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Demonceau C, Voz B, Bruyère O, Reginster JY, Beaudart C. Content validity of SarQoL, a quality of life questionnaire specific to sarcopenia. Aging Clin Exp Res 2024; 36:101. [PMID: 38710959 DOI: 10.1007/s40520-024-02756-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/13/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND The Sarcopenia & Quality of Life (SarQoL) questionnaire is a patient-reported outcome measure designed for assessing health-related quality of life in individuals with sarcopenia. Despite its wide acceptance in the scientific literature, its content validity has only been partially demonstrated so far. AIMS To enhance the evidence supporting the content validity of the SarQoL questionnaire. METHODS Following COSMIN methodology, semi-structured interviews were conducted with 17 Belgian older adults who met the EWGSOP2 criteria for the diagnosis of sarcopenia and 11 experts in sarcopenia, with clinical or research background. Comprehensiveness, relevance and comprehensibility of SarQoL content were assessed through individual transcripts and were qualitatively analyzed thematically according to the seven dimensions of SarQoL. RESULTS The majority of the concepts elicited during the semi-structured interviews fitted within existing SarQoL dimensions. Importantly, the different domains of SarQoL were consensually considered as relevant by patients and experts. Some new emergent concepts were identified by the participants. While many of them could be considered as enrichments of existing dimensions or sub-concepts, other new concepts (i.e. self-fulfilment, acceptance of the reduced condition, adaptation/use of strategies, depression) may highlight two potential dimensions not covered by SarQoL, i.e. patient empowerment and depression. Cognitive interviews also highlighted that SarQoL items and instructions were clear and comprehensible. CONCLUSIONS SarQoL, in its current form, demonstrates good evidence of content validity for assessing health-related quality of life in patients with sarcopenia. We do not recommend adding new items or dimensions to SarQoL. Instead, for researchers or clinicians who aim to specifically address self-empowerment or depression of sarcopenic populations, we suggest completing the assessment of quality of life by concurrently using additional validated scales of patient empowerment or depression.
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Affiliation(s)
- C Demonceau
- Department of Public Health, University of Liège, Liege, Belgium.
| | - B Voz
- Department of Public Health, University of Liège, Liege, Belgium
| | - O Bruyère
- Department of Public Health, University of Liège, Liege, Belgium
| | - J-Y Reginster
- College of Science, King Saud University, Riyadh, Saudi Arabia
| | - C Beaudart
- Clinical Pharmacology and Toxicology Research Unit, Department of Biomedical Sciences, Faculty of Medicine, NAmur Research Institute for LIfe Sciences (NARILIS), University of Namur, Namur, Belgium
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Beaudart C, Tilquin N, Abramowicz P, Baptista F, Peng DJ, de Souza Orlandi F, Drey M, Dzhus M, Fábrega-Cuadros R, Fernandez-Garrido J, Laurindo LF, Gasparik AI, Geerinck A, Emin G, Iacob S, Kilaitė J, Kumar P, Lee SC, Lou VWQ, Mahmoodi M, Matijevic R, Matveeva MV, Merle B, Montero-Errasquín B, Bhattoa HP, Safonova Y, Şimşek H, Topinkova E, Tsekoura M, Erdoğan T, Yoo JI, Yu R, Hiligsmann M, Reginster JY, Bruyère O. Quality of life in sarcopenia measured with the SarQoL questionnaire: A meta-analysis of individual patient data. Maturitas 2024; 180:107902. [PMID: 38142467 DOI: 10.1016/j.maturitas.2023.107902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023]
Abstract
Age-related sarcopenia, resulting from a gradual loss in skeletal muscle mass and strength, is pivotal to the increased prevalence of functional limitation among the older adult community. The purpose of this meta-analysis of individual patient data is to investigate the difference in health-related quality of life between sarcopenic individuals and those without the condition using the Sarcopenia Quality of Life (SarQoL) questionnaire. A protocol was published on PROSPERO. Multiple databases and the grey literature were searched until March 2023 for studies reporting quality of life assessed with the SarQoL for patients with and without sarcopenia. Two researchers conducted the systematic review independently. A two-stage meta-analysis was performed. First, crude (mean difference) and adjusted (beta coefficient) effect sizes were calculated within each database; then, a random effect meta-analysis was applied to pool them. Heterogeneity was measured using the Q-test and I2 value. Subgroup analyses were performed to investigate the source of potential heterogeneity. The strength of evidence of this association was assessed using GRADE. From the 413 studies identified, 32 were eventually included, of which 10 were unpublished data studies. Sarcopenic participants displayed significantly reduced health-related quality of life compared with non-sarcopenic individuals (mean difference = -12.32; 95 % CI = [-15.27; -9.37]). The model revealed significant heterogeneity. Subgroup analyses revealed a substantial impact of regions, clinical settings, and diagnostic criteria on the difference in health-related quality of life between sarcopenic and non-sarcopenic individuals. The level of evidence was moderate. This meta-analysis of individual patient data suggested that sarcopenia is associated with lower health-related quality of life measured with SarQoL.
