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Boteta-Gomes MI, Aibar-Almazán A, Hita-Contreras F, de Loureiro NEM, Brandão-Loureiro VAF. Cross-Cultural Adaptation and Validation of the Portuguese Version of the SARC-F in Community-Dwelling Older Adults. Diagnostics (Basel) 2024; 14:1096. [PMID: 38893623 PMCID: PMC11172345 DOI: 10.3390/diagnostics14111096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/07/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
(1) Background: The goal of this study was to analyze the reliability and validity of the Portuguese version of the SARC-F in older adults. (2) Methods: A total of 100 participants (77.1 ± 7.36 years, 73% women) were included in the study. In a first phase, the Portuguese SARC-F was adapted following the standardized forward-backward translation procedure, and internal consistency as well as inter-rater and test-retest reliability of the Portuguese SARC-F were analyzed. Secondly, clinical validation was evaluated by comparing the SARC-F total score with five operational definitions of sarcopenia and with other sarcopenia-related measurements. Discriminant validity, with respect to low muscle mass and strength and physical function were analyzed. (3) Results: The Portuguese SAR-F showed acceptable internal consistency (Cronbach α = 0.82), excellent inter-rater reliability (total score), and substantial to excellent test-retest reliability (ICC = 0.891 for the total score). Specificity ranged from 72.5% (FNIH) to 73.4 (IGWS), and negative predictive values went from 91.8% (EWGSOP1) to 97.3% (FNIH), but low sensitivity and positive predictive value were observed. The Portuguese SARC-F showed a moderate ability to discriminate people with low muscle strength (AUC = 0.78) and gait speed (AUC = 0.89). (4) Conclusions: The Portuguese SARC-F is a valid and reliable tool for ruling out sarcopenia in community-dwelling older adults and can discriminate between people with low handgrip strength and gait speed.
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Affiliation(s)
- Margarida Isabel Boteta-Gomes
- Department of Arts, Humanities and Sport, Polytechnic Institute of Beja, 7800-295 Beja, Portugal (N.E.M.d.L.)
- SPRINT—Sport Physical activity and health Research & INnovation CenTter, 7800-295 Beja, Portugal
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain
| | - Nuno Eduardo Marques de Loureiro
- Department of Arts, Humanities and Sport, Polytechnic Institute of Beja, 7800-295 Beja, Portugal (N.E.M.d.L.)
- SPRINT—Sport Physical activity and health Research & INnovation CenTter, 7800-295 Beja, Portugal
- ISAMB, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Vânia Azevedo Ferreira Brandão-Loureiro
- Department of Arts, Humanities and Sport, Polytechnic Institute of Beja, 7800-295 Beja, Portugal (N.E.M.d.L.)
- SPRINT—Sport Physical activity and health Research & INnovation CenTter, 7800-295 Beja, Portugal
- ISAMB, University of Lisbon, 1649-028 Lisbon, Portugal
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Iwasaki M, Shirobe M, Motokawa K, Hayakawa M, Miura K, Kalantar L, Edahiro A, Kawai H, Fujiwara Y, Ihara K, Watanabe Y, Obuchi S, Hirano H. Validation of self-reported articulatory oral motor skill against objectively measured repetitive articulatory rate in community-dwelling older Japanese adults: The Otassha Study. Geriatr Gerontol Int 2023; 23:729-735. [PMID: 37673795 DOI: 10.1111/ggi.14658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/20/2023] [Accepted: 08/22/2023] [Indexed: 09/08/2023]
Abstract
AIM To assess the validity of self-reported articulatory oral motor skill against objectively measured repetitive articulatory rate (oral diadochokinesis [oral-DDK]) as a gold standard index for articulatory oral motor skill in community-dwelling older Japanese adults. METHODS This cross-sectional study included 607 Japanese adults (mean age = 73.9 years). A single-item self-report questionnaire for articulatory oral motor skill was developed. Study participants completed a 1-month-interval test-retest protocol to assess reliability of the questionnaire, and the protocol was tested by the kappa statistic. Oral-DDK with /ta/ (i.e., the number of repetitions of the monosyllable /ta/ per second) was measured during the on-site examination. Low oral-DDK performance was defined as <5.2 times/s in men and <5.4 times/s in women. Oral-DDK performance, oral functions other than articulatory oral motor skill, and physical frailty were compared in the groups with and without self-reported low articulatory oral motor skill as determined by the response to the questionnaire. RESULTS Self-reported low articulatory oral motor skill was identified in 18.5% of the study population. The self-report questionnaire had good test-retest reliability, with a kappa statistic of 0.71. Self-reported low articulatory oral motor skill was significantly associated with a lower value of oral-DDK with /ta/ and a higher proportion of low oral-DDK performance, difficulties in chewing and swallowing, dry mouth, and physical frailty. Self-report had high specificity (83.1%) but low sensitivity (42.1%) for detecting low oral-DDK performance. CONCLUSIONS A single-item self-report questionnaire for articulatory oral motor skill had acceptable test-retest reliability and was associated with objectively measured articulatory oral motor skill. Geriatr Gerontol Int 2023; 23: 729-735.
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Affiliation(s)
- Masanori Iwasaki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Misato Hayakawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kazuhito Miura
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Lena Kalantar
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Yutaka Watanabe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Huang L, Shu X, Ge N, Gao L, Xu P, Zhang Y, Chen Y, Yue J, Wu C. The accuracy of screening instruments for sarcopenia: a diagnostic systematic review and meta-analysis. Age Ageing 2023; 52:afad152. [PMID: 37596923 DOI: 10.1093/ageing/afad152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 06/09/2023] [Indexed: 08/21/2023] Open
Abstract
OBJECTIVE This review aimed to summarise the diagnostic accuracy of screening tools for sarcopenia. METHODS We conducted a systematic review along with a critical appraisal of published studies on screening tools for sarcopenia. We assessed the measurement properties of screening instruments using the consensus-based standards for selecting health measurement instruments (COSMIN) checklist. We evaluated the risk bias of the included studies using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. The diagnostic test accuracy of instruments for sarcopenia was reported using sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR). RESULTS We screened 7,120 titles and abstracts; 42 studies including five screening tools for sarcopenia were included. The overall study quality assessed by the QUADAS-2 tool was moderate to good. Of the five screening tools, three instruments had specificities ≥85%: 92% [95% confidence interval (CI): 63-99%] for the SARC-F modified version, 87% (95% CI: 82-90%) for the SARC-F and 85% (95% CI: 77-90%) for the Ishii score. Three tools had sensitivity ≥75%, namely, MSRA 82% (95% CI: 69-90%), Ishii score 79% (95% CI: 62-89%) and U-TEST 76%. PLR higher than 5.0 were present for the Ishii score and SARC-F modified versions; the Ishii score also had the best NLR of 0.25 of all scales. CONCLUSION The MSRA and Ishii score had excellent sensitivity for sarcopenia screening at an early stage; SARC-F modified versions and Ishii score had superior specificity for sarcopenia diagnosis.
