Screening for Pre-Frailty Using Phase Angle Derived from Bioelectrical Impedance Analysis in Community-Dwelling Older Adults.

Abstract

Background/Objectives: To evaluate the utility of phase angle (PhA) derived from bioelectrical impedance analysis as a screening indicator for pre-frailty in community-dwelling older adults. Methods: This cross-sectional study included 171 participants (36 men and 135 women) in Japan in 2023. PhA at 50 kHz was measured using bioelectrical impedance analysis and evaluated as a potential screening indicator for pre-frailty. Assessments included body composition, physical function tests (maximum walking speed, Timed Up and Go (TUG), grip strength, knee extension strength, and one-leg stance time with eyes open), cognitive function (MoCA-J), and the Motor Fitness Scale (MFS), a questionnaire assessing physical function, along with the Kihon Checklist (KCL). Frailty status was defined using KCL scores (4-7: pre-frailty; ≥8: frailty), and participants were classified into robust and pre-frail/frail groups. Results: PhA was significantly correlated with physical function measures, including grip strength (r = 0.54, p < 0.01), MFS (r = 0.36, p < 0.01), maximum walking speed (r = 0.20, p < 0.05), knee extension strength (r = 0.16, p < 0.05), and TUG (r = -0.17, p < 0.05). In women, logistic regression analysis showed that PhA was independently associated with pre-frailty (age-adjusted odds ratio: 2.38; 95% CI: 1.08-5.23; p < 0.05). ROC analysis yielded an area under the curve of 0.65 (95% CI: 0.56-0.74), indicating modest discriminative ability. Age-adjusted cutoff values of PhA were 4.19° and 4.74°, corresponding to points prioritizing sensitivity and specificity, respectively. Conclusions: PhA is associated with physical function and may serve as a simple, non-invasive indicator for identifying pre-frailty in community settings. However, given its modest discriminative ability, PhA alone may not be sufficient as a standalone screening tool and should be used in combination with other clinical indicators for clinical application.