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Affiliation(s)
- Charlotte Beaudart
- Departement of Biomedical Sciences, Namur Research Institute for Life Sciences (NARILIS), Faculty of Medicine, University of Namur, Namur, Belgium; WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Department of Health Services Research, University of Maastricht, Maastricht, the Netherlands.
| | - Noémie Tilquin
- Department of Biomedical Sciences, Faculty of Health, Medicine, and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Pawel Abramowicz
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, Bialystok, Poland
| | - Fátima Baptista
- Department of Sports and Health, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Dao Juan Peng
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Dalian Road, Huichuan District, Zunyi, Guizhou, China
| | | | - Michael Drey
- Department of Medicine IV, LMU University Hospital, LMU Munich, Germany
| | - Marta Dzhus
- Bogomolets National Medical University, Department of Internal Medicine, Kyiv, Ukraine
| | | | | | - Lucas Fornari Laurindo
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), Marília 17525-902, São Paulo, Brazil; Department of Biochemistry and Pharmacology, School of Medicine, Faculdade de Medicina de Marília (FAMEMA), Marília 17519-030, São Paulo, Brazil
| | - Andrea-Ildiko Gasparik
- Department of Public Health and Health Management, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Romania
| | - Anton Geerinck
- Departement of Biomedical Sciences, Namur Research Institute for Life Sciences (NARILIS), Faculty of Medicine, University of Namur, Namur, Belgium
| | - Gyulnaz Emin
- Yeni Yüzyıl University Gaziosmanpaşa Hospital, Physical Medicine and Rehabilitation Department, Istanbul, Turkey
| | - Speranta Iacob
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Fundeni Clinical Institute, Bucharest, Romania
| | - Justina Kilaitė
- Clinic of Internal Diseases, Family Medicine and Oncology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Prabal Kumar
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka 576104, India
| | - Shu-Chun Lee
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taiwan
| | - Vivian W Q Lou
- Sau Po Centre on Ageing, Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong
| | - Marzieh Mahmoodi
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Radmila Matijevic
- University of Novi Sad, Faculty of Medicine in Novi Sad, Serbia, Orthopaedic and Trauma Clinic, Novi Sad, Serbia
| | - Mariia V Matveeva
- Siberian State Medical University, Department of Pediatrics with Course of Enoccrinology, Department of Outpatient Therapy, Tomsk, Russian Federation
| | - Blandine Merle
- INSERM UMR 1033-Université de Lyon, 5 Place d'Arsonval, 69437 Lyon, France
| | | | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Hungary
| | - Yuliya Safonova
- Department of Geriatrics, North Western State Medical University, named after I.I. Mechnikov, Russian Federation
| | - Hilal Şimşek
- Hilal Simsek: Department of Nutrition and Dietetics, Graduate School of Health Sciences, Ankara University, Ankara, Turkey
| | - Eva Topinkova
- Department of Geriatric Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic; Faculty of Health and Social Sciences, University of South Bohemia, Ceske Budejovice, Czech Republic
| | - Maria Tsekoura
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece
| | - Tuğba Erdoğan
- Internal Medicine and Geriatrics Clinic, Tekirdağ Dr. Ismail Fehmi Cumalıoğlu City Hospital, Tekirdağ, Turkey
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Inha University Hospital, 27, Inhang-Ro, Jun-Gu, Incheon 22332, Republic of Korea
| | - Ruby Yu
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Mickael Hiligsmann
- Department of Health Services Research, University of Maastricht, Maastricht, the Netherlands
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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Beaudart C, Reginster JY, Amuthavalli Thiyagarajan J, Bautmans I, Bauer J, Burlet N, Cesari M, Cherubini A, Cooper C, Cruz-Jentoft AJ, Dawson-Hughes B, Fielding RA, Harvey NC, Landi F, Laslop A, Maggi S, Montero-Errasquin B, Concepción PYM, Rolland Y, Rizzoli R, Visser M, Bruyère O. Measuring health-related quality of life in sarcopenia: summary of the SarQoL psychometric properties. Aging Clin Exp Res 2023; 35:1581-1593. [PMID: 37219755 PMCID: PMC10363087 DOI: 10.1007/s40520-023-02438-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/08/2023] [Indexed: 05/24/2023]
Abstract
Patient perspectives are now widely recognized as a key element in the evaluation of health interventions. Therefore, the provision of specific and validated Patient Reported Outcome Measures that emphasize the lived experience of patients suffering from specific diseases is very important. In the field of sarcopenia, the only validated specific health-related quality of life (HRQoL) instrument available is the Sarcopenia Quality of Life questionnaire (SarQoL). This self-administrated HRQoL questionnaire, developed in 2015, consists of 55 items arranged into 22 questions and has currently been translated into 35 languages. Nineteen validation studies performed on SarQoL have consensually confirmed the capacity of SarQoL to detect difference in HRQoL between older people with and without sarcopenia, its reliability and its validity. Two further observational studies have also indicated its responsiveness to change. A short form SarQoL, including only 14 items has further been developed and validated to reduce the potential burden of administration. Research on the psychometric properties of SarQoL questionnaire is still encouraged as the responsiveness to change of SarQoL has not yet been measured in the context of interventional studies, as limited prospective data currently exist and as there is still not cut-off score to define a low HRQoL. In addition, SarQoL has mainly been used in community-dwelling older individuals with sarcopenia and would benefit to be studied in other types of populations. This review aims to provide to researchers, clinicians, regulators, pharmaceutical industries and other stakeholders a clear summary of comprehensive evidence on the SarQoL questionnaire published up to January 2023Query.
