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Bilgin S, Suzan V, Avci S, Yavuzer H, Bolayirli IM, Doventas A, Erdincler DS. Insights into geriatric health: primary sarcopenia and innate immunity dynamics, examining SARC-F, serum TLR 4, TLR 9, and resolvin levels. Intern Emerg Med 2024; 19:1867-1875. [PMID: 38910224 PMCID: PMC11467011 DOI: 10.1007/s11739-024-03678-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/09/2024] [Indexed: 06/25/2024]
Abstract
The aim of this study is to evaluate the relationship between serum TLR (Toll Like Receptor) 4, 9 and Resolvin E1 levels and primary sarcopenia in geriatric patients and to compare the diagnostic accuracy of these biomarkers with the SARC-F score. A total of 88 patients aged 65 years and older were evaluated in the study. Comorbidities and geriatric syndromes were identified and patients with secondary sarcopenia were excluded. EWGSOP2 criteria were used as diagnostic criteria for sarcopenia and SARC-F questionnaire was used to find individuals at risk for sarcopenia. Serum TLR 4, 9 and Resolvin E1 levels were analyzed by ELISA. There were no significant differences between the two groups in terms of age and gender (p = 0.654 and p = 1.000, respectively). SARC-F, serum TLR 9 and Resolvin E1 were significantly higher in the sarcopenia group compared to the non-sarcopenia group (p < 0.001, p < 0.001 and p = 0.040, respectively). Statistically significant parameters were evaluated by multiple regression analysis. TLR 9 and SARC-F score were both found to be associated with sarcopenia in multivariate logistic regression analysis [Odds ratio (OR) 3145, (95%) confidence interval (CI) 5.9-1,652,888.3, p = 0.012; OR 4.788, (95%) CI 2.148-10.672, p < 0.001, respectively]. ROC curve analysis showed that the area under the ROC curve (AUC) for TLR 9 and SARC-F was 0.896 (p < 0.001) and 0.943 (p < 0.001), respectively. Although this study supports the use of the SARC-F questionnaire in daily practice, serum TLR 9 levels may be an alternative to SARC-F in cases where SARC-F is not feasible.
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Affiliation(s)
- Seyda Bilgin
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa Mahallesi Kocamustafapaşa Caddesi No:34/E Fatih, Istanbul, Turkey.
- Department of Immunology, Institute of Health Sciences, Istanbul University, Istanbul, Turkey.
| | - Veysel Suzan
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa Mahallesi Kocamustafapaşa Caddesi No:34/E Fatih, Istanbul, Turkey
| | - Suna Avci
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa Mahallesi Kocamustafapaşa Caddesi No:34/E Fatih, Istanbul, Turkey
| | - Hakan Yavuzer
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa Mahallesi Kocamustafapaşa Caddesi No:34/E Fatih, Istanbul, Turkey
| | - Ibrahim Murat Bolayirli
- Department of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Alper Doventas
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa Mahallesi Kocamustafapaşa Caddesi No:34/E Fatih, Istanbul, Turkey
| | - Deniz Suna Erdincler
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa Mahallesi Kocamustafapaşa Caddesi No:34/E Fatih, Istanbul, Turkey
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Peng Y, Zhang L, Kong Y, Zhang X, Li Z, Jia H. Comparison of six screening methods for sarcopenia among rural community-dwelling older adults: a diagnostic accuracy study. Eur Geriatr Med 2024; 15:681-688. [PMID: 38451402 DOI: 10.1007/s41999-024-00955-6] [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: 11/05/2023] [Accepted: 01/24/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE The objective of this analysis was to determine the diagnostic efficacy of the Ishii test, SarSA-Mod, SARC-F, SARC-Calf, SARC-F+AC, and SARC-Calf+AC for screening for sarcopenia among rural community-dwelling older adults. METHODS The AWGS 2019 diagnostic criteria was a diagnostic reference for sarcopenia. There were six screening tools whose accuracy was determined through the use of metrics, including specificity, sensitivity, negative and positive predictive values, and the receiver operating characteristic (ROC) curve. RESULTS The study included 551 participants (304 women, age 70.9 ± 4.9 years). The prevalence of sarcopenia was 44.5% in men and 39.1% in women. In males, the sensitivity/specificity of the Ishii test, SarSA-Mod, SARC-F, SARC-Calf, SARC-F+AC, and SARC-Calf+AC screening sarcopenia were 87.3%/65.7%, 98.2%/21.9%, 6.4%/98.5%, 28.2%/91.2%, 33.6%/83.9%, and 84.6%/43.8%, and in females, they were 68.1%/82.2, 100%/23.2%, 16.0%/90.3%, 35.3%/84.3%, 58.8%/61.1%, and 89.9%/42.2%, respectively. In males, the area under the curves of the Ishii test, SarSA-Mod, SARC-F, SARC-Calf, SARC-F+AC, and SARC-Calf+AC were 0.846 (95% CI 0.795-0.889), 0.800 (95% CI 0.745-0.848), 0.581 (95% CI 0.516-0.643), 0.706 (95% CI 0.645-0.762), 0.612 (95% CI 0.548-0.673), and 0.707 (95% CI 0.646-0.763), respectively, and in females, they were 0.824 (95% CI 0.776-0.865), 0.845 (95% CI 0.799-0.883), 0.581 (95% CI 0.524-0.637), 0.720 (95% CI 0.666-0.770), 0.632 (95% CI 0.575-0.686), and 0.715 (95% CI 0.661-0.765), respectively. CONCLUSION Our findings demonstrate that the overall accuracy of the Ishii test was best among the six screening tools for sarcopenia screening in rural community-dwelling older adults.
