Transforming health systems in Vietnam's demographic transition: sarcopenia screening thresholds

Abstract

Introduction: Vietnam is undergoing a rapid demographic transition, with an increasingly aging population, posing new challenges for the healthcare system. Sarcopenia, an important contributor to frailty, functional decline, and disability in older adults, remains underdiagnosed due to the inconvenience of standardized assessment tools and the lack of validated anthropometric thresholds for specific populations. Methods: We conducted a cross-sectional study involving 416 community-dwelling individuals aged ≥60 years in Can Tho, Vietnam. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Receiver operating characteristic (ROC) curve analysis was used to identify optimal cutoff values for body mass index (BMI), calf circumference (CC), arm circumference (AC), and waist circumference (WC), with the Youden index applied to determine the most accurate thresholds. Results: The identified Vietnam-specific anthropometric thresholds for sarcopenia were: BMI ≤22.6 kg/m² for men and ≤21.2 kg/m² for women; CC ≤ 34.5 cm and ≤32.0 cm; AC ≤26.0 cm and ≤24.0 cm; WC ≤ 85.0 cm and ≤78.0 cm, respectively. These localized thresholds improved diagnostic accuracy, with BMI showing the strongest performance. CC and AC were less reliable among women, while WC offered high specificity but lower sensitivity. Conclusion: Our results endorse Vietnam-specific anthropometric cutoffs, particularly BMI, as a practical, cost-effective sarcopenia screening tool for under-resourced primary care. Integrating these thresholds into national guidelines can accelerate universal health coverage and sustainable aging by enabling early detection and community-based interventions to avert functional decline in Vietnam's aging population.