Determination of Hand Grip Strength Cut-Off Values for Malnutrition Risk Screening Among Elderly Patients in Primary Care Units
VOLUME 23, 2026
The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review
VOLUME 6, 2023
Parinya Pawenawan, Kod Phithakwongrojn, Tatree Bosittipichet, Thanakamon Leesri
Abstract
Background: According to the European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines, the Mini Nutritional Assessment (MNA) is recommended for screening malnutrition in the elderly1. However, the MNA may have limitations regarding the time required for administration and the reliance on the elderly patient's memory.
Objective: To determine the optimal cut-off values for hand grip strength (HGS) to identify the risk of malnutrition and to investigate risk factors associated with malnutrition in elderly patients aged over 60 years in a primary care setting.
Methods: A cross-sectional study was conducted involving 367 elderly participants (164 males, 203 females). Data collection included hand grip strength measurement using a dynamometer and malnutrition risk screening using the MNA.
Results: The prevalence of malnutrition risk was 13.4% in males and 25.1% in females. The optimal HGS cut-off values associated with malnutrition risk were identified as 24.5 kgF for males (Sensitivity 72.7%, Specificity 92.3%) and 19.1 kgF for females (Sensitivity 80.4%, Specificity 78.9%). Significant risk factors associated with malnutrition risk included Body Mass Index (BMI) < 18.5 kg/m² (p < 0.001), diabetes mellitus (p = 0.021), heart disease (p = 0.021), and depression (p = 0.004).
Conclusion: The optimal HGS cut-off values for screening malnutrition risk are 24.5 kgF for males and 19.1 kgF for females. These values are suitable for use in screening elderly patients within primary care units.
Keywords :
Hand Grip Strength; Cut-off Values; Malnutrition Risk Screening; Elderly Patients; Primary Care Units.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Abstract
Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords :
Diabetic foot ulcer, angiosome, angioplasty