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Affiliation(s)
- Yating Peng
- School of Public Health, Southwest Medical University, Sichuan, Luzhou, China
| | - Liangchuan Zhang
- School of Public Health, Southwest Medical University, Sichuan, Luzhou, China
| | - Yuan Kong
- School of Public Health, Southwest Medical University, Sichuan, Luzhou, China
| | - Xue Zhang
- School of Public Health, Southwest Medical University, Sichuan, Luzhou, China
| | - Zetian Li
- School of Public Health, Southwest Medical University, Sichuan, Luzhou, China
| | - Hong Jia
- School of Public Health, Southwest Medical University, Sichuan, Luzhou, China.
- Collaborating Center of the National Institute of Health Data Sciences of China, Southwest Medical University, Sichuan, Luzhou, China.
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Quaresma MVLDS, Vicente BM, Balchiunas RE, Ribeiro SML. Sarcopenia risk, sarcopenia-related quality of life, and associated factors in people living with human immunodeficiency virus (HIV): A web-based survey. Nutrition 2024; 120:112352. [PMID: 38306734 DOI: 10.1016/j.nut.2024.112352] [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: 06/16/2023] [Revised: 11/17/2023] [Accepted: 01/02/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVES We aimed to screen for the risk of sarcopenia and sarcopenia-related quality of life and associated factors of people living with HIV (PLWH). RESEARCH METHODS AND PROCEDURES This nonprobabilistic web-based survey evaluated PLWH. The participants were invited directly from a university-based inpatient clinic and responded to a web questionnaire that included the SARC-F and SarQoL to screen people at risk of sarcopenia and their quality of life. People at risk of sarcopenia were defined by the proposed cutoff points for SARC-F (≥ 4 points), and SarQoL overall score was categorized according to the median. Moreover, we performed a logistic regression to investigate associations between HIV-, lifestyle-, and health-associated factors (i.e., physical activity, dietary pattern, sleep quality, gastrointestinal symptoms, HIV diagnosis, type, combinations, and duration of ART, smoking, drinking, BMI, and weight loss), and outcomes (SARC-F and SarQoL). RESULTS The sample comprised 202 PLWH, mainly middle-aged (50.6-60.5 y; n = 101). Only 5.9% (n = 12) are at risk of sarcopenia according to SARC-F, and only 17.3% (n = 35) exhibited lower sarcopenia-related quality of life according to SarQoL. In the multiple models, only the gastrointestinal symptoms increased the odds of sarcopenia risk (OR: 1.058; P = 0.01) and poor sarcopenia-associated quality of life (OR: 1.041; P = 0.013). CONCLUSIONS We verified that only 5.9% and 17.3% of PLWH are at risk of sarcopenia and presented lower sarcopenia-related quality of life, respectively. Only the gastrointestinal symptoms were associated with a risk of sarcopenia and lower sarcopenia-related quality of life, without significant differences between age groups.
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Affiliation(s)
- Marcus V L Dos Santos Quaresma
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Centro Universitário São Camilo, São Paulo, Brazil
| | | | - Roseli Espindola Balchiunas
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Centro Universitário São Camilo, São Paulo, Brazil
| | - Sandra M L Ribeiro
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, Brazil.