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Affiliation(s)
- Li Huang
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiaoyu Shu
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ning Ge
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Langli Gao
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ping Xu
- Department of Biomedical Engineering, Sichuan University Library, Chengdu, Sichuan Province, China
| | - Yu Zhang
- Department of Biomedical Engineering, Sichuan University Library, Chengdu, Sichuan Province, China
| | - Yu Chen
- Department of Applied Mechanics, Sichuan University, Chengdu, Sichuan Province, China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu Province, China
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Barreto de Lima A, Dos Santos Ribeiro G, Henriques-Neto D, Rúbio Gouveia É, Baptista F. Diagnostic performance of SARC-F and SARC-CalF in screening for sarcopenia in older adults in Northern Brazil. Sci Rep 2023; 13:11698. [PMID: 37474595 PMCID: PMC10359260 DOI: 10.1038/s41598-023-39002-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/18/2023] [Indexed: 07/22/2023] Open
Abstract
To compare the performance of SARC-F and SARC-CalF as screening tools for sarcopenia. Cross-sectional study with a convenience sample of 312 community-dwelling older people. Sarcopenia was defined as low handgrip strength (HGS) or low gait speed (GS ≤ 0.8 m/s). HGS was measured by dynamometry and GS by the 4-m walking speed test. For HGS, six criteria (C) were used to identify sarcopenia in men/women: CI: < 27 kg/16 kg; CII: < 35.5 kg/20.0 kg; CIII: grip over body mass index < 1.05/< 0.79; CIV: grip strength over total body fat < 1.66/< 0.65; CV: grip over bodyweight < 0.45/< 0.34; CVI: < 27 kg/16 kg and low skeletal muscle mass index (SMMI); CI and CVI defined according to the European Working Group on sarcopenia in older people and the rest according to the sarcopenia definition and outcomes Consortium. For sarcopenia screening, the SARC-F (≥ 4 points) and the SARC-CalF (≥ 11 points) were used. The kappa analysis revealed no agreement between the SARC-F and the various criteria for the identification of sarcopenia in men. The same lack of agreement was observed in women with some exceptions: CI = 0.161 ± 0.074, p = 0.020; GS = 0.209 ± 0.076, p = 0.003. Concerning the Cohen's kappa between the SARC-Calf and the reference criteria of sarcopenia, the following coefficients were observed as significant for women: CI = 0.201 ± 0.069, p = 0.003; CII = 0.186 ± 0.064, p = 0.005; GS = 0.273 ± 0.068, p = 0.0001; and for men: CII = 0.139 ± 0.053, p = 0.021; GS = 0.223 ± 0.099, p = 0.011. ROC curves revealed the SARC-Calf with acceptable discrimination and reasonable sarcopenia predictive capacity considering a cutoff value of 10.5 in both men (AUC: 67.5%, p = 0.022; Se = 52.9%; Sp = 76.8%) and women (AUC: 72.4%, p < 0.001; Se = 63%; Sp = 68.5%) concerning GS. The SARC-CalF performed better than the SARC-F for screening sarcopenia in the population ≥ 60 years of age in the Amazonas, measured through walking slowness.
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Affiliation(s)
- Alex Barreto de Lima
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal.
- Universidade do Estado do Amazonas, Amazonas, Brazil.
| | - Gustavo Dos Santos Ribeiro
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Duarte Henriques-Neto
- Research Center in Sports Sciences, Health Sciences and Human Development, University of Maia, Maia, Portugal
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, Funchal, Portugal
- LARSYS, Interactive Technologies Institute, Funchal, Portugal
| | - Fátima Baptista
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
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The Geriatric Nutritional Risk Index predicts sarcopenia in patients with cirrhosis. Sci Rep 2023; 13:3888. [PMID: 36890183 PMCID: PMC9995649 DOI: 10.1038/s41598-023-31065-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 03/06/2023] [Indexed: 03/10/2023] Open
Abstract
Patients with cirrhosis are at high risk for sarcopenia and malnutrition, which are associated with reduced quality of life and increased mortality. We investigated the relationship between the Geriatric Nutritional Risk Index (GNRI) and sarcopenia/gait speed and assessed the usefulness of the GNRI for predicting sarcopenia in patients with cirrhosis. We evaluated 202 patients with cirrhosis and divided them into three groups based on baseline GNRI values: low (L)-GNRI (< 94.0, n = 49), intermediate (I)-GNRI (between 94.0 and 109.5, n = 103), and high (H)-GNRI groups (> 109.5, n = 50). Sarcopenia was diagnosed according to the criteria of the Japan Society of Hepatology. The prevalence of sarcopenia and slow gait speed was the lowest in the H-GNRI group (8.0% and 26.0%, respectively) and the highest in the L-GNRI group (49.0% and 44.9%, respectively). They increased stepwise with a decline in the GNRI group (p < 0.001 and p = 0.05, respectively). The GNRI values were significantly and positively correlated with handgrip strength, skeletal muscle mass index, and gait speed. Multivariate analysis identified lower GNRI as an independent risk factor for sarcopenia. The optimal cutoff value of the GNRI for predicting sarcopenia was 102.1 (sensitivity/specificity, 0.768/0.630). The GNRI was significantly associated with sarcopenia and physical performance and could be a helpful screening tool for predicting sarcopenia in patients with cirrhosis.
