加载中

    logo
    Letter to the Editor: Influence of Obesity on Diagnostic Accuracy and Optimal Cutoffs for Sarcopenia Screening in Non-Frail Older Adults: A Comparison of SARC-F versus SARC-CalF. Lim W S,Lim J P,Chew J,Tan A W K The journal of nutrition, health & aging 10.1007/s12603-020-1393-5
    Changes in the screening efficacy of lower calf circumference, SARC-F score, and SARC-CalF score following update from AWGS 2014 to 2019 sarcopenia diagnostic criteria in community-dwelling older adults. Ito Akihiro,Ishizaka Masahiro,Kobayashi Kaoru,Sawaya Yohei,Hara Tsuyoshi,Nagasaka Yoshihisa,Yakabi Akihiro,Watanabe Miyoko,Kubo Akira Journal of physical therapy science [Purpose] To identify changes in the efficacy of the Asia Working Group for Sarcopenia (AWGS) screening tools and the differences between the different screening tools following the updates from the AWGS 2014 to 2019 criteria for community-dwelling older adults. [Participants and Methods] We included 139 community-dwelling older adults aged ≥65 years. We assessed the lower calf circumference, SARC-F score, SARC-CalF score, skeletal muscle mass, grip strength, and gait speed. Moreover, we investigated the sensitivity, specificity, likelihood ratios, and area under the ROC curve of the lower calf circumference, SARC-F score, and SARC-CalF score using the AWGS 2014 and 2019 criteria for sarcopenia diagnosis. [Results] The prevalences of sarcopenia were 10.8% and 12.9%, and 5.0% using the AWGS 2014 and 2019, and 2019 severe sarcopenia diagnostic criteria, respectively. Using AWGS 2014 criteria, the sensitivity and specificity of lower calf circumference, SARC-F score, and SARC-CalF score, were 86.7% and 62.1%, 13.3% and 91.9%, and 66.7% and 80.6%, respectively. Using AWGS 2019 criteria, the sensitivity and specificity of lower calf circumference, SARC-F score, and SARC-CalF score were 83.3% and 62.8%, 11.1% and 91.7%, and 66.7% and 81.8%, respectively. Using AWGS 2019 severe sarcopenia criteria, the sensitivity and specificity of lower calf circumference, SARC-F score, and SARC-CalF score were 100% and 59.8%, 14.3% and 91.7%, and 71.4% and 78.0%, respectively. [Conclusion] All screening tools used in AWGS 2014 and 2019 were similar in terms of efficacy; however, the AWGS 2019 severe sarcopenia criteria had different characteristics. 10.1589/jpts.33.241
    Practical screening tools for sarcopenia in patients with systemic sclerosis. Hax Vanessa,do Espírito Santo Rafaela Cavalheiro,Dos Santos Leonardo Peterson,Farinon Mirian,de Oliveira Marianne Schrader,Três Guilherme Levi,Gasparin Andrese Aline,de Andrade Nicole Pamplona Bueno,Bredemeier Markus,Xavier Ricardo Machado,Chakr Rafael Mendonça da Silva PloS one INTRODUCTION:In view of the method of diagnosing sarcopenia being complex and considered to be difficult to introduce into routine practice, the European Working Group on Sarcopenia in Older People (EWGSOP) recommends the use of the SARC-F questionnaire as a way to introduce assessment and treatment of sarcopenia into clinical practice. Only recently, some studies have turned their attention to the presence of sarcopenia in systemic sclerosis (SSc).There is no data about performance of SARC-F and other screening tests for sarcopenia in this population. OBJECTIVE:To compare the accuracy of SARC-F, SARC-CalF, SARC-F+EBM, and Ishii test as screening tools for sarcopenia in patients with SSc. METHODS:Cross-sectional study of 94 patients with SSc assessed by clinical and physical evaluation. Sarcopenia was defined according to the revised 2019 EWGSOP diagnostic criteria (EWGSOP2) with assessments of dual-energy X-ray absorptiometry, handgrip strength, and short physical performance battery (SPPB). As case finding tools, SARC-F, SARC-CalF, SARC-F+EBM and Ishii test were applied, including data on calf circumference, body mass index, limitations in strength, walking ability, rising from a chair, stair climbing, and self reported number of falls in the last year. The screening tests were evaluated through receiver operating characteristic (ROC) curves. Standard measures of diagnostic accuracy were computed using the EWGSOP2 criteria as the gold standard for diagnosis of sarcopenia. RESULTS:Sarcopenia was identified in 15 (15.9%) patients with SSc by the EWGSOP2 criteria. Area under the ROC curve of SARC-F screening for sarcopenia was 0.588 (95% confidence interval (CI) 0.420-0.756, p = 0.283). The results of sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR) and diagnostic Odds Ratio (DOR) with the EWGSOP2 criteria as the gold standard were 40.0% (95% CI, 19.8-64.2), 81.0% (95% CI, 71.0-88.1), 2.11 (95% CI, 0.98-4.55), 0.74 (95% CI, 0.48-1.13) and 2.84 (95% CI, 0.88-9.22), respectively. SARC-CalF and SARC-F+EBM showed better sensitivity (53.3%, 95% CI 30.1-75.2 and 60.0%, 95% CI 35.7-80.2, respectively) and specificity (84.8%, 95% CI 75.3-91.1 and 86.1%, 95% CI 76.8-92.0, respectively) compared with SARC-F. The best sensitivity was obtained with the Ishii test (86.7%, 95% CI 62.1-96.3), at the expense of a small loss of specificity (73.4%, 95% CI 62.7-81.9). Comparing the ROC curves, SARC-F performed worse than SARC-CalF, SARC-F+EBM and Ishii test as a sarcopenia screening tool in this population (AUCs 0.588 vs. 0.718, 0.832, and 0.862, respectively). Direct comparisons between tests revealed differences only between SARC-F and Ishii test for sensitivity (p = 0.013) and AUC (p = 0.031). CONCLUSION:SARC-CalF, SARC-F+EBM, and Ishii test performed better than SARC-F alone as screening tools for sarcopenia in patients with SSc. Considering diagnostic accuracy and feasibility aspects, SARC-F+EBM seems to be the most suitable screening tool to be adopted in routine care of patients with SSc. 10.1371/journal.pone.0245683
    Basis for Sarcopenia Screening With the SARC-CalF in Nursing Homes. Urzi Felicita,Šimunič Boštjan,Buzan Elena Journal of the American Medical Directors Association BACKGROUND:Sarcopenia is a major health problem of the older population. The European Working Group on Sarcopenia in Older People (EWGSOP) developed diagnostic criteria for diagnosis of sarcopenia that require assessing muscle mass and strength or physical performance. Recently, however, a rapid screening method SARC-CalF was developed. OBJECTIVE:The aim of the present study was to validate the SARC-CalF test using EWGSOP sarcopenia diagnostic criteria in a sample of nursing home residents. METHODS:Cross-sectional study. A sample of 80 nursing home residents [30% of men; mean age 84.3 (7.9) years]. Sarcopenia was determined as proposed by the EWGSOP diagnostic criteria, whereby muscle mass was measured by bioelectrical impedance, muscle strength by handgrip strength, and physical performance by usual gait speed and a Short Physical Performance Battery score. Sarcopenia was also assessed by the SARC-CalF screening test. RESULTS:A total of 38.7% of sarcopenia was evaluated using EWGSOP diagnostic criteria and 36.2% using the SARC-CalF test. The SARC-CalF demonstrated a sensitivity level of 77.4% and specificity of 89.8%. The area under the receiver operating characteristic curves of SARC-CalF test was 0.84 (95% confidence interval 0.74, 0.94). CONCLUSIONS:SARC-CalF could be a useful screening test for sarcopenia in nursing home residents. The incorporation of the test as a basis for sarcopenia screening will provide additional value to current nursing home preventive measures. 10.1016/j.jamda.2017.07.011
    Comparison of four sarcopenia screening tools in nursing home residents. Yang Ming,Lu Jing,Jiang Jiaojiao,Zeng Yanli,Tang Huairong Aging clinical and experimental research BACKGROUND:Several screening tools have been developed for identifying sarcopenia in elderly nursing home residents. OBJECTIVE:To compare the diagnostic accuracy of four sarcopenia screening tools in nursing homes: Mini Sarcopenia Risk Assessment full version (MSRA-7) and short version (MSRA-5), SARC-F, and SARC-F combined with calf circumference (SARC-CalF). METHODS:Elderly nursing home residents (aged ≥ 65 years) were recruited. Four common diagnostic criteria (EWGSOP, AWGS, IWGS, and FNIH) were separately applied as the "gold standard". The sensitivity/specificity analyses of the four tools were calculated. Receiver operating characteristic (ROC) curves and area under the ROC curves (AUC) were applied to compare the overall diagnostic accuracy. RESULTS:We included 277 participants aged 81.6 ± 3.3 years. Using different "gold standards", the sensitivity of SARC-CalF, SARC-F, MSRA-7, and MSRA-5 ranged from 55.7 to 64.4%, from 17.0 to 21.8%, from 53.3 to 57.8%, and from 49.1 to 56.7%, respectively, whereas the specificity ranged from 84.5 to 86.5%, from 96.8 to 98.4%, from 80.2 to 84.2%, and from 82.8 to 84.1%, respectively. Regardless of the "gold standard", SARC-CalF had the largest AUC (from 0.816 to 0.867) among the tools; the AUC of SARC-F (from 0.769 to 0.791) and MSRA-5 (from 0.713 to 0.767) was not significantly different; whereas MSRA-7 had the smallest AUC (from 0.681 to 0.746). CONCLUSION:Among the four screening tools, SARC-CalF appears to be an optimal choice for screening sarcopenia in nursing home residents. SARC-F and MSRA-5 are alternatives, of which, SARC-F has a better specificity and MSRA-5 has a better sensitivity. 10.1007/s40520-018-1083-x
    Comparison of Three Screening Methods for Sarcopenia in Community-Dwelling Older Persons. Mo Yi-Han,Zhong Jing,Dong Xin,Su Yi-Dong,Deng Wen-Yu,Yao Xue-Mei,Liu Bei-Bei,Wang Xiao-Qin,Wang Xiu-Hua Journal of the American Medical Directors Association OBJECTIVE:The 2019 Asian Working Group on Sarcopenia in Older People (AWGS 2019) recommends using either calf circumference or the strength, assistance in walking, rising from a chair, climbing stairs, and falls (SARC-F) or SARC-F combined with calf circumference (SARC-CalF) questionnaires for sarcopenia screening. The aim of this study was to compare the ability and applicability of calf circumference, SARC-F, and SARC-CalF for screening sarcopenia among community-dwelling older adults. DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:A total of 1050 community-dwelling older people were enrolled. METHODS:Sarcopenia was diagnosed according to the AWGS 2019 criteria: bioimpedance analysis for appendicular skeletal muscle index, hand grip, and 6-m gait speed test. Participants also completed the SARC-F questionnaire and calf circumference measurement. The screening tools' performances were evaluated through receiver operating characteristic (ROC) curves, area under the ROC curves (AUC), and sensitivity/specificity analyses. RESULTS:Sarcopenia was identified in 263 (25.0%) participants by the AWGS 2019 criteria. Calf circumference had a sensitivity of 81.4% and a specificity of 77.0%. Sensitivity and specificity of SARC-F for screening sarcopenia were 17.9% and 93.7%, respectively. SARC-CalF improved the sensitivity of SARC-F (47.5%) while keeping similar specificity (92.0%). The AUCs of calf circumference, SARC-F, and SARC-CalF were 0.79 [95% confidence interval (CI), 0.77-0.82], 0.56 (95% CI, 0.52-0.59), and 0.70 (95% CI, 0.67-0.73), respectively. The differences across ROC curves were statistically significant among 3 screening tools (P < .001). CONCLUSIONS AND IMPLICATIONS:The overall screening ability of calf circumference was better than that of SARC-F and SARC-CalF for sarcopenia in community-dwelling older persons despite gender, age, and cognitive function. SARC-F and SARC-CalF have high specificity but are susceptible to the preceding factors. 10.1016/j.jamda.2020.05.041
