Objective To explore optimal cut-off value of mid-arm circumference (MAC) and calf circumference (CC) in malnutrition diagnosis and to provide references for nutritional assessment among elderly residents in China.

Methods Totally 868 community residents aged 60 years or older were recruited in 3 districts and a county in Ji′nan city of Shandong province and 2 districts of Shanghai city with stratified random cluster sampling; then, measurements of height, weight, MAC, CC, and blood pressure and detections for fasting blood glucose (FBG), total cholesterol (TC), and triglycerides (TG) were conducted among the elderly from September to December 2015. The differences in all the nutritional indicators and the validity of MAC and CC cut-off values were analyzed; receiver operating characteristics curve (ROC) and Youden index (YI) were adopted to identify optimal MAC and CC cut-off values for malnutrition assessment.

Results Among all the elderly surveyed, 60 (6.91%) were assessed as malnutrition. Compared to those in the female elderly, significantly higher mean MAC (29.79 ± 4.50 cm vs. 28.90 ± 4.20 cm) and CC (35.98 ± 4.51 cm vs. 34.41 ± 3.60 cm) were measured among the male elderly (both P < 0.01). In terms of malnutrition assessment, the optimal cut-off values of MAC and CC for were 28.10 cm and 32.60 cm for the male elderly and 25.10 cm and 31.10 cm for the female elderly, respectively. With those optimal MAC and CC cut-off values, the elderly individuals with malnutrition could be identified effectively and there was no significant difference in the assessment results compared to those using the body mass index (BMI) as the indicator.

Conclusion Mid-arm circumference and calf circumference could be used as valid indicators in evaluation of malnutrition among community elderly residents in China.