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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: 4] [Impact Index Per Article: 4.0] [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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de Lima AB, Baptista F, Henrinques-Neto D, Pinto ADA, Gouveia ER. Symptoms of Sarcopenia and Physical Fitness through the Senior Fitness Test. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2711. [PMID: 36768077 PMCID: PMC9915373 DOI: 10.3390/ijerph20032711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Physical fitness concerns a set of attributes related to the ability to perform physical activity that may justify the symptoms reported by the elderly in the context of sarcopenia. OBJECTIVE This study aimed to investigate the relationship between the perception (symptomatology) of physical functioning (what the person thinks they are capable of) and the capacity itself for physical functioning in elderly people in northern Brazil. METHODS Cross-sectional study that analyzed 312 elderly people (72.6 ± 7.8 years) from the city of Novo Aripuanã, Amazonas, Brazil. Sarcopenia symptomatology was assessed using the SARC-F, a 5-item questionnaire designed for screening sarcopenia in older individuals in five domains: strength, walking aids, difficulty getting up from a chair, difficulty climbing stairs, and falls. Physical fitness was assessed by the Senior Fitness Test (SFT) battery including balance evaluated with the short version of the Fullerton Advanced Balance scale (FAB). RESULTS ROC curve analysis revealed that the tests with the greatest ability to discriminate participants with significant symptoms for sarcopenia (≥4 points on SARC-F) were arm curl and 6 min walk: the probability of suspected sarcopenia increased exponentially with an arm curl < 11.5 reps for men (se = 71%; sp = 69%; AUC = 0.706, 95% CI: 0.612-0.788; p = 0.013) and women (se = 81%; sp = 51%; AUC = 0.671, 95% CI: 0.601-0.735; p ≤ 0.001) or with a 6-min walk <408.5 m for men (se = 71%; sp = 63%; AUC = 0.720, 95% CI: 0.628-0.690; p = 0.001) and <366.0 m for women (se = 69%; sp = 58%; AUC = 0.692, 95% CI: 0.623-0.755; p = 0.0001). CONCLUSIONS Physical fitness assessed through the senior fitness test, particularly the 30-s-arm curl test and the 6-min walk test, can discriminate for suspected symptoms of sarcopenia.
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Affiliation(s)
- Alex Barreto de Lima
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Cruz-Quebrada, Portugal
- Course of Physical Education, Universidade do Estado do Amazonas, Manaus 69065-001, AM, Brazil
| | - Fátima Baptista
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Cruz-Quebrada, Portugal
| | - Duarte Henrinques-Neto
- Research Center in Sports Sciences, Health Sciences and Human Development, Maia University, 4475-690 Maia, Portugal
- School of Higher Education, Polytechnic Institute of Porto, 4200-465 Porto, Portugal
| | - André de Araújo Pinto
- Department of Physical Education, Universidade Estadual de Roraima, UERR, Boa Vista 69306-530, RR, Brazil
| | - Elvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, 9000-072 Funchal, Portugal
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal
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Can Biological Drugs Diminish the Risk of Sarcopenia in Psoriatic Patients? Life (Basel) 2022; 12:life12030435. [PMID: 35330186 PMCID: PMC8952562 DOI: 10.3390/life12030435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 11/28/2022] Open
Abstract
Sarcopenia and psoriasis are different inflammatory diseases that share common comorbidities (e.g., cardiovascular diseases, metabolic syndrome, obesity, autoimmune diseases, depression). Psoriasis is a dermatosis involving the skin, joints, and nails. Its estimated prevalence is 2–4%, and the possibility of progression to psoriatic arthritis reaches 6–42%. Sarcopenia is defined as reduced muscle strength, muscle quantity, and physical performance due to non-ageing related causes. It affects up to 10% of the general population. We conducted a review of the literature to provide up-to-date information about the risk of sarcopenia in psoriasis and to identify risk factors that increase this risk. The search of the literature allowed us to include 51 publications, but only five cross-sectional studies provided quantitative results on the rates of sarcopenia in psoriasis. The prevalence of sarcopenia in psoriasis varied from 9.1% to 61.7%. This wide range was caused by different definitions of sarcopenia and different cut-off values across studies. Prognostic factors include lean mass and fat mass. Further research based on the European Working Group on Sarcopenia in Older People guidelines is required. Such studies should include not only muscle mass and strength but also other factors that may influence the occurrence of sarcopenia and inflammatory markers.