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Kera T, Saida K, Higuchi D, Shinohara T, Onozawa H, Kawai H, Obuchi S. Utility of SARC-F in daycare facilities for older people. Geriatr Gerontol Int 2022; 22:889-893. [PMID: 36059047 DOI: 10.1111/ggi.14464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/18/2022] [Accepted: 07/26/2022] [Indexed: 11/29/2022]
Abstract
AIM SARC-F, a sarcopenia screening tool, has limited use but may be beneficial for detecting sarcopenia in frail older people. This study aimed to clarify the validity of the SARC-F questionnaire in older people. METHODS In this validation study, 74 (36 men; age, 81.9 ± 6.7 years, 38 women; age, 83 ± 6.2 years) community-dwelling older people who attended a daycare facility participated in our study. Participants completed the SARC-F and SARC-calf circumference (SARC-CalF) questionnaires, and their body composition, walk speed and grip strength were measured. Sarcopenia was determined using the Asian Working Group for Sarcopenia criteria, and the participants were divided into non-sarcopenia and sarcopenia groups. SARC-F and SARC-CalF scores were evaluated using receiver operating characteristic curve analysis for sarcopenia considering the area under the curve. Internal consistency was evaluated using Cronbach's alpha. RESULTS The prevalence of sarcopenia, defined by physical characteristics, was 60.0% in men and 48.1% in women. The area under the curve of the SARC-F for sarcopenia was 0.703 (95% confidence interval [CI]: 0.585-0.821, P = 0.001). Cronbach's alpha was 0.81, and the internal consistency was high. SARC-F had lower sensitivity (0.47; 95% CI: 0.31-0.64) but higher specificity (0.78; 95% CI: 0.60-0.89) than the sensitivity and specificity of SARC-CalF, respectively, and the sensitivity of SARC-F was higher than that reported in previous studies. CONCLUSION The SARC-F questionnaire is more sensitive in assessing sarcopenia in low-functioning populations and can be used as a screening tool for sarcopenia in long-term daycare facilities for older people rather than in community-based healthcare activities. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Takeshi Kera
- Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan.,Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kosuke Saida
- Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan
| | - Daisuke Higuchi
- Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan
| | - Tomoyuki Shinohara
- Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan
| | | | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Validation of the Italian Version of the SARC-F Questionnaire to Assess Sarcopenia in Older Adults. Nutrients 2022; 14:nu14122533. [PMID: 35745264 PMCID: PMC9228620 DOI: 10.3390/nu14122533] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 02/05/2023] Open
Abstract
Background: SARC-F is a simple sarcopenia screening tool. This study aimed to examine the validity of the Italian version of SARC-F. Methods: A total of 97 elderly individuals (37/60 males/females, 65 years and older) who met the study’s selection criteria were included. SARC-F was translated into the Italian language in a culturally responsive manner. The total score was calculated by adding the scores on the five items. The participants were divided into two groups according to the total score (SARC-F < 4 vs. SARC-F ≥ 4), and their associations with various factors (handgrip test, chair stand test, and Skeletal Muscle Index assessed by DXA) have been examined by gender. In addition, the tool’s validity was analyzed by comparing it with different international working group diagnostic criteria for sarcopenia. Results: The total prevalence of sarcopenia according to the SARC-F was 14.2% and, specifically, 12.8% among men and 14.3% in women. The sensitivity of the SARC-F was (male (M): 11−50% and female (F): 22−36%) medium-low compared with the European, international, and Asian criteria of sarcopenia; however, SARC-F showed a high specificity (M: 77.3−100% and F: 79.5−100%) and a moderate Cronbach’s alpha coefficient of (0.669 (CI95%: 0.358−0.830). The participants in the SARC-F ≥ 4 group had poorer handgrip for EWGSOP2 (p < 0.001) and chair stand (p < 0.001) than the participants in the SARC-F < 4 group. Conclusions: The Italian language version of SARC-F showed high specificity, moderate reliability, and good associations with other predictive tests. The Italian version of SARC-F appears to be a useful screening tool for the diagnosis of sarcopenia in Italian elderly populations.
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Janakiram C, Ayoob A, Neelamana S. Impact of oral frailty on general frailty in geriatric population: A scoping review. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2022. [DOI: 10.4103/jiaphd.jiaphd_91_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Zhou J, Li T, Chen X, Wang M, Jiang W, Jia H. Comparison of the Diagnostic Value of SARC-F and Its Three Modified Versions for Screening Sarcopenia in Chinese Community-Dwelling Older Adults. J Nutr Health Aging 2022; 26:77-83. [PMID: 35067707 DOI: 10.1007/s12603-021-1718-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Sarcopenia refers to age-related loss of skeletal muscle mass. SARC-F is a screening tool for sarcopenia with high specificity and relatively good overall diagnostic accuracy but with low sensitivity. This study evaluated the diagnostic utility of SARC-F and its three modified versions (SARC-CalF, SARC-F+AC, and SARC-CalF+AC) for screening sarcopenia in community-dwelling older adults. DESIGN Diagnostic accuracy study. SETTINGS AND PARTICIPANTS We screened sarcopenia of older adults (age ≥ 60 years) in three communities in 2020. The participants' information and anthropometric measurements were collected, respectively. METHODS The updated consensuses of AWGS2019 and the EWGSOP2 were applied as the reference standards. we performed sensitivity/specificity analyses and estimated the areas under the receiver operating characteristic curves (AUCs) of the four scales. RESULTS The prevalence of sarcopenia was 26.4% and 12.5% based on the AWGS2019 and EWGSOP2 criteria, respectively. The sensitivities/specificities of SARC-F, SARC-CalF, SARC-F+AC, and SARC-CalF+AC were 12.26%/95.59%, 47.17%/91.53%, 82.08%/68.47%, and 75.47%/83.73%, respectively, using the AWGS2019 criteria. Further, the corresponding AUCs of SARC-F, SARC-CalF, SARC-F+AC, and SARC-CalF+AC were 0.650 (95% confidence interval [CI]: 0.601-0.697), 0.811 (95% CI: 0.769-0.848), 0.801 (95% CI: 0.759-0.839), and 0.848 (95% CI: 0.809-0.881), respectively. Using the EWGSOP2 criteria, the sensitivities/specificities of SARC-F, SARC-CalF, SARC-F+AC, and SARC-CalF+AC were 20.00%/95.44%, 56.00%/86.61%, 70.00%/81.20%, and 80.00%/74.93%, respectively. The AUCs of SARC-F, SARC-CalF, SARC-F+AC, and SARC-CalF+AC were 0.706 (95% CI: 0.659-0.750), 0.799 (95% CI: 0.756-0.837), 0.815 (95% CI: 0.774-0.852), and 0.834 (95% CI: 0.794-0.869), respectively. CONCLUSIONS The modified versions of SARC-F+AC and SARC-CalF+AC, which have superior sensitivity, can be used to screen sarcopenia in community-dwelling older adults. SARC-CalF+AC had the highest overall diagnostic accuracy for screening sarcopenia among community-dwelling older adults.