    SARC-F as a Screening Tool for Sarcopenia and Possible Sarcopenia Proposed by AWGS 2019 in Hospitalized Older Adults. Ishida Y,Maeda K,Nonogaki T,Shimizu A,Yamanaka Y,Matsuyama R,Kato R,Ueshima J,Murotani K,Mori N The journal of nutrition, health & aging 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. 10.1007/s12603-020-1462-9
    Prevalence of Sarcopenia in Community-Dwelling Older Adults in Valencia, Spain. Guillamón-Escudero Carlos,Diago-Galmés Angela,Tenías-Burillo Jose M,Soriano Jose M,Fernández-Garrido Julio J International journal of environmental research and public health This study is an observational and cross-sectional study on the prevalence of sarcopenic disease in 202 autonomous older adults; 18.8 and 81.2% were men and women, respectively, living in their own homes in Valencia, Spain. Sarcopenia was diagnosed using the criteria and cutting points for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), using the tests: SARC-F, grip strength, sit-to-stand, gait speed, appendicular skeletal muscle mass and short physical performance battery. According to the EWGSOP2 criteria, probable sarcopenia was present in 21.1% and 18.3% of men and women, respectively, and the sum of confirmed and severe sarcopenia was 7.9% and 7.3% in men and in women, respectively. A relationship was shown between the prevalence of the disease and the age of the participants, but no significant differences were found between the sum of confirmed and severe sarcopenia between the sexes, nor a relationship between the amount of muscle mass and the strength of grip. The SARC-F questionnaire diagnosed 40% of the sarcopenia cases present in the study. More thorough research is needed to continue using the EWGSOP2 criteria in different populations to establish a correct prevalence of sarcopenic disease in different populations of the world. 10.3390/ijerph17239130
    Polish version of SARC-F to assess sarcopenia in older adults: An examination of reliability and validity. Krzymińska-Siemaszko Roma,Deskur-Śmielecka Ewa,Kaluźniak-Szymanowska Aleksandra,Styszyński Arkadiusz,Wieczorowska-Tobis Katarzyna PloS one 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. 10.1371/journal.pone.0244001
    Calf Circumference as an Optimal Choice of Four Screening Tools for Sarcopenia Among Ethnic Chinese Older Adults in Assisted Living. Chen Chung-Yao,Tseng Wen-Chun,Yang Yao-Hung,Chen Chia-Ling,Lin Lain-Li,Chen Fang-Ping,Wong Alice M K Clinical interventions in aging Introduction:Sarcopenia is highly prevalent among residents of assisted-living facilities. However, the optimal screening tools are not clear. Therefore, we compared the performance of four recommended screening tools for predicting sarcopenia. Methods:The study recruited 177 people over 65 years of age in assisted-living facilities. Appendicular muscle mass index was measured using bioelectrical impedance analysis. Calf circumference (CC), handgrip, six-meters walking speed, and screening questionnaires including SARC-CalF, SARC-F and 5-item Mini Sarcopenia Risk Assessment (MSRA-5) were evaluated. The diagnosis criteria for sarcopenia were based on the Asian Working Group for Sarcopenia 2019 consensus. The area under the receiver operating characteristic curves (AUC) was used to contrast the diagnostic accuracy of screening tools. Results:The prevalence of sarcopenia was 52.7% among men and 51.2% among women. After adjusting for age, sex, body mass index and SARC-CalF score, CC remained significantly associated with sarcopenia in logistic regression analysis. The prediction model for sarcopenia based on CC alone had the highest accuracy compared to SARC-CalF, MSRA-5 and SARC-F (AUC, 0.819 vs 0.734 vs 0.600 vs 0.576; sensitivity/specificity, 80.4%/71.8% vs 38.0%/80.0% vs 60.7%/54.2% vs 10.9%/91.8%). Differences in AUCs between the prediction models were statistically significant (CC vs. SARC-CalF, P = 0.0181; SARC-CalF vs. MSRA-5, P = 0.0042). Optimal cutoff values for predicting sarcopenia were CC <34 cm in men and <33 cm in women. Conclusion:To predict sarcopenia based on low CC alone is accurate, easy and inexpensive for use in assisted-living facility settings. Further validation studies in different populations are suggested. 10.2147/CIA.S287207
    Screening Accuracy of SARC-F for Sarcopenia in the Elderly: A Diagnostic Meta-Analysis. Lu J-L,Ding L-Y,Xu Q,Zhu S-Q,Xu X-Y,Hua H-X,Chen L,Xu H The journal of nutrition, health & aging 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. 10.1007/s12603-020-1471-8
    SARC-F as a case-finding tool for sarcopenia according to the EWGSOP2. National validation and comparison with other diagnostic standards. Piotrowicz Karolina,Głuszewska Anna,Czesak Joanna,Fedyk-Łukasik Małgorzata,Klimek Ewa,Sánchez-Rodríguez Dolores,Skalska Anna,Gryglewska Barbara,Grodzicki Tomasz,Gąsowski Jerzy Aging clinical and experimental research 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. 10.1007/s40520-020-01782-y
    Sarcopenia Risk Evaluation in a Sample of Hospitalized Elderly Men and Women: Combined Use of the Mini Sarcopenia Risk Assessment (MSRA) and the SARC-F. Rossi Andrea P,Caliari Cesare,Urbani Silvia,Fantin Francesco,Brandimarte Piero,Martini Angela,Zoico Elena,Zoso Giulia,Babbanini Alessio,Zanotelli Alfredo,Zamboni Mauro Nutrients BACKGROUND:SARC-F and Mini Sarcopenia Risk Assessment (MSRA) questionnaires have been proposed as screening tools to identify patients at risk of sarcopenia. The aim of this study is to test the use of SARC-F and MSRA, alone and combined, as a pre-screening tool for sarcopenia in geriatric inpatients. METHODS:152 subjects, 94 men and 58 women, aged 70 to 94, underwent muscle mass evaluation by dual energy X-ray absorptiometry (DXA), muscle strength evaluation by handgrip, and completed the MSRA, SARC-F and Activity of daily living (ADL) questionnaires. RESULTS:66 subjects (43.4%) were classified as sarcopenic according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. The 7-item SARC-F and MRSA and 5-item MSRA showed an area under the curve (AUC) of 0.666 (95% confidence interval (CI): 0.542-0.789), 0.730 (95% CI: 0.617-0.842) and 0.710 (95% CI: 0.593-0.827), respectively. The optimal cut-off points for sarcopenia detection were determined for each questionnaire using the Youden index method. The newly calculated cut-off points were ≤25 and ≤40 for MSRA 7- and 5-items, respectively. The ideal cut-off for the SARC-F was a score ≥3. Applying this new cut-off in our study population, sensitivity and specificity of the 7-item MSRA were 0.757 and 0.651, and 0.688 and 0.679 for the 5-item MSRA, respectively. Sensitivity and specificity of SARC-F were 0.524 and 0.765, respectively. The combined use of the 7-item SARC-F and MSRA improved the accuracy in sarcopenia diagnosis, with a specificity and sensitivity of 1.00 and 0.636. CONCLUSION:7-item SARC-F and MSRA may be co-administered in hospital wards as an easy, feasible, first-line tool to identify sarcopenic subjects. 10.3390/nu13020635
    SARC-F Is Inaccurate to Identify Geriatric Rehabilitation Inpatients at Risk for Sarcopenia: RESORT. Dedeyne Lenore,Reijnierse Esmee M,Pacifico Jacob,Kay Jacqueline E,Maggs Patricia,Verschueren Sabine,Tournoy Jos,Gielen Evelien,Lim Wen Kwang,Maier Andrea B Gerontology 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. 10.1159/000516117
    The role of SARC-F scale in predicting progression risk of COVID-19 in elderly patients: a prospective cohort study in Wuhan. Ma Yao,He Min,Hou Li-Sha,Xu Shen,Huang Zhi-Xin,Zhao Na,Kang Yan,Yue Ji-Rong,Wu Chenkai BMC geriatrics BACKGROUND:Since the outbreak of COVID-19, it has been documented that old age and underlying illnesses are associated with poor prognosis among COVID-19 patients. However, it is unknown whether sarcopenia, a common geriatric syndrome, is associated with poor prognosis among older COVID-19 patients. The aim of our prospective cohort study is to investigate the association between sarcopenia risk and severe disease among COVID-19 patients aged ≥60 years. METHOD:A prospective cohort study of 114 hospitalized older patients (≥60 years) with confirmed COVID-19 pneumonia between 7 February, 2020 and 6 April, 2020. Epidemiological, socio-demographic, clinical and laboratory data on admission and outcome data were extracted from electronic medical records. All patients were assessed for sarcopenia on admission using the SARC-F scale and the outcome was the development of the severe disease within 60 days. We used the Cox proportional hazards model to identify the association between sarcopenia and progression of disease defined as severe cases in a total of 2908 person-days. RESULT:Of 114 patients (mean age 69.52 ± 7.25 years, 50% woman), 38 (33%) had a high risk of sarcopenia while 76 (67%) did not. We found that 43 (38%) patients progressed to severe cases. COVID-19 patients with higher risk sarcopenia were more likely to develop severe disease than those without (68% versus 22%, p < 0.001). After adjustment for demographic and clinical factors, higher risk sarcopenia was associated with a higher hazard of severe condition [hazard ratio = 2.87 (95% CI, 1.33-6.16)]. CONCLUSION:We found that COVID-19 patients with higher sarcopenia risk were more likely to develop severe condition. A clinician-friendly assessment of sarcopenia could help in early warning of older patients at high-risk with severe COVID-19 pneumonia. 10.1186/s12877-021-02310-x
    Reliability and Concurrent Validity of the SARC-F and Its Modified Versions: A Systematic Review and Meta-Analysis. Voelker Stefanie N,Michalopoulos Nikolaos,Maier Andrea B,Reijnierse Esmee M Journal of the American Medical Directors Association 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. 10.1016/j.jamda.2021.05.011
