Identification of Probable sarcopenia based on SARC-F and SARC-CalF in older adults from a low-resource setting

[Prevalence of physical inactivity and risk of sarcopenia in primary care. Cross-sectional study]

OBJECTIVES

Assess the prevalence of physical inactivity and risk of sarcopenia in primary care patients and their companions.

DESIGN

Cross-sectional study. We carried out an anonymous survey of primary care users (patients and companions) in primary care consultations and stands coinciding with a community health activity for World Physical Activity Day. SITE: Five primary care centers (CAPs) of the South Metropolitan health region: in Cornellà de Llobregat (CAP Jaume Soler), in l'Hospitalet de Llobregat (CAP Florida Nord, CAP Florida Sud and CAP Bellvitge) and in Viladecans (CAP Maria Bernades) between 27 March to April 6, 2023 (coinciding with World Physical Activity Day).

PARTICIPANTS

Primary care population consists of patients and their companions over 18 years of age.

INTERVENTIONS

The health workers administered questionnaires to users and companions.

MAIN MEASUREMENTS

We evaluated physical inactivity with the BPAAT questionnaire, risk of sarcopenia with SARC-F screening test, sex and age range. We performed an univariate descriptive analysis to report prevalence.

RESULTS

Nine hundred ninety-eight participants were surveyed. Physical inactivity was present in 38.9% of the participants. Among those over 50 years (665 participants), 15.4% were at risk of sarcopenia (9.58% men, 19.2% women).

CONCLUSIONS

The prevalence of physical inactivity and risk of sarcopenia (in individuals over 50 years old) in the studied population is high. Women have greater physical inactivity and a greater risk of sarcopenia than men.

Prospective sarcopenia outcomes associated with physical performance in individuals aged 55 years and over in Malaysia

Background

While the potential of physical performance tests as screening tools for sarcopenia is evident, limited information on relevant reference values for sarcopenia detection. In this study, we aimed to establish the prospective relationship between physical performance tests, including time up and go (TUG), functional reach (FR), gait speed (GS), and hand grip strength (HGS) with five-year sarcopenia risk and to determine suitable cut-off values for screening activities.

Method

This was a prospective study utilizing data from the Malaysian Elders Longitudinal Research (MELoR) study, which involved community-dwelling older adults aged 55 years and above at recruitment. Baseline (2013-2015) and wave 3 (2019) data were analyzed. Sarcopenia risk was determined using the strength, assistance walking, rising from a chair, climbing stairs, and falls (SARC-F) tool, with SARC-F ≥ 4 indicating sarcopenia. Baseline physical performance test scores were dichotomized using ROC-determined cut-offs.

Result

Data were available from 774 participants with mean age of 68.13 (SD = 7.13) years, 56.7% women. Cut-offs values for reduced GS, TUG, FR, and HGS were: <0.7 m/s (72.9% sensitivity and 53% specificity), >11.5 s (74.2%; 57.2%), <22.5 cm (73%; 54.2%) and HGS male <22 kg (70.0%; 26.7%) and female <17 kg (70.0%; 20.3%) respectively. Except for FR = 1.76 (1.01-3.06), GS = 2.29 (1.29-4.06), and TUG = 1.77 (1.00-3.13) were associated with increased sarcopenia risk after adjustments for baseline demographics and sarcopenia.

Conclusion

The defined cut-off values may be useful for the early detection of five-year sarcopenia risk in clinical and community settings. Despite HGS being a commonly used test to assess strength capacity in older adults, we advocate alternative strength measures, such as the sit-to-stand test, to be included in the assessment. Future studies should incorporate imaging modalities in the classification of sarcopenia to corroborate current study findings.

