PW20 - ESTABLISHING FAT-FREE MASS INDEX CUT-OFFS FOR LOW MUSCLE MASS IN OLDER JAPANESE ADULTS: A GLIM-ORIENTED STUDY

PW20

ESTABLISHING FAT-FREE MASS INDEX CUT-OFFS FOR LOW MUSCLE MASS IN OLDER JAPANESE ADULTS: A GLIM-ORIENTED STUDY

K. Maeda^1,^2,*, S. Takagi³, S. Satake^2,^3,^4,⁵, S. Miyahara^2,⁵, Y. Ishida⁶, H. Akatsu⁵, H. Arai⁷

¹Nutrition Therapy Support Center, Aichi Medical University, Nagakute, ²Department of Geriatric Medicine, ³Department of Nutrition Management, ⁴Department of Frailty Research, ⁵Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, ⁶Department of Nutrition, Aichi Medical University Hospital, Nagakute, ⁷National Center for Geriatrics and Gerontology, Obu, Japan

Rationale: Determining low muscle mass is central to the Global Leadership Initiative on Malnutrition (GLIM) criteria, yet population-specific fat-free mass index (FFMI) cut-offs in Asia remain undefined. This study aimed to derive sex-specific FFMI thresholds in older Japanese outpatients and assess their clinical relevance.

Methods: In this prospective study, body composition was measured using bioelectrical impedance analysis to calculate FFMI, while dual-energy X-ray absorptiometry (DXA) was employed to assess the appendicular skeletal muscle index (ASMI). Receiver operating characteristic (ROC) curve analysis determined the optimal FFMI cut-offs, with reduced ASMI assessed by DXA (<7.0 kg/m² for men and <5.4 kg/m² for women) as the reference standard. Fall incidence was recorded over one year to evaluate the predictive value of the identified thresholds.

Results: A total of 696 participants (mean age 76.1 ± 7.4 years; 64.8% female) were enrolled. The optimal FFMI cut-offs were identified as <17.5 kg/m² for men and <14.4 kg/m² for women. The areas under the ROC curves were 0.926 (95% confidence interval [CI] 0.893–0.958) for men and 0.927 (0.902–0.953) for women, demonstrating high sensitivity and specificity in detecting low ASMI assessed by DXA. During the one-year follow-up, 25.9% of participants experienced at least one fall, and individuals with FFMI values below these cut-offs had a significantly increased risk of falling (odds ratio 1.49, 95%CI 1.01–2.20, p=0.044).

Conclusion: The newly defined FFMI thresholds offer an accessible alternative to DXA for the clinical application of GLIM in older Japanese adults. Early detection of malnutrition using these cut-offs may improve patient outcomes and reduce the risk of functional decline.

Disclosure of Interest: None declared