 414, rounded off to 420 elderly persons. Simple random sampling was used to select the participants from the HMIS.
Ethical clearance was obtained from the All India Institute of Medical Sciences Ethics Committee. Informed written consent was obtained from all participants. Participants requiring treatment were appropriately treated or referred as per need.
Data were collected by house-to-house visits. If a participant could not be contacted despite three home visits, s/he was considered as nonresponder. All participants were explained about the purpose of the visit and the procedure. Height and arm-span were measured according to the World Health Organization standard procedures (1995). Both measurements were taken using a flexible steel tape. Height was measured without footwear, with heels, buttocks, scapula touching the wall, with participant standing upright, looking forward (Frankfurt's plane). Arm-span was taken from tip of middle finger of one hand to tip of middle finger of other hand, with arms stretched laterally at shoulder level and the person looking straight. Measurements were recorded to nearest 0.1 cm. Each measurement was taken twice, and the average was calculated.
Data were entered in Microsoft Excel 2010 and analyzed in STATA v. 12.00. Arm-span and height of the participants are reported as mean ± standard deviation. Sex-wise distribution of arm-span and height across the age groups was also done. Associations were assessed using Pearson's product-moment correlation coefficient®. Linear regression analysis was performed to estimate the change of height with one unit change of arm-span. Scatter plot was made to show the correlation between height and arm-span. P < 0.05 was considered as statistically significant.
| Results|| |
Out of the sample of 420 elderly persons, 27 were found to be deceased or migrated. Of the remaining 393 participants, seven could not be contacted despite three home visits. Among the 386 participants, anthropometry could not be recorded in six participants. The reasons for nonavailability of anthropometric measurements were inability of the participant to stand or stretch arm due to senility, severe kyphosis, malunion after fracture, osteoarthritis, and diarrhea. A total of 380 observations were made. There were 160 males and 220 females. Mean arm-span was more than mean height in both the sexes in all age groups. The mean height was (166.4 ± 10.5 cm) and mean arm-span was (162.3 ± 10.6 cm). In males, the mean arm-span (174.1 ± 8.3 cm) and height (169.8 ± 8.5 cm) were more than those in females (arm-span: 161.1 ± 8.1 cm, height: 156.8 ± 8.4 cm).
[Table 1] shows sex-wise distribution of height and arm-span across all age groups. It was observed that mean arm-span in all age-groups was more than mean height in males. In females too, similar findings were noted.
[Table 2] shows regression analysis for males and females separately for correlation between arm-span and height. There was a strong correlation between arm-span and height overall and also when analyzed by sex (P < 0.001). Variance (R2) was also calculated. Variance (R2) shows proportion of variability in height that can be explained by arm-span. In both males and females, R2 was almost equal. In males, the regression coefficient was 0.99 (0.95–1.03), and in females, it was 0.99 (0.97–1.03). The overall regression coefficient was 0.99 (0.98–1.02). This meant that for every unit increase of arm-span, the increase in height was 0.99 cm in males (P < 0.001), 0.99 cm in females (P < 0.001), and 0.99 cm (P < 0.001) overall. All the findings were statistically significant.
|Table 2: Correlation and regression analysis between arm-span and height in men and women|
Click here to view
This study showed strong correlation between arm-span and height in both males and females in all the age groups [Figure 1] and [Figure 2]. This finding was also statistically significant (P < 0.001). Linear relationships were observed, even when estimated sex-wise and within subgroups of age. Arm-span and height were more in males. This is depicted in the scatter plot based on gender, i.e., clustering is seen at higher values for males, and there is clustering at lower values for females.
|Figure 1: Scatter plot showing age-specific relation between arm-span and height in males|
Click here to view
|Figure 2: Scatter plot showing age-specific relation between arm-span and height in females|
Click here to view
| Discussion|| |
In a similar study by Jamir et al. in 2013 in the rural area, it was observed that there was a high correlation between arm-span and height in elderly persons, and arm-span measurement can be a substitute for height. Arm-span was significantly more than height in all age groups. The mean arm-span (164.4 ± 11.1 cm) of the elderly participants was higher than the mean height (156.1 ± 9.1 cm). Males had a higher mean arm-span (173.6 ± 7.6 cm) and height (163.6 ± 6.8 cm) when compared to females (arm-span: 156.8 ± 6.9 cm; height: 150.1 ± 5.6 cm). The correlation coefficient was about 0.8 for both sexes, and this was statistically significant.
Similar findings were reported in the study by Goswami et al. in elderly population of urban colony of Delhi in 2018. In this study, the overall regression coefficient for males was 0.73 and that in females was 0.70, both were statistically significant (P < 0.001). Strong correlation between arm-span and height was reported for both males and females in this study.