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Affiliation(s)
- J Zhou
- Hong Jia, School of Public Health, Southwest Medical University, Luzhou City, Sichuan Province, China,
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Hanai T, Hiraoka A, Shiraki M, Sugimoto R, Taniki N, Hiramatsu A, Nakamoto N, Iwasa M, Chayama K, Shimizu M. Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan. J Clin Med 2021; 10:3448. [PMID: 34362231 PMCID: PMC8348368 DOI: 10.3390/jcm10153448] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/16/2021] [Accepted: 08/02/2021] [Indexed: 12/23/2022] Open
Abstract
Diagnosing sarcopenia is challenging. This multicenter cross-sectional study aimed to evaluate the utility of the SARC-F score system for identifying sarcopenia in patients with chronic liver disease (CLD). We enrolled 717 patients from five participating centers who completed the SARC-F between November 2019 and March 2021. Sarcopenia was diagnosed based on the Japan Society of Hepatology Working Group on Sarcopenia in Liver Disease Consensus. Muscle strength was estimated using a grip dynamometer, and muscle mass was assessed using computed tomography or bioelectrical impedance analysis. The association between SARC-F and sarcopenia was analyzed using a logistic regression model. The optimal SARC-F cutoff value for identifying sarcopenia was determined using receiver operating characteristic (ROC) curve analysis. Of the 676 eligible patients, 15% were diagnosed with sarcopenia. The SARC-F distribution was 0 points in 63% of patients, 1 point in 17%, 2 points in 7%, 3 points in 4%, and ≥4 points in 8%. The SARC-F items of "Strength" (odds ratio (OR), 1.98; 95% confidence interval (CI), 1.03-3.80) and "Falls" (OR, 2.44; 95% CI, 1.48-4.03) were significantly associated with sarcopenia. The SARC-F value of 1 point showed a higher discriminative ability for identifying sarcopenia than the 4 points that are conventionally used (p < 0.001), with an area under the ROC curve of 0.68, sensitivity of 0.65, specificity of 0.68, positive predictive value of 0.27, and negative predictive value of 0.92. SARC-F is useful for identifying patients with CLD who are at risk of sarcopenia.
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Affiliation(s)
- Tatsunori Hanai
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan; (M.S.); (M.S.)
| | - Atsushi Hiraoka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama 790-0024, Japan;
| | - Makoto Shiraki
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan; (M.S.); (M.S.)
| | - Ryosuke Sugimoto
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan; (R.S.); (M.I.)
| | - Nobuhito Taniki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; (N.T.); (N.N.)
| | - Akira Hiramatsu
- Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Science, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Nobuhiro Nakamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; (N.T.); (N.N.)
| | - Motoh Iwasa
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan; (R.S.); (M.I.)
| | - Kazuaki Chayama
- Collaborative Research Laboratory of Medical Innovation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Masahito Shimizu
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan; (M.S.); (M.S.)
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Dent E, Woo J, Scott D, Hoogendijk EO. Sarcopenia measurement in research and clinical practice. Eur J Intern Med 2021; 90:1-9. [PMID: 34238636 DOI: 10.1016/j.ejim.2021.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 06/04/2021] [Accepted: 06/06/2021] [Indexed: 12/15/2022]
Abstract
Sarcopenia is a disease related to accelerated loss of skeletal muscle and subsequent decline in functional capacity. It affects approximately 13% of the world's population aged over 60 years. Sarcopenia is primarily managed and prevented through a combination of exercise prescription combined with appropriate nutritional strategies. This review outlines diagnostic and case finding/screening tools for age-related (primary) sarcopenia used in research and clinical practice. Diagnostic tools critically reviewed include those of the: European Workgroup for Sarcopenia (EWGSOP) versions 1 and 2; Asian Working Group for Sarcopenia (AWGS) versions 1 and 2; Foundation for the National Institutes of Health (FNIH); and the Sarcopenia Definition and Outcomes Consortium (SDOC). Criteria used by diagnostic tools (muscle mass, muscle strength and physical functioning/performance) are also detailed. Case-finding tools include the SARC-F questionnaire, Ishii's formula and Goodman's screening grid. Additionally, this review discusses the strengths and weaknesses of each diagnostic and case-finding tool, and examines their ability to reliably predict adverse clinical outcomes and patient responses to potential therapies.
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Affiliation(s)
- Elsa Dent
- Torrens University Australia, 88 Wakefield St, Adelaide SA, 5000 Australia; Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne VIC, 3004 Australia.
| | - Jean Woo
- Chinese University of Hong Kong, The Chinese University of Hong Kong, Central Ave, Hong Kong.
| | - David Scott
- Deakin University, Melbourne VIC, 3004 Australia; Monash University, Wellington Rd, Clayton VIC, 3800 Australia.
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC - location VU University medical center, Amsterdam, the Netherlands.
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Piotrowicz K, Głuszewska A, Czesak J, Fedyk-Łukasik M, Klimek E, Sánchez-Rodríguez D, Skalska A, Gryglewska B, Grodzicki T, Gąsowski J. SARC-F as a case-finding tool for sarcopenia according to the EWGSOP2. National validation and comparison with other diagnostic standards. Aging Clin Exp Res 2021; 33:1821-1829. [PMID: 33506313 PMCID: PMC8249283 DOI: 10.1007/s40520-020-01782-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 12/22/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Sarcopenia is a potentially reversible condition, which requires proper screening and diagnosis. AIMS To validate a Polish version of sarcopenia screening questionnaire (SARC-F), and assess its clinical performance. METHODS Cross-sectional validation study in community-dwelling subjects ≥ 65 years of age. Diagnosis of sarcopenia was based on the 2018 2nd European Working Group on Sarcopenia in Older People (EWGSOP2) consensus. Hand grip and 4-m gait speed were measured, and the Polish version of SARC-F was administered. RESULTS The mean (SD) age of 73 participants (21.9% men) was 77.8 (7.3) years. Seventeen participants (23.3%) fulfilled the EWGSOP2 criteria of sarcopenia, and 9 (12.3%) criteria for severe sarcopenia. Fourteen (19.2%) participants fulfilled the SARC-F criteria for clinical suspicion of sarcopenia. The Cronbach's alpha coefficient for internal was 0.84. With EWGSOP2 sarcopenia as a gold standard, the sensitivity of SARC-F was 35.3% (95% CI 14.2-61.7, p = 0.33), specificity was 85.7% (95% CI 73.8-93.6, p < 0.0001). The corresponding positive and negative predictive values were 42.9% (p = 0.79) and 81.4% (p < 0.0001), respectively. The probability of false-positive result was 14.3% (95% CI 6.4-26.2, p < 0.0001) and the probability of false-negative result was 64.7% (95% CI 38.3-85.8, p = 0.33). Overall the predictive power of SARC-F was low (c-statistic 0.64). DISCUSSION SARC-F is currently recommended for sarcopenia case finding in general population of older adults. However, its sensitivity is low, despite high specificity. CONCLUSIONS At present SARC-F is better suited to rule out sarcopenia then to case-finding. Further refinement of screening for sarcopenia with the use of SARC-F seems needed.