    Comparing Mini Sarcopenia Risk Assessment With SARC-F for Screening Sarcopenia in Community-Dwelling Older Adults. Yang Ming,Hu Xiaoyi,Xie Lingling,Zhang Luoying,Zhou Jie,Lin Jing,Wang Ying,Li Yaqi,Han Zengli,Zhang Daipei,Zuo Yun,Li Ying Journal of the American Medical Directors Association OBJECTIVE:The Mini Sarcopenia Risk Assessment (MSRA), a new sarcopenia screening tool, has 2 versions: MSRA-7 (full version, 7 items) and MSRA-5 (short version, 5 items). We aimed to compare the diagnostic values of MSRA-7 and MSRA-5 to SARC-F for screening sarcopenia. DESIGN:A diagnostic accuracy study. SETTING:A community in Chengdu, China. PARTICIPANTS:Older adults. MEASUREMENTS:Muscle mass, strength, and physical performance were tested using a bioimpedance analysis (BIA) device, handgrip strength, and walking speed, respectively. Using the Asian Working Group for Sarcopenia (AWGS) criteria as the gold standard, the sensitivity/specificity analyses of the 3 scales were assessed. Receiver operating characteristic (ROC) curves and area under the ROC curves (AUC) were used to compare the overall diagnostic accuracy of the 3 scales. RESULTS:We recruited 384 participants. Against the AWGS criteria, SARC-F had a sensitivity of 29.5% and a specificity of 98.1%, and the MSRA-7 had a sensitivity of 86.9% and a specificity of 39.6%, whereas the MSRA-5 had a sensitivity of 90.2% and a specificity of 70.6%. The AUCs of SARC-F, MSRA-7, and MSRA-5 were 0.89 [95% confidence interval (CI), 0.86-0.92], 0.70 (95% CI, 0.65-0.74), and 0.85 (95% CI, 0.81-0.89), respectively. The differences in AUCs between SARC-F and MSRA-7 and in those between MSRA-7 and MSRA-5 were statistically significant (P <.001), but the difference between SARC-F and MSRA-5 was not statistically significant (P = .130). CONCLUSION:MSRA-5 may serve as a novel screening tool for sarcopenia in Chinese community-dwelling older adults. SARC-F, a class screening tool, is also suitable for this population. MSRA-5 and SARC-F demonstrated a similar diagnostic accuracy in our study population. MSRA-5 has better sensitivity, whereas SARC-F has better specificity. However, the diagnostic value of MSRA needs to be further validated in different populations. 10.1016/j.jamda.2018.04.012
    The SARC-F Questionnaire: Diagnostic Overlap with Established Sarcopenia Definitions in Older German Men with Sarcopenia. Kemmler Wolfgang,Sieber Cornel,Freiberger Ellen,von Stengel Simon Gerontology BACKGROUND:The high relevance of sarcopenia for the aging societies of most developed nations is emphasized by its recent inclusion in the ICD-10-CM (M62.84). However, diagnosing sarcopenia is a daunting task. Apart from varying definitions, the proper assessment of recognized sarcopenia criteria is time and cost consuming. A short and inexpensive screening tool may thus be welcome for clinicians and others working in the area of gerontology. Recently, a simple questionnaire was provided (SARC-F) that may adequately realize this aim. OBJECTIVE:The purpose of this study is to compare established sarcopenia definitions (European Working Group on Sarcopenia in Older People [EWGSOP], Foundation National Institute of Health [FNIH], International Working Group on Sarcopenia [IWGS]) with the SARC-F. Our hypothesis was that the diagnostic overlap between the SARC-F and sarcopenia as determined by these recognized definitions was too low to reliably diagnose sarcopenia. METHODS:Seventy-four community-dwelling German men aged 70 years and older with established sarcopenia according to EWGSOP and/or FNIH and/or IWGS were screened with the SARC-F questionnaire. RESULTS:Applying the definitions of EWGSOP, IWGS, and FNIH, 66.2, 43.2, and 50% of the cohort were classified sarcopenic, respectively. The SARC-F identified 33.5% of the cohort as sarcopenic. The predictive power of the SARC-F increased when men were classified as sarcopenic according to 2 (57.1%) or all (78.8%) sarcopenia definitions. The diagnostic overlap with the 3 sarcopenia definitions varied between 38.8% (SARC-F-FNIH) and 54.1% (SARC-F-IWGS). In comparison, the overlap of diagnosed sarcopenia ranged from 27.0% (FNIH-IWGS) to 49.0% (IWGS-EWGSOP) among the definitions themselves. Only 12.2% of the men met all 3 sarcopenia definitions. CONCLUSION:The diagnostic overlap with respect to sensitivity of the SARC-F and present sarcopenia definitions was at least as high as the range of the diagnostic overlap of these approaches themselves. Thus, although the sensitivity of the SARC-F may be debatable, for want of a better option it seems reasonable to consider the SARC-F as a first simple step within a hierarchical screening procedure. Independently of this procedure, a universally accepted mandatory sarcopenia definition along with comprehensive criteria and fixed cutoff points should be provided promptly. 10.1159/000477935
    Verification of the predictive validity for mortality of the SARC-F questionnaire based on a meta-analysis. Ida Satoshi,Kaneko Ryutaro,Imataka Kanako,Okubo Kaoru,Shirakura Yoshitaka,Azuma Kentaro,Fujiwara Ryoko,Takahashi Hiroka,Murata Kazuya Aging clinical and experimental research BACKGROUND:Although the association between SARC-F questionnaire positivity and mortality has previously been studied, the results are inconsistent. Testing the predictive validity of the SARC-F questionnaire for clinically relevant outcomes of vital prognoses is important. AIM:The objective of this study was to test the predictive validity of SARC-F by conducting a meta-analysis on the association between SARC-F, a screening tool for sarcopenia, and mortality. METHODS:This meta-analysis used the MEDLINE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and Google Scholar databases for literature searches. Studies that examined the relationship between SARC-F questionnaire positivity and mortality and reported hazard ratios or odds ratios and 95% confidence intervals were included. A random-effects model was used for statistical analyses, and pooled hazard ratios, pooled odds ratios, and 95% confidence intervals were calculated. RESULTS:Through the literature search, we found five studies (7501 individuals) that met the eligibility criteria for this study. The pooled hazard ratio for SARC-F questionnaire positivity and mortality was 1.87 (95% confidence interval 1.41-2.46; P < 0.001), indicating a significant association. The pooled odds ratio for SARC-F questionnaire positivity and mortality was 1.97 (95% confidence intervals 1.10-3.53; P = 0.02), showing a significant association. CONCLUSIONS:There was a significant association between SARC-F positivity and future mortality, indicating the predictive validity of the SARC-F questionnaire. TRIAL REGISTRATION:Not applicable. 10.1007/s40520-020-01585-1
    Performance of SARC-F in Regard to Sarcopenia Definitions, Muscle Mass and Functional Measures. Bahat G,Yilmaz O,Kılıç C,Oren M M,Karan M A The journal of nutrition, health & aging OBJECTIVE:To assess the reliability and validity of Turkish version of SARC-F in regard to screening with current definitions of sarcopenia, muscle mass and functional measures. DESIGN:Cross-sectional study. PARTICIPANTS:Community-dwelling older adults aged >=65 years admitting to a geriatric outpatient clinic. MEASUREMENTS:Muscle mass (bioimpedance analysis), handgrip strength, usual gait speed, chair sit-to-stand test, functional reach test, short physical performance battery, SARC-F questionnaire, FRAIL questionnaire Sarcopenia was evaluated with 4 current different definitions: European Working Group on Sarcopenia in Older People's (EWGSOP); Foundation for the National Institutes of Health (FNIH), International Working Group on Sarcopenia (IWGS) and Society on Sarcopenia, Cachexia and Wasting Disorders (SCWD). RESULTS:After cross-cultural adaptation, 207 subjects were analysed in the clinical validation study. Mean age was 74.6±6.7 years, 67.6% were women. Against EWGSOP, FNIH, IWGS and SCWD definitions of sarcopenia, sensitivity of SARC-F were %25, 31.6%, 50% and 40%; specificity were 81.4%, 82.4%, 81.8% and 81.7%, respectively. Positive predictive values were between 5.1-15.4% and negative predictive values were 92.3-98.2%. Against parameters of low muscle mass, sensitivity were about 20% and specificity were about 81%. Against parameters of function; for low hand grip strength, sensitivity of SARC-F were 33.7% (for Turkish cut-off); 50% (for FNIH cut-off); specificity were 93.7% (for Turkish cut-off) and 85.8% (for FNIH cut-off). Against low UGS, poor performance in chair sit to stand test, functional reach test, SPPB and presence of positive frailty screening sensitivity were 58.3%, 39.2%, 59.1%, 55.2% and 52.1% while specificity were 97.3%, 97.8%, 88.1%, 99.3% and 91.2%, respectively. CONCLUSION:The psychometric performance of Turkish SARC-F was similar to the original SARC-F. It revealed low sensitivity but high specificity with all sarcopenia definitions. Sensitivity and specificity were higher for muscle function tests reflecting its inquiry and input on functional measures. Our findings suggest that SARC-F is an excellent test to exclude muscle function impairment and sarcopenia. SARC-F is relatively a good screening test for functional measures. 10.1007/s12603-018-1067-8
    SARC-F Is Better Correlated with Muscle Function Indicators than Muscle Mass in Older Hemodialysis Patients. Marini A C B,Perez D R S,Fleuri J A,Pimentel G D The journal of nutrition, health & aging BACKGROUND:Sarcopenia can be characterized by European Consensus for Sarcopenia (EWGSOP2) criteria, but it methods are not easily accessible. Likewise, the Strength, Assistance with walking, Rise from a Chair, Climb stairs and Falls (SARC-F) has been proposed. OBJECTIVE:The aim of this study was i) to evaluate the prevalence for risk sarcopenia and ii) to correlate the SARC-F with components of the EWGSOP2 consensus in hemodialysis (HD) patients. MEASUREMENTS:This cross-sectional study enrolled ninety-five (male n= 59; 62%) HD older patients. Sarcopenia risk was assessed using the SARC-F, which ≥4 score indicates sarcopenia risk. Sarcopenia was confirmed through of the EWGSOP2 consensus, including the handgrip strength (HGS <27kg for men and <16kg for women) using the dynamometer, muscle mass through appendicular muscle mass (ASMI/m2 <7.0 kg/m2 for men and 5.5 kg/m2 for women) using the bioimpedance electrical, and physical performance through of gait speed (GS <0.8 m/s). RESULTS:From 95 patients, n=21(22%) presented sarcopenia risk. SARC-F ≥4 group are older (64.9±13.9 vs. 56.9±14.6 y, p= 0.028), presented lower ASMI (7.4±1.2 vs. 8.3±1.8 kg/m2, p=0.033), HGS (20.5±5.7 vs. 27.2±10.2 kg, p=0.005), and GS (0.5±0.1 vs. 0.7±0.1 m/s, p=0.001) than SARC-F<4 group. SARC-F score was negatively correlated with EWGSOP2 components: ASMI x SARC-F (r=-0.27, p=0.007), HGS x SARC-F (r=-0.35, p=0.0005), and GS x SARC-F (r=-0.47, p<0.0001). Although, no difference of number of patients with low or normal ASMI values was found, 62% and 95% of SARC-F≥4 group patients presented low HGS and gait speed, respectively. CONCLUSIONS:In older HD patients, 22% presented sarcopenia risk. In addition, SARC-F is better correlated with muscle function indicators (HGS and gait speed) than muscle mass. 10.1007/s12603-020-1426-0
