Comparison of the performance of different anthropometric indicators,malnutrition,and sarcopenia for poststroke frailty in ischemic stroke

Abstract

Objective

This study explored the correlation between different nutritional indicators and poststroke frailty (PSF), and compared the receiver operating characteristic curve of different nutritional indexes for PSF.

Methods

This cross-sectional study enrolled 266 adults with acute ischemic stroke. Frailty was assessed using the FRAIL scale. Nutritional status was assessed using Mini Nutritional Assessment Short Form (MNA-SF) and Nutritional Risk Screening 2002 (NRS2002); sarcopenia risk was evaluated by SARC-F. Anthropometric measures included Body Mass Index (BMI), Handgrip Strength (HGS), Triceps Skinfold Thickness (TST), Mid-Upper Arm Circumference (MUAC), Calf Circumference (CC), Weight-Adjusted Waist Index (WWI), and 4-Meter Walk Test (4-MWT). Logistic regression analysis was performed to analyze factors related to PSF, and receiver operating characteristic curve analysis was also used to compare the performance of these variables.

Results

The frailty group (n = 89) had significantly lower values for HGS, 4-MWT speed, TST, MUAC, CC, albumin, and MNA-SF, but higher SARC-F and NRS2002 scores (all P < 0.05). Four indicators showed AUC > 0.65: MNA-SF (AUC = 0.70), SARC-F (AUC = 0.67), CC (AUC = 0.67), TST (AUC = 0.66). In elderly patients (≥65 years, n = 134), CC achieved the highest AUC (0.71). Logistic regression in separate models (each adjusted for age, gender, ADL, NIHSS, and stroke history) showed that higher MNA-SF, CC, TST, and 4-MWT as protective factors, while elevated SARC-F and NRS2002 were risk factors (all P < 0.05).

Conclusions

MNA-SF, SARC-F, and CC are effective PSF predictors, with CC optimal in elderly patients. Integrating these tools could optimize frailty risk stratification, guiding targeted nutrition/resistance training to mitigate post-stroke frailty.