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Affiliation(s)
- Karolina Piotrowicz
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Anna Głuszewska
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Joanna Czesak
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
- Department of Clinical Rehabilitation, University School of Physical Education, Kraków, Poland
| | - Małgorzata Fedyk-Łukasik
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Ewa Klimek
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Dolores Sánchez-Rodríguez
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
- Geriatrics Department, Rehabilitation Research Group, Hospital Del Mar Medical Research Institute (IMIM), Universitat Pompeu Fabra, Barcelona, Spain
| | - Anna Skalska
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Barbara Gryglewska
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Medical College, Jagiellonian University, Ul. Jakubowskiego 2, 30-688, Kraków, Poland.
- Department of Internal Medicine and Geriatrics, University Hospital, Kraków, Poland.
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13
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Voelker SN, Michalopoulos N, Maier AB, Reijnierse EM. Reliability and Concurrent Validity of the SARC-F and Its Modified Versions: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2021; 22:1864-1876.e16. [PMID: 34144049 DOI: 10.1016/j.jamda.2021.05.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 04/13/2021] [Accepted: 05/10/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Sarcopenia, being prevalent in up to 40% of older adults, is associated with adverse health outcomes. The international sarcopenia guidelines recommend screening for sarcopenia using the SARC-F. A previous meta-analysis (2017) reported poor validity of the SARC-F among community-dwelling older adults. Since then, modified SARC-F versions were developed and new sarcopenia definitions were published, including the SARC-F for case-finding. This systematic review and meta-analysis aimed to assess the reliability of the SARC-F and its concurrent validity to identify sarcopenia. DESIGN Systematic review and meta-analyses. SETTING AND PARTICIPANTS Adults (all ages) from any study population. METHODS A systematic search was conducted in MEDLINE, EMBASE, Cochrane, and CINAHL (January 1, 2013, to April 6, 2020). Articles were included if they reported on the reliability and/or concurrent validity of the (modified) SARC-F. No restrictions were applied for sex, age, study population, or sarcopenia definition. Reliability measures included inter-rater reliability, test-retest reliability, and internal consistency. Meta-analyses were performed for concurrent validity. RESULTS The 29 included articles included 21,855 individuals (mean age of 63.3±14.6 years, 61.3% females) among community-dwelling (n = 16), geriatric inpatient (n = 5), geriatric outpatient (n = 2), nursing home (n = 2), and long-term care (n = 1) populations. The SARC-F had good (2/4 articles) to excellent (2/4 articles) inter-rater reliability, moderate (1/6 articles) to good (5/6 articles) test-retest reliability, and low (4/8 articles) to high (4/8 articles) internal consistency. The SARC-F had low to moderate sensitivity (28.9%-55.3%) and moderate to high specificity (68.9%-88.9%) according to the European Working Group on Sarcopenia in Older People (EWGSOP; n = 13), revised EWGSOP definition (EWGSOP2; n = 6), Asian Working Group for Sarcopenia (AWGS; n = 13), Foundation for the National Institutes of Health (FNIH; n = 8), International Working Group on Sarcopenia (IWGS; n = 9), and Society on Sarcopenia, Cachexia and Wasting Disorders (n = 2). The SARC-CalF had low to moderate sensitivity (45.9%-57.2%) and high specificity (87.7%-91.3%) according to the EWGSOP (n = 5), AWGS (n = 4), FNIH (n = 3), and IWGS (n = 3). CONCLUSIONS AND IMPLICATIONS Despite the good reliability of the SARC-F, its low to moderate sensitivity and moderate to high specificity make it nonoptimal to use for sarcopenia screening. It is recommended to apply the diagnostic criteria for sarcopenia without screening.
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Affiliation(s)
- Stefanie N Voelker
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Nikolaos Michalopoulos
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Melbourne, Victoria, Australia; Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Healthy Longevity Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore.
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Melbourne, Victoria, Australia; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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14
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Dedeyne L, Reijnierse EM, Pacifico J, Kay JE, Maggs P, Verschueren S, Tournoy J, Gielen E, Lim WK, Maier AB. SARC-F Is Inaccurate to Identify Geriatric Rehabilitation Inpatients at Risk for Sarcopenia: RESORT. Gerontology 2021; 68:252-260. [PMID: 34062544 DOI: 10.1159/000516117] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/16/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Sarcopenia is highly prevalent in geriatric rehabilitation inpatients; screening using the Strength, Assistance in walking, Rise from a chair, Climb stairs, Falls history questionnaire (SARC-F) has been recommended. This study assessed the diagnostic accuracy of the SARC-F in identifying sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP), EWGSOP2, and Asian Working Group for Sarcopenia (AWGS) definitions in geriatric rehabilitation inpatients. METHODS REStOring health of acutely unwell adulTs (RESORT) is an observational, longitudinal cohort of geriatric rehabilitation inpatients. The SARC-F was completed for 2 time-points, status at preadmission (1 month before admission) and at admission; a score ≥4 was considered at risk for sarcopenia. Muscle mass (bioelectrical impedance analysis), handgrip strength (handheld dynamometry), and gait speed (4-m walk test) were measured at admission. Diagnostic accuracy was determined by sensitivity, specificity, and area under the curve (AUC). RESULTS The sarcopenia prevalence (n = 290, median age 84.0 years [IQR 79.0-89.0], 56.9% female) was 40.3% (EWGSOP1), 25.4% (EWGSOP2), and 38.8% (AWGS). For preadmission and admission status, respectively, the SARC-F identified 67.9 and 82.1% (EWGSOP), 66.0 and 81.0% (EWGSOP2), and 67.5 and 81.6% (AWGS) inpatients at risk for sarcopenia. The SARC-F showed fair sensitivity (67-74%), poor specificity (32-37%), and poor AUC (0.411-0.474) to identify inpatients at risk for sarcopenia at preadmission status, and fair-good sensitivity (79-84%), poor specificity (17-20%), and poor AUC (0.401-0.432) to identify inpatients at risk for sarcopenia at admission, according to EWGSOP, EWGSOP2, and AWGS definitions. CONCLUSION The SARC-F showed poor diagnostic accuracy in identifying sarcopenia in geriatric rehabilitation inpatients. Assessment of sarcopenia is recommended without screening.
