Utilization of arm span instead of height in body mass index calculation in elderly subjects

Dear editorWe read with interest the article by Falsarella et al.1 The authors investigated the relationship between body composition and frailty in community-dwelling elderly individuals aged 65 years or older. The findings of this study have considerable importance in terms of evolving preventive, diagnostic, and treatment measures for frailty in the elderly population. We would like to make a comment on this well-designed study. For calculating body mass index (BMI), using arm span instead of height would be more accurate.2 Conditions such as kyphosis and asymptomatic vertebral fractures are commonly seen in elderly individuals (especially in frail ones), and calculation of BMI using height may result in overestimation of BMI in these circumstances. In this way, subjects with low BMI may be considered to have normal BMI, and this may result in underestimation of malnutrition, which is an important contributor to frailty phenotype.