In the study in Wonogiri district of Central Java, Indonesia, among 136 elderly persons of age 60–69 years, Pertiwi et al., in 2018, reported strong positive correlation between arm-span and height in men (P < 0.001; r = 0.886) and (P < 0.001; r = 0.992) in women. In the study on Indonesian elderly persons by Fatma et al., in 2010, in Depok city, West Java province, Indonesia, arm-span had the strongest correlation with the height (r = 0.883) as compared to knee height and sitting height.
In the study by Quanjer et al. in 2014, arm-span to height ratio varied nonlinearly with age. It was reported that estimating standing height from arm-span is to be preferred because it is more accurate and leads to low level of misclassifications for abnormally low forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC or restrictive pattern, rendering this approach clinically useful. Data from nine different countries were analyzed.
In the study by Blankson et al. in 2012, carried out among elderly persons (60–92 years), in rural areas of Ashanti region of Ghana, the body mass index calculated from height was found to be positively strongly correlated with body mass index calculated from arm-span (r = 0.999, P < 0.001).
In the study by Nygaard et al., in 2008, among hospital residents of Bergen, Norway, there was significant correlation between arm-span and height (r = 0.75, P < 0.001) and was considered to be a reliable substitute for height in hospital residents (age: 54–96 years of age).
Chilima et al. conducted a study in Lilongwe, Malawi in 1998 among people of age 55–94 years. In the study, height was estimated by measuring arm-span in kyphotic participants. Regression equations were derived from data of nonkyphotic participants. Arm-span exceeded height in both sexes significantly. Body mass index was calculated from arm-span for kyphotic participants. In 1996, Rabe et al. conducted a study in Central Jakarta, Indonesia, among elderly persons (60–69 years). The correlation coefficient between arm-span and height in males and females were 0.81 and 0.83 (P < 0.001), respectively.
All the above studies show strong positive correlation between height and arm-span in elderly persons. Hence, all studies conclude similarly as our study.
This was a community-based study and simple random sampling was used. The response rate was high. However, the findings are limited to a rural area of North India. In cases of joint stiffness, chest deformities, contractures, and limb deformities, measurement of arm-span is not possible, making the proxy measurement infeasible as height.
| Conclusion|| |
The present study has similar findings like previous other studies. This reports that arm-span and height have strong correlations. Substituting height with arm-span will be a good way for calculating body mass index for assessment of nutritional status and other parameters in elderly persons.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Shahar S, Pooy NS. Predictive equations for estimation of stature in Malaysian elderly people. Asia Pac J Clin Nutr 2003;12:80-4.
Mohanty SP, Babu SS, Nair NS. The use of arm span as a predictor of height: A study of South Indian women. J Orthop Surg (Hong Kong) 2001;9:19-23.
Datta Banik S. Arm span as a proxy measure for height and estimation of nutritional status: A study among Dhimals of Darjeeling in West Bengal India. Ann Hum Biol 2011;38:728-35.
Kant S, Misra P, Gupta S, Goswami K, Krishnan A, Nongkynrih B, et al.
The Ballabgarh health and demographic surveillance system (CRHSP-AIIMS). Int J Epidemiol 2013;42:758-68.
Kalaiselvi S, Arjumand Y, Jayalakshmy R, Gomathi R, Pruthu T, Palanivel C. Prevalence of under-nutrition, associated factors and perceived nutritional status among elderly in a rural area of Puducherry, South India. Arch Gerontol Geriatr 2016;65:156-60.
Jamir L, Kalaivani M, Nongkynrih B, Misra P, Kumar Gupta S. Relationship between arm span and height among elderly persons in a rural area of Ballabgarh, Haryana. Indian J Med Spec 2013;4:24-53.
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.
] [Full text]
Pertiwi J, Kartasurya MI, Lukmono DT, Setyawan H, Martini M. A calculating actual stature of elderly through arm span and knee height measurements. Health Notions 2018;2:265-70.
Quanjer PH, Capderou A, Mazicioglu MM, Aggarwal AN, Banik SD, Popovic S, et al.
All-age relationship between arm span and height in different ethnic groups. Eur Respir J 2014;44:905-12.
Blankson B, Hall A. The anthropometric status of elderly women in rural Ghana and factors associated with low body mass index. J Nutr Health Aging 2012;16:881-6.
Nygaard HA. Measuring body mass index (BMI) in nursing home residents: The usefulness of measurement of arm span. Scand J Prim Health Care 2008;26:46-9.
Chilima DM, Ismail SJ. Anthropometric characteristics of older people in rural Malawi. Eur J Clin Nutr 1998;52:643-9.
Rabe B, Thamrin MH, Gross R, Solomons NW, Schultink W. Body mass index of the elderly derived from height and from armspan. Asia Pac J Clin Nutr 1996;5:79-83.
[Figure 1], [Figure 2]
[Table 1], [Table 2]