    Screening for Sarcopenia with a Self-Reported Cartoon Questionnaire: Combining SARC-F with Finger-Ring Test. Li R,Hu X,Tan L,Xie L,Zhang L,Zhou J,Yang M The journal of nutrition, health & aging OBJECTIVES:No pictorial questionnaire is available for screening sarcopenia. We aimed to develop a self-reported cartoon questionnaire based on the SARC-F and the Finger-Ring test and to compare its diagnostic accuracy with the SARC-F and the SARC-F combined with calf circumference (SARC-CalF). DESIGN:A diagnostic accuracy study. SETTING:Urban communities in Chengdu, China. PARTICIPANTS:Older adults aged ≥ 60 years. METHODS:We established a multidiscipline team to design this pictorial questionnaire, entitled Self-Reported Cartoon SARC-CalF (cSARC-CalF). We used the Asian Working Group for Sarcopenia (AWGS) criteria as the "gold standard" of sarcopenia. We performed sensitivity/ specificity analyses of the three tools (cSARC-CalF, SARC-CalF, and SARC-F) and applied the receiver operating characteristics (ROC) curves and the area under the ROC curves (AUC) to compare the diagnostic accuracy of the three tools. RESULTS:We included 1,009 participants. Using the Youden Index method, the cutoff of the cSARC-CalF for identifying sarcopenia was set as ≥11 points. Both the cSARC-CalF and the SARC-CalF showed better sensitivity but similar specificity than the SARC-F for identifying sarcopenia (sensitivity: 33.3%, 41.4%, and 23.0%; specificity: 90.1%, 85.9%, and 88.1%). The AUCs of the cSARC-CalF, SARC-CalF, and SARC-F were 0.74 (95% CI, 0.71 - 0.77), 0.79 (95% CI, 0.76 - 0.81), and 0.67 (95% CI, 0.64 - 0.70), respectively. The difference in AUCs between cSARC-CalF and SARC-F and the difference in AUCs between SARC-CalF and SARC-F was statistically significant (p=0.012 and p<0.001, respectively). However, the difference in AUCs between cSARC-CalF and SARC-CalF was not significant (p=0.109). CONCLUSION:The cSARC-CalF showed a better overall diagnostic accuracy than the SARC-F and a similar overall diagnostic accuracy as the SARC-CalF in Chinese community-dwelling older adults. It may serve as a new tool for screening sarcopenia; however, it needs to be validated in other populations. 10.1007/s12603-020-1445-x
    Correlation between SARC-F Score and Ultrasound-Measured Thigh Muscle Thickness in Older Hospitalized Cancer Patients. Gomes T L N,Borges T C,Pichard C,Pimentel G D The journal of nutrition, health & aging BACKGROUND:Strength, Assistance for walking, Rise from a chair, Climb stairs, and Falls (SARC-F) score is frequently used for screening the sarcopenia risk in older people. However, the agreement between SARC-F and loss of ultrasound-derived muscle thickness in hospitalized older cancer patients is unexplored. OBJECTIVE:The primary objective was to evaluate the relationship between the SARC-F score and ultrasound-derived muscle thickness of rectus femoris and vastus intermedius in older hospitalised cancer patients. The secondary objective was to identify the presence of sarcopenia. MEASUREMENTS:A cross-sectional study enrolled forty-one older hospitalised cancer patients ongoing chemotherapy or surgical treatment. Body weight (kg) was measured using a digital scale and height using a portable stadiometer to assess body mass index. SARC-F was performed to assess and classify sarcopenia risk (with (SARC-F: ≥4), without (SARC-F: <4). US-derived muscle thickness of rectus femoris and vastus intermedius was assessed using a portable ultrasound. Relationship between the SARC-F and muscle thickness was tested using Pearson´s correlation and Bland-Altman analyses. RESULTS:Approximately, 46.3% of the patients presented sarcopenia and a lower non-significant muscle thickness of rectus femoris and vastus intermedius (SARC-F ≥4: 18.54±6.28 vs. SARC-F <4: 22.22±9.16 mm, p=0.07). There was a moderate negative correlation between SARC-F and muscle thickness (r=-0.40, p=0.004). Additionally, Bland-Altman plots no found systematic bias risk between SARC-F and ultrasound-derived muscle thickness. CONCLUSIONS:Approximately, 46.3% of older hospitalized cancer patients presented sarcopenia. Additionally, we found a moderate inverse correlation and no systematic bias risk between SARC-F and ultrasound-measured muscle thickness. 10.1007/s12603-020-1524-z
    Utility of SARC-F for Assessing Physical Function in Elderly Patients With Cardiovascular Disease. Tanaka Shinya,Kamiya Kentaro,Hamazaki Nobuaki,Matsuzawa Ryota,Nozaki Kohei,Maekawa Emi,Noda Chiharu,Yamaoka-Tojo Minako,Matsunaga Atsuhiko,Masuda Takashi,Ako Junya Journal of the American Medical Directors Association OBJECTIVES:A simple and inexpensive tool for screening of sarcopenia would be helpful for clinicians. The present study was performed to determine whether the SARC-F questionnaire is useful in screening of patients with cardiovascular disease (CVD) for impaired physical function. DESIGN:Cross-sectional study. SETTING:Single university hospital. PARTICIPANTS:A total of 235 Japanese patients ≥65 years old admitted to our hospital for CVD. MEASUREMENTS:SARC-F, handgrip strength, leg strength, respiratory muscle strength, standing balance, usual gait speed, Short Physical Performance Battery (SPPB) score, and 6-minute walking distance were measured before discharge from hospital. The patients were divided into 2 groups according to SARC-F score: SARC-F < 4 (nonsarcopenia group) and SARC-F ≥ 4 (sarcopenia group). RESULTS:The sarcopenia prevalence rate was 25.5% and increased with age (P trend < .001). The sarcopenia group (SARC-F score ≥ 4) had significantly lower handgrip strength, leg strength, and respiratory muscle strength, poorer standing balance, slower usual gait speed, lower SPPB score, and shorter 6-minute walking distance compared to the nonsarcopenia group (SARC-F score < 4). Patients in the sarcopenia group had consistently poorer physical function even after adjusting for covariates. CONCLUSION:The SARC-F questionnaire is a useful screening tool for impaired physical function in elderly CVD patients. These findings support the use of the SARC-F for screening in hospital settings. 10.1016/j.jamda.2016.10.019
    Reliability and Validity of SARC-F Questionnaire to Assess Sarcopenia Among Vietnamese Geriatric Patients. Nguyen Tam Ngoc,Nguyen Anh Trung,Khuong Long Quynh,Nguyen Thanh Xuan,Nguyen Huong Thi Thu,Nguyen Thu Thi Hoai,Hoang Minh Van,Pham Thang,Nguyen Tu Ngoc,Vu Huyen Thi Thanh Clinical interventions in aging 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. 10.2147/CIA.S254397
    Validating the SARC-F: a suitable community screening tool for sarcopenia? Woo Jean,Leung Jason,Morley John E Journal of the American Medical Directors Association OBJECTIVES:Using data from the Hong Kong Mr and Ms Os study, we validated the SARC-F against 3 consensus definitions of sarcopenia from Europe, Asia, and an international group, and compared the ability of all 4 measures to predict 4-year physical limitation, walking speed, and repeated chair stands. DESIGN:Prospective cohort study. SETTING:Hong Kong community. PARTICIPANTS:Four thousand men and women living in the community. MEASUREMENTS:A questionnaire regarding ability to carry a heavy load, walking, rising from a chair, climbing stairs, and falls frequency was administered. These questions were used to calculate the SARC-F score. Measurements, including appendicular muscle mass, were taken using dual-energy X-ray, grip strength using a dynamometer, 6-m gait speed, and time taken for repeated chair stand. Classification using the SARC-F score was compared using consensus panel criteria from international, European, and Asian sarcopenia working groups. The performance of all 4 methods was compared by examining the predictive ability for 4-year outcomes using ROC curve. RESULTS:The SARC-F has excellent specificity but poor sensitivity for sarcopenia classification; however, all 4 methods have comparable but modest predictive power for 4-year physical limitation. CONCLUSION:The SARC-F may be considered a suitable tool for community screening for sarcopenia. 10.1016/j.jamda.2014.04.021
    SARC-F for sarcopenia screening in community-dwelling older adults: Are 3 items enough? Yang Ming,Hu Xiaoyi,Xie Lingling,Zhang Luoying,Zhou Jie,Lin Jing,Wang Ying,Li Yaqi,Han Zengli,Zhang Daipei,Zuo Yun,Li Ying,Wu Linna Medicine A 3-item SARC-F (termed SARC-F-3 in our study) was recently suggested as a screening tool for sarcopenia.The aim of this study was to compare the diagnostic value of SARC-F-3 to SARC-F in community-dwelling older people.We conducted a diagnostic accuracy study in an urban community in Chengdu, China. People aged 60 years or older were included. Muscle mass, strength, and physical performance were measured by a bio-impedance analysis (BIA) device, handgrip strength, and gait speed test, respectively. The Asia Working Group for Sarcopenia (AWGS) criteria were applied as the "gold reference." The sensitivity/specificity analyses of SARC-F and SARC-F-3 were performed. The receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were applied to compare the overall accuracy of SARC-F and SARC-F-3. The cut-off points of SARC-F-3 for sarcopenia were determined using the Youden index method.A total of 384 older people aged 71.5 ± 5.8 years were included. On the basis of the AWGS criteria, the prevalence of sarcopenia in our study population was 15.9%. The optimal cut-off point of SARC-F-3 for identifying sarcopenia was a total score of ≥ 2. In the whole study population, the sensitivity and specificity of SARC-F were 29.5% [95% confidence interval (95% CI): 18.5-42.6] and 98.1% (95% CI: 96.0-99.3), respectively, whereas the sensitivity and specificity of SARC-F-3 were 13.1% (95% CI: 5.8-24.2) and 97.8% (95% CI: 95.6-99.1), respectively. The AUCs of SARC-F and SARC-F-3 were 0.894 (95% CI: 0.859-0.923) and 0.676 (95% CI: 0.627-0.723), respectively (P < .001).The 3-item SARC-F may not be suitable for screening sarcopenia in community-dwelling older people. 10.1097/MD.0000000000011726