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Affiliation(s)
- Lenore Dedeyne
- Department of Public Health and Primary Care, Gerontology & Geriatrics, KU Leuven, Leuven, Belgium.,Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Jacob Pacifico
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Jacqueline E Kay
- Department of Allied Health, Physiotherapy, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Patricia Maggs
- Department of Allied Health, Physiotherapy, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Sabine Verschueren
- Department of Rehabilitation Sciences, Musculoskeletal revalidation, KU Leuven, Leuven, Belgium
| | - Jos Tournoy
- Department of Public Health and Primary Care, Gerontology & Geriatrics, KU Leuven, Leuven, Belgium.,Department of Geriatric Medicine, UZ Leuven, Leuven, Belgium
| | - Evelien Gielen
- Department of Public Health and Primary Care, Gerontology & Geriatrics, KU Leuven, Leuven, Belgium.,Department of Geriatric Medicine, UZ Leuven, Leuven, Belgium
| | - Wen Kwang Lim
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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15
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Saitsu A, Iwazu Y, Matsushita H, Hayashi H, Mizuhashi Y, Kotani K. Low urine pH associated with sarcopenia in the elderly: A multi-center observational study. Medicine (Baltimore) 2021; 100:e26114. [PMID: 34032755 PMCID: PMC8154474 DOI: 10.1097/md.0000000000026114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/10/2021] [Indexed: 01/04/2023] Open
Abstract
The pathophysiology of sarcopenia is complex and must be further explored. While metabolic acidosis may be a risk factor for sarcopenia, it remains unclear whether acidic urine is related to sarcopenia. The purpose of the present study was to investigate the association between sarcopenia and urine pH in the elderly.An elderly population (n = 123 [male = 46]; mean age = 81.7 years) was classified into 2 groups based on the sarcopenia status according to their strength, requirement of assistance in walking, their ability to rise from a chair their ability to climb stairs, and their history of falls. Urinalysis was measured using dipstick tests.The sarcopenia group (n = 32) was significantly older, had less exercise habit and showed a lower urine pH (mean pH = 5.5) in comparison to the nonsarcopenia group (mean pH = 6.2, P < .01). A multivariate analysis that was adjusted for age, male sex, body mass index, uro-renal variables and exercise habit revealed that urine pH (odds ratio, 0.43; 95% confidence interval, 0.22-0.85, P = .02), age and less exercise habit were independently and significantly associated with sarcopenia.The findings of the present study suggest a potential association between metabolic acidosis and the pathophysiology of sarcopenia in the elderly. As urine pH is a simple biomarker that can be obtained using dipstick tests, it is therefore expected to be helpful for detecting sarcopenia in the clinical setting.
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Affiliation(s)
- Akihiro Saitsu
- Division of Community and Family Medicine, Center for Community Medicine
| | - Yoshitaka Iwazu
- Division of Anti-aging Medicine, Center for Molecular Medicine, Jichi Medical University, Shimotsuke-City, Tochigi
| | - Haruka Matsushita
- Department of Internal Medicine, Kamiamakusa General Hospital, Ryugatake-Town, Kamiamakusa-City
| | - Hirotaka Hayashi
- Department of Internal Medicine, Kamiamakusa General Hospital, Ryugatake-Town, Kamiamakusa-City
| | - Yumiko Mizuhashi
- Department of Internal Medicine, Oguni Municipal Hospital, Oguni-Town, Aso-Country, Kumamoto, Japan
| | - Kazuhiko Kotani
- Division of Community and Family Medicine, Center for Community Medicine
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Krzymińska-Siemaszko R, Deskur-Śmielecka E, Styszyński A, Wieczorowska-Tobis K. Polish Translation and Validation of the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire to Assess Nutritional and Non-Nutritional Risk Factors of Sarcopenia in Older Adults. Nutrients 2021; 13:1061. [PMID: 33805185 PMCID: PMC8064359 DOI: 10.3390/nu13041061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/06/2021] [Accepted: 03/10/2021] [Indexed: 12/25/2022] Open
Abstract
A simple, short, cheap, and reasonably sensitive and specific screening tool assessing both nutritional and non-nutritional risk factors for sarcopenia is needed. Potentially, such a tool may be the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire, which is available in a seven-item (MSRA-7) and five-item (MSRA-5) version. The study's aim was Polish translation and validation of both MSRA versions in 160 volunteers aged ≥60 years. MSRA was validated against the six sets of international diagnostic criteria for sarcopenia used as the reference standards. PL-MSRA-7 and PL-MSRA-5 both had high sensitivity (≥84.9%), regardless of the reference standard. The PL-MSRA-5 had better specificity (44.7-47.2%) than the PL-MSRA-7 (33.1-34.7%). Both questionnaires had similarly low positive predictive value (PL-MSRA-5: 17.9-29.5%; PL-MSRA-7: 14.4-25.2%). The negative predictive value was generally high for both questionnaires (PL-MSRA-7: 89.8-95.9%; PL-MSRA-5: 92.3-98.5%). PL-MSRA-5 had higher accuracy than the PL-MSRA-7 (50.0-55% vs. 39.4-45%, respectively). Based on the results, the Mini Sarcopenia Risk Assessment questionnaire was successfully adopted to the Polish language and validated in community-dwelling older adults from Poland. When compared with PL-MSRA-7, PL-MSRA-5 is a better tool for sarcopenia risk assessment.
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Affiliation(s)
- Roma Krzymińska-Siemaszko
- Department of Palliative Medicine, Poznan University of Medical Sciences, 61-245 Poznan, Poland; (E.D.-Ś.); (A.S.); (K.W.-T.)
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Lu JL, Ding LY, Xu Q, Zhu SQ, Xu XY, Hua HX, Chen L, Xu H. Screening Accuracy of SARC-F for Sarcopenia in the Elderly: A Diagnostic Meta-Analysis. J Nutr Health Aging 2021; 25:172-182. [PMID: 33491031 DOI: 10.1007/s12603-020-1471-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sarcopenia is an age-related disease, which is characterized by a decline in muscle mass and function. It is one of the most important health issues in the elderly and often leads to a high rate and variety of adverse outcomes. OBJECTIVES To evaluate the screening accuracy of SARC-F for sarcopenia in the elderly. DESIGN We conducted a meta-analysis using articles available in 6 databases including PubMed (Medline), Web of Science, Embase, Cochrane Controlled Register of Trials (CENTRAL), China Knowledge Resource Integrated Database (CNKI), and Wanfang databases from inception to May 2020. PARTICIPANTS Adults aged 60 years and older. MEASUREMENTS Sarcopenia was defined by EWGSOP2, EWGSOP, AWGS, FNIH and IWGS. Two authors independently extracted data based on predefined criteria. Where data were available we calculated pooled summary estimates of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and their 95% confidence interval (CI) based on different criteria using the hierarchical logistic regression modeling including bivariate modeling and hierarchical summary receiver operating characteristic (HSROC) modeling. RESULTS We included 20 studies, with the prevalence of sarcopenia ranging from 6.42% to 21.56%. The number of the literatures using EWGSOP, EWGSOP2, AWGS, IWGS and FNIH as diagnostic criteria was 13, 4, 13, 8, 7, respectively. Bivariate analysis yielded a pooled sensitivity of 32% (95%CI:19%-47%), 77% (95%CI: 49%-92%), 27% (95%CI: 16%-42%), 39% (95%CI: 27%-52%), 35% (95%CI: 23%-49%) and a pooled specificity of 86% (95%CI:77%-92%), 63% (95%CI: 43%-79%), 91% (95%CI: 85%-95%), 86% (95%CI: 76%-92%), 89% (95%CI: 81%-93%), respectively. The area under the HSROC curve were 0.68 (95%CI: 0.64-0.72), 0.75 (95%CI: 0.71-0.78), 0.73 (95%CI: 0.69-0.77), 0.67 (95%CI: 0.62-0.71), 0.70 (95%CI: 0.65-0.73), respectively. CONCLUSIONS The screening accuracy of SARC-F was various based on different diagnostic criteria. There were some limitations for SARC-F, however, considering the higher practicability and specificity for screening sarcopenia in practice, SARC-F was still an effective screening tool for sarcopenia in the elderly. And the screening accuracy of SARC-F needs further exploration when EWGSOP2 is applied as diagnostic criteria and geriatric inpatients are the target participants.