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Abstract
PURPOSE OF REVIEW Sarcopenia screening tools can enable clinicians to select individuals for more demanding evaluations, and hence, may facilitate its timely diagnosis and management. The most common recommended screening test is SARC-F, whereas many others are proposed. We aimed to summarize the recent studies and evidence performed on SARC-F and other sarcopenia screening tools. RECENT FINDINGS Meta-analysis studies reported that despite having moderate-high specificity, SARC-F has low-moderate sensitivity to detect sarcopenia, which would cause a significant number of individuals having sarcopenia to be unrecognized. Several recent studies aimed to increase sensitivity and utility of SARC-F as a screening tool by i.e., application of lower cut-offs, adding extra-items, and combining with other screening tests. Some of these approaches increased its screening efficacy significantly. In line with its previous studies, SARC-F showed success to predict adverse outcomes in the latest studies as well. Recently, it has also been suggested as a reasonable screening test for frailty. In addition to the long-standing screening tests i.e., anthropometric measures, Ishii Test and Mini Sarcopenia Risk Assessment (MSRA) Questionnaire; new tests, i.e., Taiwan Risk Score for Sarcopenia, Sarcopenia Scoring Assessment Model (SarSA-Mod) and re-purposed tests, i.e., SARQoL questionnaire and fracture risk assessment tool have been investigated as potential screening tests for sarcopenia. Some of these tests performed as well as or superior to standard SARC-F. SUMMARY Screening of sarcopenia is critical for public health given its significant prevalence and adverse outcomes. SARC-F is the most recommended tool for screening but has low-moderate sensitivity. Studies performed recently indicate that its sensitivity can be increased by some attempts and it may be used as a reasonable test to screen frailty as well. Some other tests have also been developed/re-purposed for an efficient screening, needing to be tested for their performance and usability with future studies in different populations and settings.
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Affiliation(s)
- Gülistan Bahat
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University
| | - Tuğba Erdoğan
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University
| | - Birkan İlhan
- Department of Internal Medicine, Division of Geriatrics, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Pachołek K, Sobieszczańska M. Sarcopenia Identification during Comprehensive Geriatric Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:32. [PMID: 35010295 PMCID: PMC8751172 DOI: 10.3390/ijerph19010032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/12/2021] [Accepted: 12/19/2021] [Indexed: 06/14/2023]
Abstract
Comprehensive geriatric assessment (CGA) is a multidimensional diagnostic process enabling evaluation of elderly patients' physical and mental health status that implies implementation of the management targeted on the preservation of functional independence. Sarcopenia is a common but often underdiagnosed geriatric syndrome associated with increased likelihood of functional dependence and mortality risk. The main objectives of the study were the evaluation of sarcopenia prevalence in the patient group subjected to CGA with the upgraded EWGSOP2 algorithm considering muscle strength as the key criterion and usage of bioimpedance (BIA) muscle mass assessment. The study group consisted of 101 patients (76 women and 25 men) admitted for planned CGA to the Geriatrics Department of Wroclaw University Hospital. A diagnosis of sarcopenia was made according to the EWGSOP2 protocol. Body composition was determined with the bioimpedance technique. Functional status was assessed with ADLs from the VES-13 scale and additional questions. Sarcopenia was diagnosed in 16.8% of the study participants. Sarcopenic individuals presented worse functional status and impaired social activity. Muscle strength, gait speed and muscle mass below cut-off values were associated with dependence found in ADLs. Results showed that sarcopenia is a common impairment correlated with worse functional status and vulnerability to adverse outcomes. BIA can be treated as an accessible and accurate technique for muscle mass measurement in screening for sarcopenia, and the EWGSOP2 algorithm should be an essential part of the routine CGA procedure.
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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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Suzan V, Yavuzer H, Bag Soytas R, Bektan Kanat B, Arman P, Emiroglu Gedik T, Unal D, Atar O, Bolayirli IM, Doventas A. The relationship between primary sarcopenia and SARC-F, serum MMP9, TIMP1 levels, and MMP9/TIMP1 ratio in the geriatric patients. Eur Geriatr Med 2021; 12:1229-1235. [PMID: 34106445 DOI: 10.1007/s41999-021-00519-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE The purpose of this study is to evaluate the relationship between serum MMP9 (Matrix metalloproteinase), TIMP1 (Tissue inhibitor of metalloproteinase) levels and MMP9/TIMP1 ratio and primary sarcopenia in geriatric patients, and compare the diagnostic accuracy of such biomarkers with that of the SARC-F score. METHODS A total of 88 patients aged 65 years and older were assessed in the study. Comorbidities and geriatric syndromes were determined and patients with secondary sarcopenia were excluded. EWGSOP2 criteria were used as diagnostic criteria for sarcopenia and SARC-F questionnaire was used to find individuals at risk for sarcopenia. Serum MMP9 and TIMP1 levels were analyzed by ELISA method. RESULTS SARC-F, serum MMP9 and MMP9/TIMP1 ratio were significantly higher in the group with sarcopenia compared to the group without sarcopenia (p = 0.001, p = 0.026 and p = 0.006, respectively). In univariate logistic regression analysis, while SARC-F score and MMP9/TIMP1 ratio were significant, MMP9, TIMP1, age and gender were not. In the multivariate logistic regression analysis of the SARC-F score and the MMP9/TIMP1 ratio, it was determined that both of them were associated with sarcopenia [Odds ratio (OR) 1.447 (95%) confidence interval (CI) 1.170-1.791, p = 0.001; OR 1.127, (95%) CI 1.016-1.249, p = 0.023, respectively]. ROC curve analysis showed that the area under ROC curve (AUC) of SARC-F and MMP9/TIMP1 was 0.703 (p = 0.001, %95 CI 0.594-0.812) and 0.670 (p = 0.006, %95 CI 0.557-0.783), respectively. CONCLUSION Although this study supports the use of SARC-F questionnaire in daily practice; if SARC-F can't be applicable, the MMP9/TIMP1 ratio could be an alternative choice to the SARC-F.