    The SARC-F Score on Admission Predicts Falls during Hospitalization in Older Adults. Ishida Y,Maeda K,Ueshima J,Shimizu A,Nonogaki T,Kato R,Matsuyama R,Yamanaka Y,Mori N The journal of nutrition, health & aging OBJECTIVES:Community-dwelling older adults with sarcopenia are likely to fall. However, few studies have investigated whether sarcopenia is associated with falls during hospitalization in older adults. The purpose of this study was to determine whether the SARC-F when used as a simple screening tool for sarcopenia at the time of admission, predicts in-hospital falls. DESIGN:A retrospective, observational study. SETTING:A 900-bed university hospital. PARTICIPANTS:A total of 9,927 patients aged 65 years and older were hospitalized at the hospital between April 2019 and March 2020. MEASUREMENTS:The SARC-F contains five items: strength, assistance in walking, rise from a chair, climb stairs, and falls were evaluated at hospital admission. To investigate the relationship between the SARC-F score and falls, a ROC curve analysis was performed. Multivariate analysis adjusted for fall-related confounding factors such as age, gender, ADL, and disease were performed. RESULTS:Mean age: 75.9±6.7 years; male: 56.2% were analyzed, and 159 patients (1.6%) fell during hospitalization. SARC-F scores at admission were significantly higher in the fall group than in the control group (3 [1-6] points vs. 0 [¬0-2] point, p<0.001). Statistical association was observed between the SARC-F and in-hospital fall (area under the curve = 0.721 [0.678-0.764], p < 0.001). The cut-off value for the highest sensitivity and specificity of the SARC-F score for in-hospital falls was two (sensitivity = 0.679, specificity = 0.715). Among the subitem of the SARC-F, the hazard ratios for climbing stairs were significantly higher (HR = 1.52 [1.10-2.09], p = 0.011) and for a history of fall was significantly higher (HR = 1.41 [1.02-1.95], p = 0.036). A SARC-F score ≥ 2 had a significantly higher incidence of in-hospital falls compared to a SARC-F score <2 (3.7% vs. 0.7%, p < 0.001). Also, a SARC-F score ≥ 2 had a significantly higher hazard ratio for falls (2.11 [1.37-3.26], p < 0.001). CONCLUSION:SARC-F can help predict falls among hospitalized older adults. 10.1007/s12603-021-1597-3
    Evaluation of the Hungarian-language SARC-F sarcopenia-screening questionnaire Gasparik Andrea Ildikó,Demián Monica-Beáta,Pascanu Ionela Maria,Merlan Iulian,Hodinka László,Vereckei Edit Orvosi hetilap Összefoglaló. Bevezetés: A sarcopenia - időskori izomerő- és izomtömeg-csökkenés - a természetes öregedés része, ha viszont súlyos működési zavarokat okoz, már betegségnek tekintendő. Ezért a szövődményes, rossz kimenetelek mérsékléséhez minél korábbi felismerése nélkülözhetetlen. Célkitűzés: A sarcopenia kockázatának gyors értékelésére a SARC-F szerzői egyszerű szűrő kérdőívet alkottak, amelyet a sarcopeniát meghatározó diagnosztikus ajánlások kiemelten javallanak. E kérdőív magyar változatának jellemzőit vizsgáltuk, annak validálása céljából. Módszer: A kérdőívet 105, 65 éves vagy ennél idősebb személy bevonásával teszteltük. Az izomtömeg, az izomerő és a teljesítmény értékelése előtt a résztvevők kitöltöttek két generikus, valamint egy betegségspecifikus életminőség-kérdőívet. A megbízhatóság, konvergens, divergens, valamint konstruktumérvényesség vizsgálata mellett az eszköz diagnosztikus alkalmasságát is teszteltük. Statisztikai analízis: A Cronbach-alfa-érték, a Spearman/Pearson-féle korrelációs koefficiensek, a khi-négyzet-teszt, a szenzitivitás, a specificitás meghatározásához, a pozitív és negatív predikciós számításokhoz az SPSS 17.0 programot használtuk. Eredmények: A sarcopenia várható kockázata a SARC-F-teszt szerint (≥4 pont) 36%, míg az európai konszenzusdefiníció alapján sarcopeniásnak minősített esetek előfordulása 40% volt. A sarcopeniás egyéneknek jelentősen magasabb - domének szerinti és összesített - SARC-F-pontjaik voltak. A kérdőívet nagyon jó belső konzisztencia (Cronbach-alfa: 0,755), jó specificitás és magas negatív predikciós értékek jellemezték. Következtetés: A SARC-F magyar változata megbízható eszköznek tekinthető a sarcopenia kockázatának gyors és olcsó előrejelzésére. Orv Hetil. 2020; 161(47): 2000-2005. SUMMARY: INTRODUCTION:Sarcopenia is an age-related involution process, causing a significant functional disability, therefore it can be classified as a disease. Early recognition of the disease is essential. Objetive: Authors of the original SARC-F questionnaire developed a simple and rapid screening tool, recommended by the European Working Group on Sarcopenia as the mandatory first step in the diagnostic process of sarcopenia. Our study aimed to test and validate the Hungarian version of this instrument. METHOD:105 volunteers of 65+ years were recruited and evaluated for sarcopenia (muscle mass, strength and performance). Participants completed the SARC-F, other two generic and one disease-specific quality-of-life questionnaires. We checked the instrument for reliability, validity (discriminative power, construct, convergent and divergent validity) and screening performance. STATISTICAL ANALYSIS:Cronbach's alpha test, the Pearson/Spearman's correlation coefficient, chi-square test, sensitivity, specificity, positive and negative predictive value calculations have been performed. The SPSS 17.0 statistical program was used. RESULTS:The prevalence of sarcopenia according to the SARC-F test (score: ≥4) was 36%, while 40% was diagnosed with the European consensus definition. Sarcopenic individuals had significantly higher SARC-F total and domain scores. Very good internal consistency (Cronbach's alpha 0.755), specificity and negative predictive values were found. CONCLUSION:A reliable, rapid and inexpensive sarcopenia indicator is now available to timely detect the Hungarian-speaking patients at risk of sarcopenia. Orv Hetil. 2020; 161(47): 2000-2005. 10.1556/650.2020.31932
    Validation of the Danish SARC-F in Hospitalized, Geriatric Medical Patients. Gade J,Beck A M,Rønholt F,Andersen H E,Munk T,Vinther A The journal of nutrition, health & aging 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. 10.1007/s12603-020-1453-x
    ROMANIAN TRANSLATION AND VALIDATION OF THE SARC-F QUESTIONNAIRE. Gasparik A,Demián M B,Pascanu I Acta endocrinologica (Bucharest, Romania : 2005) Context:Several studies have addressed the impact of sarcopenia on various health outcomes. As the most critical issue is the early identification of individuals, a short screening tool may help clinicians to simply test for sarcopenia and start early management of the disease. Recently, a simple questionnaire, Sarc-F was provided that may adequately realize this aim. Subjects and Methods:To validate the questionnaire we translated the original Sarc-F according to the recommended methodology. A total of 80 people, aged 65+ were evaluated for sarcopenia. Muscle mass, strength, and physical performance were measured. Volunteers completed the Sarc-F as well as other two questionnaires. Discriminative power, reliability, construct validity analyses, specificity, sensitivity, negative and positive predictive value evaluations were made. Results:A good discriminative power and internal consistency were found. With the functional sarcopenia diagnostic criteria the test demonstrates a high specificity (84%). The positive and negative predictive values were: 78% and 77%. Using the more conservative diagnostic criteria the negative predictive value was: 85.4%, sufficient to rule out those not at risk of having sarcopenia and eliminate the need for further investigations. Conclusions:A valid Romanian Sarc-F questionnaire is now available to simply detect patients at risk/no risk of sarcopenia. 10.4183/aeb.2020.216
    SARC-F: A validation study with community-dwelling older Japanese adults. Kera Takeshi,Kawai Hisashi,Hirano Hirohiko,Kojima Motonaga,Watanabe Yutaka,Motokawa Keiko,Fujiwara Yoshinori,Ihara Kazushige,Kim Hunkyung,Obuchi Shuichi Geriatrics & gerontology international AIM:The SARC-F is a useful clinical index for sarcopenia screening; however, this measure has low sensitivity. Furthermore, this tool has never been validated on community-dwelling older Japanese adults. The goal of the present study was to validate a Japanese version of the SARC-F and confirm its suitability for Japanese samples. METHODS:Participants were 734 community-dwelling older adults in the Itabashi Ward, Japan. Bioimpedance measures, walking speed, grip strength and instrumental activities of daily living (IADL) were measured. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People, the Asian Working Group for Sarcopenia criteria and Japanese-adjusted Asian Working Group for Sarcopenia. SARC-F receiver operating characteristic curves for each sarcopenia measure were used to evaluate diagnostic accuracy. Physical functioning, IADL and sarcopenia screening tools were compared with the SARC-F. RESULTS:A total of nine men (3.1%) and 15 women (3.4%) were classified into a SARC-F sarcopenia group. The sarcopenia group had lower physical functioning and Mini Sarcopenia Risk Assessment scores and higher frailty status than the control group. The Cronbach's alpha for the SARC-F was 0.610, suggesting insufficient internal consistency. SARC-F scores were related to physical functioning, IADL, and Mini Sarcopenia Risk Assessment scores. Receiver operating characteristic analyses of the SARC-F based on each criterion showed low sensitivity, but high specificity. CONCLUSIONS:The Japanese version of the SARC-F appears to be a useful index for reflecting physical functioning and IADL. However, it is necessary to further determine whether this tool is useful for detecting sarcopenia among community-dwelling older adults. Geriatr Gerontol Int 2019; 19: 1172-1178. 10.1111/ggi.13768
