Evaluating the role of toe grip strength and anthropometric measures in diagnosing sarcopenia: A predictive model for middle-aged and older adults in Taiwan.

Background: Sarcopenia, characterized by the loss of muscle mass and strength, is a major health concern among older adults, contributing to disability and mortality. Early identification is crucial for timely intervention. This study evaluated the role of toe grip strength (TGS) for diagnosing sarcopenia and developed a simplified diagnostic algorithm that reduces reliance on tools such as bioelectrical impedance analysis and handgrip strength.

Methods: A total of 771 participants (591 women, 180 men), aged 50 and above, were enrolled from a health management center in Taiwan. Participants underwent measurements of calf circumference, handgrip strength, TGS, and body composition. Sarcopenia was defined by the EWGSOP2 criteria: low muscle strength and reduced appendicular skeletal muscle mass index. Logistic regression models assessed the predictive power of age, TGS, and anthropometric measurements for sarcopenia diagnosis.

Results: Sarcopenia was identified in 18.3 % of participants, with a higher percentage in women (18.8 %) than in men (16.7 %). In women, age, height, and calf circumference were strong predictors of sarcopenia, and when combined, resulted in a high AUROC of 0.885. TGS, used alone, had a moderate AUROC of 0.736 and did not significantly improve discrimination when added to the model. In men, TGS was a stronger predictor (AUROC of 0.825), but adding it to the model did not significantly improve diagnostic performance.

Conclusion: Age, height, and calf circumference are effective in identifying sarcopenia in women. TGS may provide insights into mobility but does not enhance sarcopenia diagnosis. Future research should validate these findings and explore novel diagnostic tools.