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Affiliation(s)
- J-L Lu
- Qin Xu, Professor of Nursing, School of Nursing, Nanjing Medical University, 140 Hanzhong Road, Gulou District, Nanjing, China (211166), E-mail:
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18
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Krzymińska-Siemaszko R, Deskur-Śmielecka E, Kaluźniak-Szymanowska A, Styszyński A, Wieczorowska-Tobis K. Polish version of SARC-F to assess sarcopenia in older adults: An examination of reliability and validity. PLoS One 2020; 15:e0244001. [PMID: 33347486 PMCID: PMC7751882 DOI: 10.1371/journal.pone.0244001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION SARC-F is a quick questionnaire recommended as a screening tool for sarcopenia. The aim of the study was to translate, adapt, and validate the Polish version of the SARC-F for community-dwelling older adults in Poland. MATERIALS AND METHODS We included 160 Polish volunteers aged ≥ 60 years (44% of men). The Polish version of SARC-F was adapted following standardized forward-backward translation procedure. SARC-F was validated against the six sets of diagnostic criteria as the reference standards [developed independently by European Working Group on Sarcopenia in Older People1 (EWGSOP1), European Working Group on Sarcopenia in Older People2 (EWGSOP2), Foundation for the National Institutes of Health (FNIH) Sarcopenia Project, Asia Working Group for Sarcopenia (AWGS), the International Working Group for Sarcopenia (IWGS), and Society on Sarcopenia, Cachexia and Wasting Disorders (SCWD)]. RESULTS SARC-F score ≥ 4 points was observed in 18.8% of the study population. Cronbach's alpha was 0.70. The sensitivity of SARC-F varied from 33.3% to 50.0% depending on the diagnostics criteria used, while the specificity was about 85%. Positive predictive value (PPV) was low (about 30%) for five out of six sets of the diagnostic criteria used (EWGSOP2, IWGS, AWGS, FNIH, and SCWD), while the negative predictive value (NPV) was generally high (>88%). The area under the ROC curves (AUC) was 0.652-0.728. SARC-F had the largest AUC against FNIH criteria (0.728), indicating a moderate diagnostic accuracy. Similar results were found for EWGSOP2 and IWGS criteria. The AUC values were below 0.7 for AWGS, SCWD, and EWGSOP1 criteria. CONCLUSION Based on the results, the Polish version of SARC-F shows excellent reliability and good internal consistency. High specificity and high NPV make SARC-F a useful tool to rule-out sarcopenia with high accuracy in community-dwelling older adults, independently of the diagnostic criteria used.
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Affiliation(s)
| | - Ewa Deskur-Śmielecka
- Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Arkadiusz Styszyński
- Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland
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19
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Nguyen TN, Nguyen AT, Khuong LQ, Nguyen TX, Nguyen HTT, Nguyen TTH, Hoang MV, Pham T, Nguyen TN, Vu HTT. Reliability and Validity of SARC-F Questionnaire to Assess Sarcopenia Among Vietnamese Geriatric Patients. Clin Interv Aging 2020; 15:879-886. [PMID: 32606628 PMCID: PMC7293385 DOI: 10.2147/cia.s254397] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/01/2020] [Indexed: 12/18/2022] Open
Abstract
Background The SARC-F questionnaire has been developed as a rapid diagnostic test that can be used to screen for sarcopenia. Aim To investigate the reliability and validity of the Vietnamese version of SARC-F as a screening tool for sarcopenia in older patients in Vietnam. Methods A cross-sectional study was conducted in older people attending the outpatient clinics of the National Geriatric Hospital in Vietnam. Muscle mass (using dual-energy X-ray absorptiometry), handgrip strength and gait speed were assessed. SARC-F was validated against the three standard criteria for sarcopenia: the Foundation for the National Institutes of Health (FNIH), Asia Working Group for Sarcopenia (AWGS 2019) and European Working Group on Sarcopenia in Older People (EWGSOP2). Results There were 764 participants (mean age 71.5 ± 8.9 years). The Vietnamese SARC-F questionnaire had a good internal consistency (Cronbach’s alpha 0.85). The prevalence of sarcopenia was 49.2% according to SARC-F and 48.3%, 61.1% and 52.6% according to FNIH, AWGS 2019 and EWGSOP2, respectively. The sensitivity and specificity of SARC-F in identifying sarcopenia were 67.1% and 66.7% (for FINH), 66.7% and 67.1% (for AWGS 2019), and 64.9% and 68.2% (for EWGSOP2). The AUCs of SARC-F were 0.71–0.72 against the three sarcopenia criteria. Conclusion The Vietnamese version of SARC-F questionnaire has acceptable diagnostic value for sarcopenia. SARC-F could be used as an initial screening for sarcopenia in hospital clinics.