    Enhancing SARC-F: Improving Sarcopenia Screening in the Clinical Practice. Barbosa-Silva Thiago Gonzalez,Menezes Ana Maria Baptista,Bielemann Renata Moraes,Malmstrom Theodore K,Gonzalez Maria Cristina, Journal of the American Medical Directors Association OBJECTIVES:To validate the (Brazilian) Portuguese-translated version of the SARC-F questionnaire and to verify its performance in the separate sarcopenia screening and muscle function evaluation contexts. In addition, by associating SARC-F to an anthropometric measurement (as an estimate of muscle mass), to test for improvements in its sarcopenia screening efficacy. DESIGN:Cross-sectional study. SETTING:Urban population of Pelotas, a middle-sized city in Southern Brazil. PARTICIPANTS:Subsample of 179 community-dwelling elderly aged 60 years or older derived from a population-based study (COMO VAI?). MEASUREMENTS:Sarcopenia was evaluated using the European Working Group on Sarcopenia in Older People's diagnostic criteria: dual-energy X-ray absorptiometry, handgrip strength, and walking speed test. Participants also completed SARC-F and their calf circumference (CC) was measured. SARC-F and CC were combined into an original score. The questionnaires' performances were evaluated through receiver operating characteristic curves, sensitivity/specificity analyses, and Pearson χ. RESULTS:Sarcopenia was identified in 15 (8.4%) participants by the European Working Group on Sarcopenia in Older People's criteria. Areas under the receiver operating characteristic curves of SARC-F were 0.592 (95% confidence interval (CI) 0.445, 0.739) screening for sarcopenia and 0.779 (95% CI 0.710, 0.846) evaluating muscle function (P < .001). The SARC-F+CC association significantly improved SARC-F's sarcopenia screening performance [area under the curve: 0.736 (95% CI 0.575, 0.897); comparing with SARC-F alone: P = .027]. A substantial improvement in sensitivity was achieved without compromising the remaining parameters. CONCLUSIONS:Despite the satisfactory performance evaluating muscle function, SARC-F alone has not achieved adequate results as a sarcopenia screening tool. However, the SARC-F+CC association significantly improved SARC-F's sarcopenia screening performance, enabling its use in the clinical practice. 10.1016/j.jamda.2016.08.004
    German Version of SARC-F: Translation, Adaption, and Validation. Drey Michael,Ferrari Uta,Schraml Marina,Kemmler Wolfgang,Schoene Daniel,Franke Anna,Freiberger Ellen,Kob Robert,Sieber Cornel Journal of the American Medical Directors Association OBJECTIVES:Translation, adaptation, and validation of the German version of the SARC-F for community-dwelling older adults in Germany. DESIGN:Cross-sectional. SETTING AND PARTICIPANTS:117 community-dwelling outpatients with a mean age of 79.1 ± 5.2 years were included in the study; 94 (80.4%) of them were female. Sixty-three (53.8%) had a positive SARC-F score of ≥4 points. According to the definition of sarcopenia from the European Working Group on Sarcopenia in Older People (EWGSOP2), 8 patients (6.8%) were identified as sarcopenic and 57 (48.7%) as probable sarcopenic. METHODS:According to EWGSOP2, probable sarcopenia was defined for patients with reduced hand grip strength (women: <16.0 kg; men: <27.0 kg) and/or impaired chair-rise time (both genders: >15 seconds). Patients with additional low skeletal muscle index were classified as sarcopenic (women: <5.5 kg/m; men: <7.0 kg/m). Translation and cultural adaption was composed of 7 different steps that were in general based on the guidelines put forward by the World Health Organization. Validation include test-retest and the inter-rater reliability (intraclass correlation coefficient) as well as internal consistency (Cronbach alpha). Furthermore, sensitivity, specificity, positive predictive value, and negative predictive value of the SARC-F were calculated. Receiver-operating characteristic analysis was performed to calculate the area under the curve. RESULTS:The translated and culturally adapted version of the SARC-F for the German language has shown excellent inter-rater reliability and good test-retest reliability. The internal consistency is acceptable. Sensitivity (63%) and specificity (47%) for sarcopenia is low. For detecting patients with probable sarcopenia, the SARC-F in the German version has shown 75% sensitivity and 67% specificity. CONCLUSIONS AND IMPLICATIONS:Because of a low sensitivity for detecting sarcopenia but an acceptable sensitivity for identifying probable sarcopenia, the German version of the SARC-F is a suitable tool for case finding of probable sarcopenia. 10.1016/j.jamda.2019.12.011
    SARC-F and SARC-CalF in screening for sarcopenia in older adults with Parkinson's disease. da Luz Marcella Campos Lima,Pinho Cláudia Porto Sabino,Bezerra Gleyce Kelly de Araújo,da Conceição Chaves de Lemos Maria,da Silva Diniz Alcides,Cabral Poliana Coelho Experimental gerontology INTRODUCTION:Few studies have investigated the performance of screening tools in truly sarcopenic individuals, especially subgroups of this population, or in comparison to previous and current criteria for the definition of sarcopenia. OBJECTIVES:Evaluate the performance of SARC-F and SARC-CalF in screening for sarcopenia in patients with Parkinson's disease (PD) in comparison to the diagnostic criteria proposed by the 2010 (1) and 2019 (2) European Working Group on Sarcopenia in Older People (EWGSOP). METHODS:A methodological, cross-sectional study was conducted involving male and female patients ≥60 years of age diagnosed with PD in outpatient care. The risk of sarcopenia was assessed using the SARC-F and SARC-CalF questionnaires, the latter of which includes the calf circumference as an additional item. RESULTS:Sixty patients were evaluated (mean age: 68.9 ± 6.5 years). The prevalence of sarcopenia was 21.7% according to EWGSOP-2 and 55.0% according to EWGSOP-1. Positive screening for sarcopenia was 30% according to the SARC-F and 36.7% according to SARC-CalF. The sensitivity of the SARC-F for the detection of sarcopenia was 27.2% and 23.1% using the criteria of the 2010 and 2019 consensuses, respectively. The comparative analysis of the SARC-CalF revealed a better performance in the diagnostic discrimination with the addition of calf circumference, with sensitivity ranging from 53.8 to 54.5%. Higher sensitivity was found on items addressing the ability to stand up from a chair and climb stairs (69.2%) and the occurrence of falls (76.9%) compared to the use of the complete questionnaire. CONCLUSION:Relatively low sensitivity and an underestimation of sarcopenia were found in the analysis of the SARC-F as a screening tool for sarcopenia. Thus, a significant number of sarcopenic patients would not be identified using this screening tool alone. The SARC-CalF performed better than the SARC-F. 10.1016/j.exger.2020.111183
    Accuracy of SARC-F and SARC-CalF for sarcopenia screening in older women from southern Brazil. Mazocco Letícia,Chagas Patrícia,Barbosa-Silva Thiago G,Gonzalez Maria Cristina,Schwanke Carla Helena Augustin Nutrition (Burbank, Los Angeles County, Calif.) OBJECTIVES:The aim of this study was to verify the accuracy of the SARC-F and the SARC-CalF as screening tools for sarcopenia in community-dwelling older women ≥60 y of age. METHODS:This was a cross-sectional study evaluating a convenience sample of women ≥60 y of age, living in Southern Brazil. Sarcopenia was defined according to the criteria proposed in the latest European Working Group on Sarcopenia in Older People consensus (EWGSOP2). Appendicular muscle mass was assessed by dual-energy x-ray absorptiometry. Muscle strength was measured by handheld dynamometry, and physical performance through the 4-m gait speed test. The SARC-F questionnaire and SARC-CalF score for sarcopenia screening were also applied. RESULTS:We evaluated 288 participants, with a mean age of 67.6 ± 5.8 y. The frequency of probable and confirmed sarcopenia in the sample was 7.3% and 2.1%, respectively. The frequency of risk for sarcopenia assessed by the SARC-F was 4.5% and SARC-CalF 22.2%. Despite the excellent specificity (95.4%) demonstrated by the SARC-F, its sensitivity in identifying confirmed cases was null, whereas the SARC-CalF showed high sensitivity (83.3%) and good specificity (79%). CONCLUSION:The present study findings suggested that SARC-CalF may be able to outperform SARC-F as a sarcopenia screening tool in women ≥60 y of age even under the new EWGSOP2 criteria, the main determinant of which is strength as observed in studies based on the previous definition. 10.1016/j.nut.2020.110955
    SARC-F Questionnaire Detects Frailty in Older Adults. Bahat G,Ozkok S,Kilic C,Karan M A The journal of nutrition, health & aging BACKGROUND/OBJECTIVES:The physical phenotype of frailty, described by Fried et al., shows significant overlap with sarcopenia. EWGSOP2 recommends the SARC-F questionnaire to screen for sarcopenia. Considering common features between both conditions, we aimed to investigate whether the SARC-F questionnaire could also be a valid and reliable tool to screen or evaluate frailty. DESIGN:Retrospective, cross-sectional. SETTING:Istanbul University Istanbul Faculty of Medicine. PARTICIPANTS:A total of 447 older adults (70.7% female, mean age: 74.5±6.6 years). MEASUREMENTS:Frailty was assessed by the modified Fried scale. SARC-F questionnaire was performed by all participants. We used a receiver operating characteristics curve to obtain SARC-F cut-off values to detect frailty, and calculated the area under the curve and 95% confidence interval. RESULTS:There were 93 (20.8%) older adults with frailty according to the modified Fried scale. SARC-F cut-off ≥1 had 91.4% sensitivity and 44.9% specificity. SARC-F cut-off ≥2 presented the best balance between sensitivity and specificity (sensitivity: 74.1% vs. specificity: 73.7%) to identify frailty (area under curve: 0.807; 95% confidence interval: 0.76-0.84, p<0.001). SARC-F ≥4 had high specificity of 92.6% with a sensitivity of 46.2%. CONCLUSION:We suggest that SARC-F ≥1 point can be used to screen for frailty with high sensitivity, and SARC-F ≥4 can be used to diagnose frailty with high specificity. SARC-F may be used to evaluate frailty in usual geriatric practice. 10.1007/s12603-020-1543-9