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Affiliation(s)
- Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium.
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
| | | | - Ivan Bautmans
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jürgen Bauer
- Center for Geriatric Medicine and Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Nansa Burlet
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | | | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Roger A Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, USA
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Francesco Landi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, 00168, Rome, Italy
| | - Andrea Laslop
- Scientific Office, Austrian Medicines and Medical Devices Agency, Vienna, Austria
| | | | | | | | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, CERPOP UMR 1295, University of Toulouse III, Inserm, Toulouse, France
| | - René Rizzoli
- Service of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam and the Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
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Beaudart C, Demonceau C, Reginster JY, Locquet M, Cesari M, Cruz Jentoft AJ, Bruyère O. Sarcopenia and health-related quality of life: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2023. [PMID: 37139947 DOI: 10.1002/jcsm.13243] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/08/2023] [Accepted: 04/03/2023] [Indexed: 05/05/2023] Open
Abstract
The decrease of physical abilities and functional decline that can be caused by musculoskeletal conditions such as sarcopenia, can lead to higher levels of dependency and disability. Therefore, it may influence patient reported outcome measures (PROM), such as the health-related quality of life (HRQoL). The purpose of this systematic review and meta-analysis is to provide a comprehensive overview of the relationship between sarcopenia and HRQoL. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed throughout the whole process of this work. A protocol was previously published on PROSPERO. The electronic databases MEDLINE, Scopus, Allied and Complementary Medicine (AMED), EMB Review - ACP Journal Club, EBM Review - Cochrane Central of Register of Controlled Trials and APA PsychInfo were searched until October 2022 for observational studies reporting a HRQoL assessment in both sarcopenic and non-sarcopenic individuals. Study selection and data extraction were carried out by two independent researchers. Meta-analysis was performed using a random effect model, reporting an overall standardized mean difference (SMD) and its 95% confidence interval (CI) between sarcopenic and non-sarcopenic individuals. Study quality was measured using the Newcastle-Ottawa Scale and the strength of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The search strategy identified 3725 references from which 43 observational studies were eligible and included in this meta-synthesis study. A significantly lower HRQoL was observed for sarcopenic individuals compared with non-sarcopenic ones (SMD -0.76; 95% CI -0.95; -0.57). Significant heterogeneity was associated with the model (I2 = 93%, Q test P-value <0.01). Subgroup analysis showed a higher effect size when using the specific questionnaire SarQoL compared with generic questionnaires (SMD -1.09; 95% CI -1.44; -0.74 with the SarQoL versus -0.49; 95% CI -0.63; -0.36 with generic tools; P-value for interaction <0.01). A greater difference of HRQoL between sarcopenic and non-sarcopenic was found for individuals residing in care homes compared with community-dwelling individuals (P-value for interaction <0.001). No differences were found between age groups, diagnostic techniques, and continents/regions. The level of evidence was rated as moderate using the GRADE assessment. This systematic review and meta-analysis combining 43 observational studies shows that HRQoL is significantly reduced in sarcopenic patients. The use of disease-specific HRQoL instruments may better discriminate sarcopenic patients with respect to their quality of life.
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Affiliation(s)
- Charlotte Beaudart
- WHO Collaborating Center for Public Health Aspects of Musculo-skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Céline Demonceau
- WHO Collaborating Center for Public Health Aspects of Musculo-skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Center for Public Health Aspects of Musculo-skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Médéa Locquet
- WHO Collaborating Center for Public Health Aspects of Musculo-skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | | | - Olivier Bruyère
- WHO Collaborating Center for Public Health Aspects of Musculo-skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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