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Affiliation(s)
- Tam Ngoc Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam.,Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Anh Trung Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam.,Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | | | - Thanh Xuan Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam.,Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Huong Thi Thu Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam.,Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Thu Thi Hoai Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam.,Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam.,Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam
| | | | - Thang Pham
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam.,Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Tu Ngoc Nguyen
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Huyen Thi Thanh Vu
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam.,Hanoi Medical University Hospital, Hanoi, Vietnam
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Zasadzka E, Pieczyńska A, Trzmiel T, Pawlaczyk M. Polish Translation and Validation of the SARC-F Tool for the Assessment of Sarcopenia. Clin Interv Aging 2020; 15:567-574. [PMID: 32368023 PMCID: PMC7185989 DOI: 10.2147/cia.s245074] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/31/2020] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Completion of the SARC-F questionnaire constitutes the obligatory first step in the diagnostic process of sarcopenia, according to the revised European consensus on the definition and diagnosis of sarcopenia published by the European Working Group on Sarcopenia in Older People2 (EWGSOP2). SARC-F has been recognized as the most up-to-date and coherent screening tool for sarcopenia. The aim of the study was to translate and to validate the Polish version of the SARC-F questionnaire. MATERIALS AND METHODS The validation process was performed in two stages: 1) translation and intercultural adaptation and 2) clinical validation. The inclusion criteria were as follows: age ≥65 years, unimpaired mobility, and no cognitive impairment. The EWGSOP2 criteria were used to diagnose sarcopenia. Hand grip strength measurement, physical fitness test, and body weight composition analysis were conducted. Sensitivity, specificity, accuracy-likelihood ratios, and SARC-F predictive values were calculated using the EWGSOP2 criteria. RESULTS Sixty-seven people participated in the study of whom 21% were diagnosed with sarcopenia (SARC-F score: ≥4). The reliability of the questionnaire based on the Cronbach's alpha coefficient was 0.784. Sensitivity, specificity, and negative predictive values were 92.9%, 98.1%, and 98.1%, respectively. CONCLUSION The process of validating the SARC-F questionnaire against Polish conditions demonstrated its applicability as a simple and reliable tool for diagnosing sarcopenia in daily clinical practice with older adults.
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Affiliation(s)
- Ewa Zasadzka
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznań, Poland
| | - Anna Pieczyńska
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznań, Poland
| | - Tomasz Trzmiel
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznań, Poland
| | - Mariola Pawlaczyk
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznań, Poland
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Ishida Y, Maeda K, Nonogaki T, Shimizu A, Yamanaka Y, Matsuyama R, Kato R, Ueshima J, Murotani K, Mori N. SARC-F as a Screening Tool for Sarcopenia and Possible Sarcopenia Proposed by AWGS 2019 in Hospitalized Older Adults. J Nutr Health Aging 2020; 24:1053-1060. [PMID: 33244560 DOI: 10.1007/s12603-020-1462-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECT The SARC-F questionnaire is a sarcopenia screening tool. However, the validity of the SARC-F score ≥4 (SARC-F≥4) for the evaluation of sarcopenia in the hospital setting has not been investigated. This study investigated the validity of SARC-F≥4 as a screening tool for sarcopenia among hospitalized older adults. DESIGN Cross-sectional retrospective study. SETTING A university hospital. PARTICIPANTS This study included older adult patients (age ≥65 years) who were hospitalized at, and subsequently discharged from, the hospital between April and September 2019 and underwent a nutritional assessment by the nutrition support team during their hospitalization. MEASUREMENTS SARC-F was recorded at the time of admission, and the criteria specified by the Asia Working Group for Sarcopenia in 2019 (AWGS 2019) were applied to diagnose sarcopenia and possible sarcopenia. Appendicular muscle mass was estimated through validated equations, and three different models were developed for sarcopenia diagnosis. The sensitivity, specificity, and positive/negative likelihood ratios were calculated to analyze the accuracy of the SARC-F≥4 for sarcopenia and possible sarcopenia. Receiver-operating characteristic analyses were conducted to calculate the area under the curve (AUC). RESULTS In total, 1,689 patients (mean age: 77.2±7.3 years; male: 54.4%) were analyzed, and 636 patients (37.7%) had SARC-F≥4. Patients with SARC-F≥4 had a statistically significant higher prevalence of AWGS 2019-defined sarcopenia than patients with SARC-F <4 in the models (65.4-78.9% vs 40.9-45.2%, p<0.001). The sensitivity, specificity, and positive/negative likelihood ratios of SARC-F≥4 for sarcopenia and possible sarcopenia were 49.1-51.3%, 73.9-81.2%, and 1.88-2.72/0.60-0.69 and 48.0%, 84.5%, and 3.11/0.62, respectively. The AUC for sarcopenia and possible sarcopenia were 0.644-0.695 and 0.708, respectively. The AUC of SARC-F for possible sarcopenia was equivalent to or larger than that for sarcopenia (DeLong test p=0.438, 0.088, and <0.001 vs the three models). CONCLUSIONS SARC-F≥4 is suitable as a screening tool for sarcopenia in hospitalized older adults. SARC-F assessment could facilitate the detection and exclusion of sarcopenia at hospitalization and may lead to early adoption of a therapeutic and preventive approach.
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Affiliation(s)
- Y Ishida
- Keisuke Maeda, Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan, Phone: +81-562-46-2311; FAX: +81-562-44-8518, E-mail:
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Gade J, Beck AM, Rønholt F, Andersen HE, Munk T, Vinther A. Validation of the Danish SARC-F in Hospitalized, Geriatric Medical Patients. J Nutr Health Aging 2020; 24:1120-1127. [PMID: 33244571 DOI: 10.1007/s12603-020-1453-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/08/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Validation of the Danish version of the SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls) for hospitalized geriatric medical patients, compared against the original EWGSOP (European Working Group on Sarcopenia in Older People) and revised EWGSOP2 definition for sarcopenia. Additionally, investigation of the ability of SARC-F to individually identify low strength/function and muscle mass. DESIGN Cross-sectional analysis of data from an RCT. SETTING Hospital, Medical Department. PARTICIPANTS 122 geriatric medical patients (65.6% women) ≥ 70 years of age with mixed medical conditions. MEASUREMENTS SARC-F screening, diagnostic assessment of sarcopenia (hand-grip strength, muscle mass measured by dual-frequency bio-impedance analysis, and 4-m usual gait speed). RESULTS The prevalence of risk of sarcopenia (SARC-F ≥ 4) was 48.3%, while it was diagnosed in 65.8% and 21.7%, with EWGSOP and EWGSOP2, respectively. The sensitivity, specificity, positive predictive value, negative predictive value according to EWGSOP were 50.0 %, 53.7 %, 67.2% and 36.1%, while they were 53.8 %, 53.2 %, 24.1% and 80.6%, according to EWGSOP2 (all participants). The ability of SARC-F to predict reduced strength, function, and muscle mass was modest. There was a significant negative linear, yet weak, relationship between total SARC-F score and hand-grip strength (R2=0.033) and 4-m gait speed (R2=0.111), but not muscle mass (R2=0.004). CONCLUSION SARC-F does not seem to be a suitable screening tool for identifying and excluding non-sarcopenic geriatric patients. Furthermore, the SARC-F score was more strongly correlated with reduced muscle strength and physical function than with low muscle mass.
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Affiliation(s)
- J Gade
- Anders Vinther, Dept. Physiotherapy and Occupational therapy, Borgmester Ib Juuls Vej 29, DK-2730 Herlev, Denmark, Phone: +45-26808710 and E-mail:
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