    Comparing SARC-F with SARC-CalF to Screen Sarcopenia in Community Living Older Adults. Bahat G,Oren M M,Yilmaz O,Kılıç C,Aydin K,Karan M A The journal of nutrition, health & aging OBJECTIVE:To compare the diagnostic value of the SARC-F combined with calf circumference (SARC-CalF) with the standard SARC-F to screen sarcopenia in community-dwelling older adults. DESIGN:Cross-sectional, diagnostic accuracy study. SETTING:Geriatric outpatient clinic of a university hospital. PARTICIPANTS:Older adults >= 65 years. MEASUREMENTS:Muscle mass (bioimpedance analysis device), muscle strength (hand grip strength-Jamar hydraulic hand dynamometer), and physical performance (usual gait speed). Four currently used diagnostic criteria [European Working Group on Sarcopenia in Older People (EWGSOP), Foundation for the National Institutes of Health (FNIH), International Working Group on Sarcopenia (IWGS), and Society on Sarcopenia Cachexia and Wasting Disorders (SCWD) criteria] were applied. SARC-CalF was performed by using two different calf circumference threshold: standard cut-off 31 cm (SARC-CalF-31) and national cut-off 33 cm (SARC-CalF-33). The sensitivity/specificity analyses of the SARC-CalF and SARC-F tools were run. We used the receiver operating characteristics curves and the area under the receiver operating characteristics curves (AUC) to compare the diagnostic accuracy to identify sarcopenia. RESULTS:We included 207 subjects; 67 male and 140 female with a mean age of 74.6±6.7 years. The prevalence of sarcopenia ranged from 1.9% to 9.2%. The sensitivity of SARC-F was between 25% (EWGSOP) and 50% (IWGS); specificity was about 82%. For SARC-CalF-31 and SARC-CalF-33 sensitivity was in general similar -between 25-50%- which pointed out that SARC-CalF was not superior to SARC-F for sensitivity in this sample. Corresponding specificities for SARC-CalF-31 and SARC-CalF-33 were higher than SARC-F and were between 90-98%. Additionally, the AUC values, which indicates the diagnostic accuracy of a screening test, were in general higher for SARC-CalF-33 than the SARC-F and SARC-CalF-31. CONCLUSIONS:We reported that addition of calf circumference item to SARC-F tool improved the specificity and diagnostic accuracy of SARC-F but it did not improve the sensitivity in a community-dwelling Turkish older adult population sample that had low prevalence of sarcopenia. The performance of SARC-CalF tool to screen sarcopenia is to be studied in different populations and living settings. 10.1007/s12603-018-1072-y
    A 3-Item SARC-F. Woo Jean,Yu Ruby,Leung Jason Journal of the American Medical Directors Association OBJECTIVES:To examine individual items of the SARC-F in predicting adverse outcomes. DESIGN:Prospective cohort study. SETTING:Community-dwelling older people in Hong Kong SAR China. PARTICIPANTS:A total of 4000 men and women aged 65 years and over, stratified in 3 age groups (65-69, 70-74, 75+ years of age). MEASUREMENTS:Information was collected by questionnaire, on sociodemographic details, lifestyle habits, cognitive function using the Mini-Mental State Examination, depression using the Geriatric Depression Scale, SARC-F, and physical limitation in daily activities. Physical performance measures include chair stand and walking speed. Adverse outcomes included physical limitation, lower limb strength using repeated chair stands, slow walking speed, length of hospital stay, and mortality. Predictive ability of each item of the SARC-F was assessed using receiver operating characteristic curve. Stepwise model was used to assess incremental predictive ability. RESULTS:The overall ranking of the questions in order of highest predictability in terms of area under the curve values were strength, climb stairs, assistance in walking, rise from a chair, and falls. The first 3 questions individually predicted all the adverse outcomes, and in stepwise models of the individual questions, a combination of these 3 questions gave the highest area under the curve values. CONCLUSIONS:The 5-item SARC-F may be shortened to 3 items (strength, climb stairs, and assistance in walking) in rapid screening for sarcopenia in clinical practice. 10.1016/j.jamda.2017.09.006
    Sarcopenia for predicting mortality among elderly nursing home residents: SARC-F versus SARC-CalF. Yang Ming,Jiang Jiaojiao,Zeng Yanli,Tang Huairong Medicine Little is known about the prognostic value of the strength, assistance walking, rise from a chair, climb stairs, and falls questionnaire (SARC-F) and SARC-F combined with calf circumference (SARC-CalF) among elderly nursing home residents.To compare the prognostic value of SARC-F and SARC-CalF for mortality in this population.We conducted a prospective study in four nursing homes in western China. Sarcopenia was estimated using SARC-F and SARC-CalF, respectively. Nutrition status, activities of daily living, and other covariates were evaluated. The survival status was collected via medical records and telephone interviews at the 12th month after the baseline investigation. We used multivariate Cox proportional-hazard models to calculate the hazard ratio (HR) and 95% confidence interval (CI) for 1-year all-cause mortality by SARC-F-defined sarcopenia and SARC-CalF-defined sarcopenia, separately.We included 329 participants (median age: 85 years). The prevalences of SARC-F-defined sarcopenia and SARC-CalF-defined sarcopenia were 39.8% and 46.8%, respectively. During the 1-year follow-up period, 73 participants (22.7%) died. The mortality was 29.0% and 18.3% in the participants with or without SARC-F-defined sarcopenia, respectively (P = .025). The mortality was 26.6% and 19.0% in the participants with or without SARC-CalF-defined sarcopenia, respectively (P = .105). After adjusted for the relevant confounders including malnutrition, SARC-F-defined sarcopenia was independently associated with an increased risk of 1-year mortality (adjusted HR: 2.08; 95% CI: 1.27-3.42). However, SARC-CalF-defined sarcopenia was not an independent predictor of 1-year mortality (adjusted HR: 1.54; 95% CI: 0.95-2.47).Sarcopenia is highly prevalent in Chinese elderly nursing home residents according to SARC-F or SARC-CalF. SARC-F-defined sarcopenia appears to be better for predicting the 1-year mortality of Chinese nursing home residents than SARC-CalF-defined sarcopenia. 10.1097/MD.0000000000014546
    Comparison of Diagnostic Performance of SARC-F and Its Two Modified Versions (SARC-CalF and SARC-F+EBM) in Community-Dwelling Older Adults from Poland. Krzymińska-Siemaszko Roma,Deskur-Śmielecka Ewa,Kaluźniak-Szymanowska Aleksandra,Lewandowicz Marta,Wieczorowska-Tobis Katarzyna Clinical interventions in aging Purpose:Older adults should be routinely screened for sarcopenia, which threatens healthy, independent aging. The most popular screening tool is the SARC-F questionnaire. As its sensitivity is unsatisfactory, two modified versions of the questionnaire have been published: SARC-CalF (including calf circumference as an additional item) and SARC-F+EBM (assessing additionally age and Body Mass Index). The diagnostic performance of the three versions of the questionnaire has not been compared. The analysis aimed to assess the diagnostic value of SARC-F, SARC-CalF, and SARC-F+EBM questionnaires, and to compare their psychometric properties against two reference standards of sarcopenia diagnosis, ie, EWGSOP1 and modified EWGSOP2 criteria. Materials and Methods:We performed the sensitivity/specificity analysis and compared the overall diagnostic accuracy of SARC-F, SARC-CalF (31cm) (cut-off point 31 cm for both genders), SARC-CalF (33/34cm) (cut-off points: 33 cm for women and 34 cm for men), and SARC-F+EBM in 115 community-dwelling volunteers aged ≥ 65 yrs from Poland. Results:Depending on the version of the SARC-F questionnaire used, from 10.4% [SARC-CalF (31cm)] to 33.0% (SARC-F+EBM) were identified as having an increased risk of sarcopenia. Sarcopenia was identified in 17.4% by the EWGSOP1 criteria and in 13.9% by the modified EWGSOP2 criteria. With respect to the two reference standards used, the sensitivity of SARC-F, SARC-CalF (31cm), SARC-CalF (33/34cm), and SARC-F+EBM ranged 30.0-37.5%, 35.0-37.5%, 60.0-62.5%, 55.0% (the same value for both reference standards), respectively. The specificity ranged 85.3-85.9%, 93.9-94.7%, 88.4-86.9%, 70.7-71.6%, respectively. The AUC of SARC-F, SARC-CalF (31cm), SARC-CalF (33/34cm) and SARC-F+EBM ranged 0.644-0.693, 0.737-0.783, 0.767-0.804, 0.714-0.715, respectively. Conclusion:The modified versions of SARC-F have better diagnostic performance as compared to the original questionnaire. Since an ideal screening tool should have reasonably high sensitivity and specificity, and an AUC value above 0.7, the SARC-CalF (33/34cm) seems to be the best screening tool for sarcopenia in community-dwelling older adults. 10.2147/CIA.S250508
    Association of SARC-F and dissociation of SARC-F + calf circumference with comorbidities in older hospitalized cancer patients. Mainardi Lara G,Borges Thaís C,Gomes Tatyanne L N,Pichard Claude,Laviano Alessandro,Pimentel Gustavo D Experimental gerontology The Strength, Assistance for walking, Rise from a chair, Climb stairs and Falls (SARC-F) score is a tool recommended for screening the risk of sarcopenia in older patients. However, the association between SARC-F or SARC-F + calf circumference (SARC-F + CC) and the Charlson Comorbidity Index (CCI) in hospitalized older cancer patients is not fully understood. Thus, our aim is to evaluate the association between the SARC-F or SARC-F + CC and the presence of comorbidities and risk of death in older hospitalized cancer patients. A cross-sectional study involving 90 (42 M/48F) hospitalized cancer patients over 60 years old with ongoing chemotherapy or surgical treatment is carried out. The SARC-F is performed to assess the muscle function loss (MFL if SARC-F ≥ 4), sarcopenia (SARC-F ≥ 6) and sarcopenia using the calf circumference (SARC-F + CC ≥11). CC is assessed using an inelastic tape. The CCI is used to assess the presence of comorbidities. Logistic regression is used to evaluate the association between the SARC-F and Charlson Comorbidity Index. Mean of age is 67.8 years and half (49%) of the patients present MFL (SARC-F ≥ 4), 31% present sarcopenia using the SARC-F ≥ 6 and 60% using the SARC-F + calf circumference ≥ 11. Although no association in the crude model, there is association after adjusting by age, sex, alcohol use, smoking habit, physical activity, use of oral nutritional supplementation, body mass index, performance status, tumor, and treatment type between SARC-F ≥ 4 or ≥ 6 and CCI (SARC-F ≥ 4 × CCI: OR: 2.31 [95%CI: 1.02-5.23], p = 0.04) and (SARC-F ≥ 6 × CCI: OR: 3.24 [95%CI: 1.21-8.65], p = 0.01), respectively. However, this association is lost when using the SARC-F + calf circumference (SARC-F + CC ≥11 × CCI: OR: 1.12 [95%CI: 0.63-1.90], p = 0.68). In conclusion, screening for the risk of sarcopenia in older cancer patients is highly recommended as sarcopenia is tightly associated with the clinical outcome. The use of the SARC-F score using a cut-off ≥4 or ≥ 6 is more relevant for clinical practice to detect comorbidities and risk of death than the use of SARC-F with the calf circumference. 10.1016/j.exger.2021.111315