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Affiliation(s)
- Veysel Suzan
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey.
| | - Hakan Yavuzer
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
| | - Rabia Bag Soytas
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
| | - Bahar Bektan Kanat
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
| | - Pinar Arman
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
| | - Tugce Emiroglu Gedik
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
| | - Damla Unal
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
| | - Oguz Atar
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ibrahim Murat Bolayirli
- Department of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Alper Doventas
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
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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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Roman N, Miclaus R, Repanovici A, Nicolau C. Equal Opportunities for Stroke Survivors' Rehabilitation: A Study on the Validity of the Upper Extremity Fugl-Meyer Assessment Scale Translated and Adapted into Romanian. ACTA ACUST UNITED AC 2020; 56:medicina56080409. [PMID: 32823717 PMCID: PMC7466310 DOI: 10.3390/medicina56080409] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 12/16/2022]
Abstract
Background and objectives: The Upper Extremity Fugl-Meyer Assessment (UEFMA) is one of the most recommended and used methods of clinical evaluation not only for post-stroke motor function disability conditions but also for physiotherapy goal-setting. Up to the present, an official Romanian version has not been officially available. This study aims to carry out a translation, adaptation, and validation of UEFMA in Romanian, thus giving both patients and medical practitioners the equal opportunity of benefiting from its proficiency. Material and methods: The English version of the motor component of UEFMA was back and forth translated in the assent of best practice translation guidelines. The research was performed on a group of 64 post-stroke in-patients regarding psychometric properties for content validation and an exploratory and confirmatory factorial analysis was performed using the Bayesian model. To assess internal consistency and test–retest reliability, we used the Cronbach Alpha index and Intraclass Correlation Coefficient (ICC). We used Pearson correlation with the Functional Independence Measure (FIM) and Modified Rankin Scale (MRS) to determine concurrent validation. Standardized response mean (SRM) was applied to determine the responsiveness of the instrument used. Results: After performing the exploratory factor analysis, a single factor was extracted, with an Eigenvalue of 19.363, which explained 64.543% of the variation. The model was confirmed by Bayesian exploration, with Root Mean Square Residual (RMR) 0.051, Goodness-of-fit Index (GFI) 0.980, Normed-Fit Index (NFI) 0.978 and Relative Fit Index (RFI) 0.977. The Cronbach Alpha value was 0.981, the Intraclass Correlation Coefficient (ICC) index for average measures was 0.992, the Pearson correlation with FIM 0.789, and MRS −0.787, while the SRM was 1.117. Conclusions: The Romanian version of the UEFMA scale is a reliable, responsive and valid tool which can be used as a standardized assessment in post-stroke patients across Romania.
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Affiliation(s)
- Nadinne Roman
- Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania;
| | - Roxana Miclaus
- Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania;
- Correspondence:
| | - Angela Repanovici
- Faculty of Product Design and Environment, Transilvania University of Brasov, 500068 Brasov, Romania;
| | - Cristina Nicolau
- Faculty of Economic Sciences and Business Administration, Transilvania University of Brasov, 500068 Brasov, Romania;
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Yilmaz O, Bahat G. Important Points to Consider During Practical Application and in the Validation Studies of SARC-F Tool to Screen Sarcopenia [Letter]. Clin Interv Aging 2020; 15:877-878. [PMID: 32606627 PMCID: PMC7294043 DOI: 10.2147/cia.s262334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/26/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ozlem Yilmaz
- Department of Internal Medicine, Division of Geriatrics, Istanbul University School of Medicine, Istanbul34093, Turkey
| | - Gulistan Bahat
- Department of Internal Medicine, Division of Geriatrics, Istanbul University School of Medicine, Istanbul34093, Turkey
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