Development and validation of a Sarcopenia Geriatric Scale (SARCO-GS): a new short scale for the screening of sarcopenia

Introduction

Sarcopenia is a highly prevalent disease associated with adverse outcomes such as falls, disability, and death. The current international consensuses agree that muscle strength, muscle mass, and gait speed must be included in the definition. However, these proposed criteria require objective measurements that are not available for most populations. Since the timely identification of sarcopenia is a priority, several subjective screening scales have been developed; however, they have some limitations due to their low sensitivity. The objective of this work was to develop and validate SARCO-GS, a new short scale to screen sarcopenia that is affordable, easy, and accessible for all clinical care settings.

Methods and materials

The development of the SARCO-GS included four stages: (1) Review and analysis of documentary sources, (2) Contextualization of the theoretical model of sarcopenia, (3) Scale conformation, and (4) Reliability and validity analyses. SARCO-GS was validated in the FraDySMex study, which is a longitudinal cohort of community-dwelling adults.

Results

In the studied population (n=852), the average age was 68.9 years (SD 10.21) and 80.1% of the participants were women. SARCO-GS is a seven-item scale with an innovative structure that included five subjective questions (gait speed, muscular strength, muscle mass) and two measurements of muscular strength and muscle mass (Chair stand test and calf circumference). The results regarding criterion validity showed that the cut-off point ≥ 3 had good sensitivity (77.68%) versus the EWGSOP2 consensus, with an adequate Area Under the Receiver Operating Characteristic (AUC) (0.73), in addition to showing higher values of sensitivity and AUC than SARC-F and SARC-CalF using as reference the same consensus. Furthermore, SARCO-GS presented good predictive validity for functional dependence (HR=2.22, p=0.046) and acceptable correlation with other related measurements (construct validity). Regarding reliability, the scale showed acceptable internal reliability (correlation between items and total score: 0.50 to 0.70). After the validation analysis, the scale was adapted to English.

Conclusions

The SARCO-GS is a novel scale to screen sarcopenia with high sensitivity, good construct, predictive validity, and internal reliability that may be useful for health professionals in different clinical settings and for clinical research.

Comparison Between the Clinical Effect of Percutaneous Kyphoplasty for Osteoporosis Vertebral Compression Fracture Patient with or Without Sarcopenia: A Retrospective Cohort Study

Background

Sarcopenia and osteoporosis vertebral compression fractures (OVCF) are common diseases that increase with age. This study aimed to investigate the effects of sarcopenia on OVCF patients after percutaneous kyphoplasty (PKP).

Methods

Data of 101 patients who were treated with single-level PKP between January 2021 and March 2022 at Ningbo No.6 Hospital were enrolled. Forty-five OVCF patients with sarcopenia who met our inclusion criteria were included in the Sarcopenia-PKP group (SPKP group), and 56 patients in the Normal-PKP group (NPKP group). All clinical and radiological data were collected from medical records. Baseline characteristics, operation-related parameters (operation time, time to ambulation, hospital stay, surgery segment), clinical outcomes (visual analog score [VAS], Oswestry Disability Index [ODI], Japanese Orthopaedic Association Scores [JOA] of lumber), radiological outcomes (vertebral anterior height rate and local kyphosis angle), Macnab score, and complications were evaluated and compared.

Results

There were no significant differences in age, sex, surgical segment preoperative VAS score, ODI, or JOA between the two groups (P > 0.05). The SPKP group had a significantly lower body mass index (BMI), bone mineral density (BMD), and smooth muscle index (SMI) than the NPKP group (P < 0.05). Significantly longer hospital stays and time to ambulation in SPKP group than NPKP group (3.7±0.8 vs 3.4±0.5 and 2.0±0.8 vs 1.6±0.5, P < 0.05). In SPKP group, significantly better clinical outcomes at 6- and 12-months follow-up were observed in NPKP group than SPKP group (P < 0.05), and NPKP group showed significantly better in vertebral anterior height rates than SPKP group after 6-month follow-up (P < 0.05). Moreover, there were significantly more cases of complications in the SPKP group (P < 0.05).

Conclusion

Sarcopenia could reduce the clinical effect of percutaneous kyphoplasty, and furthermore. Related studies are needed to verify the effect of sarcopenia on OVCF patients.