Arm circumference as a complementary tool in the clinical assessment of older adults in primary health care: An integrative review

The assessment of older adults in Primary Health Care requires simple, accessible instruments applicable in different care settings, including outpatient consultations, home visits, long-term care facilities, and follow-up of bedridden older adults or those with functional limitations. Anthropometric measurements such as weight, height, body mass index, and calf circumference are widely used, but may have limitations in older adults with postural instability, deformities, lower limb edema, venous insufficiency, amputations, or mobility difficulties. In this context, arm circumference (CB) emerges as a low-cost, quickly performed measurement with potential clinical utility. This study aimed to analyze, through an integrative literature review, the clinical applicability of CB as a complementary tool in the assessment of older adults, particularly regarding nutritional status, muscle mass, sarcopenia, dynapenia, frailty, functional status, and prognosis. A structured search was conducted in the PubMed/MEDLINE and SciELO databases on 25 June 2026, supplemented by manual searching and exploratory reading. Studies with available full text that assessed CB, upper arm circumference, arm-derived measurements, or equivalent terms used in the international literature, such as mid-upper arm circumference (MUAC) and arm circumference, in older adults or predominantly older populations were included. The final synthesis included 13 studies, encompassing cross-sectional designs, diagnostic studies, retrospective cohorts, and prospective cohorts. The findings were organized into four domains: nutritional status and malnutrition; sarcopenia and muscle mass; frailty, dynapenia, and functional status; prognosis and mortality. CB showed an association with nutritional status, correlation with body mass index (IMC), performance in malnutrition screening, utility as a proxy for reduced muscle mass within the Global Leadership Initiative on Malnutrition (GLIM) criteria, performance similar to that of calf circumference for sarcopenia screening in some studies, an association with dynapenia and frailty, and prognostic value in older adults with cardiovascular disease, heart failure, and hip fracture. It is concluded that CB should not be interpreted as a stand-alone substitute for established instruments, such as IMC, calf circumference, Mini Nutritional Assessment, grip strength, or comprehensive geriatric assessment. However, its simplicity, low cost, and applicability make this measurement relevant as a complementary tool for screening and longitudinal follow-up in Primary Health Care, especially when weight, height, or lower limb measurements are difficult to obtain or interpret. Keywords: Primary Health Care; Older Adults; Arm Circumference; Nutritional Assessment; Sarcopenia.