    SARC-F Validation and SARC-F+EBM Derivation in Musculoskeletal Disease: The SPSS-OK Study. Kurita N,Wakita T,Kamitani T,Wada O,Mizuno K The journal of nutrition, health & aging OBJECTIVES:To validate the SARC-F questionnaire for sarcopenia screening in musculoskeletal disease setting, and to assess improvements in diagnostic accuracy by adding "EBM" (elderly and body mass index information) to the SARC-F. DESIGN:Diagnostic accuracy study. SETTING AND PARTICIPANTS:The center involved in this study was located in an urban area of Kobe City, Japan. People with musculoskeletal disease in the knee, hip, or spine who were scheduled for surgical treatment were included. MEASUREMENTS:Sarcopenia was evaluated using the Asian Working Group for Sarcopenia (AWGS) and the European Working Group on Sarcopenia in Older People (EWGSOP2), which included bioimpedance, handgrip strength, and gait speed. Patients answered the SARC-F questionnaire and their body mass index was measured. SARC-F and "EBM" information were combined into an original score. The sensitivities, specificities, and areas under the receiver operating characteristic curve (AUC) were estimated and compared to identify sarcopenia. RESULTS:A total of 959 patients were included. Sarcopenia by AWGS criteria was identified in 36 (3.8%) patients. SARC-F had a sensitivity of 41.7% and specificity of 68.5%. SARC-F+EBM had a sensitivity of 77.8% and specificity of 69.6%, with substantial improvement in sensitivity (P<0.001). The AUCs for SARC-F and SARC-F+EBM were 0.557 (95% confidence interval [CI] 0.452-0.662) and 0.824 (95% CI 0.762-0.886), respectively (P<0.001). Similar results were obtained when EWGSOP2 criteria were used as the reference standard. CONCLUSION:The SARC-F alone is not adequate for finding cases in musculoskeletal disease settings. SARC-F+EBM significantly improved the sensitivity and overall diagnostic accuracy of the SARC-F for screening sarcopenia. SARC-F+EBM is potentially useful for screening sarcopenia in different ethnic and disease settings. 10.1007/s12603-019-1222-x
    Screening Sarcopenia in Community-Dwelling Older Adults: SARC-F vs SARC-F Combined With Calf Circumference (SARC-CalF). Yang Ming,Hu Xiaoyi,Xie Lingling,Zhang Luoying,Zhou Jie,Lin Jing,Wang Ying,Li Yaqi,Han Zengli,Zhang Daipei,Zuo Yun,Li Ying,Wu Linna Journal of the American Medical Directors Association OBJECTIVES:To compare the diagnostic value of the 5-component questionnaire that measures strength, assistance walking, rise from a chair, climb stairs, and falls (SARC-F) and SARC-F combined with calf circumference (SARC-CalF) for screening sarcopenia in community-dwelling older adults. DESIGN:A diagnostic accuracy study. SETTING:A community in Chengdu, China. PARTICIPANTS:Older adults aged 60 years or older. MEASUREMENTS:Muscle mass, muscle strength, and physical performance were estimated using a bioimpedance analysis device, handgrip strength, and gait speed, respectively. Four commonly used diagnostic criteria [European Working Group on Sarcopenia in Older People (EWGSOP), Asian Working Group for Sarcopenia (AWGS), International Working Group on Sarcopenia (IWGS), and Foundation for the National Institutes of Health (FNIH) criteria] were applied as the reference standard, separately. The sensitivity/specificity analyses of the SARC-F and SARC-CalF methods were evaluated. The receiver operating characteristics curves and the area under the receiver operating characteristics curves were used to compare the overall diagnostic accuracy of the SARC-F and SARC-CalF for identifying sarcopenia. RESULTS:We included 160 men and 224 women. Based on the 4 diagnostic criteria, the prevalence of sarcopenia ranged from 11.7% to 25.0%. Using the AWGS criteria as the reference standard, the SARC-CalF had a sensitivity of 60.7% and a specificity of 94.7% in the whole study population, whereas the SARC-F had a sensitivity of 29.5% and a specificity of 98.1%. The area under the receiver operating characteristics curves for SARC-CalF and SARC-F were 0.92 (95% confidence interval 0.89‒0.94) and 0.89 (95% confidence interval 0.86‒0.92), respectively (P = .003). We obtained similar results when using the other 3 criteria as the reference standard. Subgroup analyses revealed similar results in both men and women. CONCLUSIONS:SARC-CalF significantly improves the sensitivity and overall diagnostic accuracy of SARC-F for screening sarcopenia in community-dwelling older adults. 10.1016/j.jamda.2017.12.016
    SARC-F to screen or diagnose sarcopenia in cancer? A point-blank refusal. Malas Fevziye Ünsal,Kara Murat,Özçakar Levent Cancer 10.1002/cncr.33464
    SARC-F has low correlation and reliability with skeletal muscle mass index in older gastrointestinal cancer patients. Siqueira Jéssika M,de Oliveira Izabella C L,Soares Jéssika D P,Pimentel Gustavo D Clinical nutrition (Edinburgh, Scotland) BACKGROUND & AIMS:The evaluation of function and muscle mass in older cancer patients is essential to reduce comorbidities. We hypothesized that Simple Questionnaire to Rapidly Diagnose Sarcopenia (SARC-F) questionnaire is useful to assessment the muscle function, but not muscle mass. Thus, the purpose of this study was to evaluate the correlation and reliability between the SARC-F and skeletal muscle mass index (SMI) in older gastrointestinal cancer patients. METHODS:A cross-sectional observational study enrolled 108 (63.55 ± 8.9 y) gastrointestinal cancer patients. The patients were evaluated using the SARC-F questionnaire and the muscle mass index (SMI). SMI was calculated using Lee's equation: the appendicular muscle mass (ASM) was divided by height. Pearson's correlation was used to examine the correlation between SARC-F and SMI. The Bland-Altman plot and Cohen's kappa coefficient were used to determine the concordance and reliability between them. Statistical difference was set at p < 0.05. RESULTS:The Bland-Altman plot showed that the difference between methods were within agreement (±1.96; p = 0.001). However, SARC-F has low concordance (κ = 0.20; standard error = 0.14) and correlation (r = -0.303; p = 0.0014) with SMI. CONCLUSION:In older cancer outpatients, we found that SARC-F has low correlation and reliability with SMI. 10.1016/j.clnu.2020.08.018
    SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. Malmstrom Theodore K,Miller Douglas K,Simonsick Eleanor M,Ferrucci Luigi,Morley John E Journal of cachexia, sarcopenia and muscle BACKGROUND:A brief, inexpensive screening test for sarcopenia would be helpful for clinicians and their patients. To screen for persons with sarcopenia, we developed a simple five-item questionnaire (SARC-F) based on cardinal features or consequences of sarcopenia. METHODS:We investigated the utility of SARC-F in the African American Health (AAH) study, Baltimore Longitudinal Study of Aging (BLSA), and National Health and Nutrition Examination Survey (NHANES). Internal consistency reliability for SARC-F was determined using Cronbach's alpha. We evaluated SARC-F factorial validity using principal components analysis and criterion validity by examining its association with exam-based indicators of sarcopenia. Construct validity was examined using cross-sectional and longitudinal differences among those with high (≥4) vs. low (<4) SARC-F scores for mortality and health outcomes. RESULTS:SARC-F exhibited good internal consistency reliability and factorial, criterion, and construct validity. AAH participants with SARC-F scores ≥ 4 had more Instrumental Activity of Daily Living (IADL) deficits, slower chair stand times, lower grip strength, lower short physical performance battery scores, and a higher likelihood of recent hospitalization and of having a gait speed of <0.8 m/s. SARC-F scores ≥ 4 in AAH also were associated with 6 year IADL deficits, slower chair stand times, lower short physical performance battery scores, having a gait speed of <0.8 m/s, being hospitalized recently, and mortality. SARC-F scores ≥ 4 in the BLSA cohort were associated with having more IADL deficits and lower grip strength (both hands) in cross-sectional comparisons and with IADL deficits, lower grip strength (both hands), and mortality at follow-up. NHANES participants with SARC-F scores ≥ 4 had slower 20 ft walk times, had lower peak force knee extensor strength, and were more likely to have been hospitalized recently in cross-sectional analyses. CONCLUSIONS:The SARC-F proved internally consistent and valid for detecting persons at risk for adverse outcomes from sarcopenia in AAH, BLSA, and NHANES. 10.1002/jcsm.12048
    SARC-F for screening of sarcopenia among older adults with cancer. Williams Grant R,Al-Obaidi Mustafa,Dai Chen,Bhatia Smita,Giri Smith Cancer BACKGROUND:Sarcopenia is associated with adverse outcomes among older adults with cancer; however, no easily applied sarcopenia measure exists for use in clinical practice. The use of SARC-F, a 5-item self-reported sarcopenia screening questionnaire, among older adults with cancer remains to be investigated. METHODS:Older adults (aged ≥60 years) with cancer enrolled in the University of Alabama Cancer and Aging Resilience Evaluation Registry were identified. Patients completed the SARC-F questionnaire (with scores ≥4 considered positive for sarcopenia). The authors assessed for differences in geriatric assessment domain impairments, health-related quality of life, and health care utilization between those with and without sarcopenia using multivariate regression, then assessed the association of sarcopenia with survival using Kaplan-Meier methods and a Cox regression model, adjusting for covariates. RESULTS:In total, 256 older adults were identified. The median age was 69 years, 59% of participants were men, and 75% were White. The median SARC-F score was 2 (interquartile range, 0-4), and 33% of participants screened positive. Those with sarcopenia had higher odds of having multiple impairments, including impaired instrumental activities of daily living (adjusted odds ratio [aOR], 18.1; 95% CI, 7.5-43.8) and frailty (aOR, 43.5; 95% CI, 17.7-106.8) as well as reduced physical and mental health-related quality of life (β coefficient, -13.6 and -11.5, respectively) and increased emergency room visits (aOR, 2.4; 95% CI, 1.3-4.7). Furthermore, sarcopenia was independently associated with inferior overall survival (adjusted hazard ratio, 2.98; 95% CI, 1.1-8.3; P = .04). CONCLUSIONS:One-third of older adults with cancer in this cohort screened positive for sarcopenia using the SARC-F screening questionnaire, and these positive scores are associated with geriatric assessment domain impairments, reduced health-related quality of life, increased emergency room visits, and inferior overall survival. 10.1002/cncr.33395
    Comparing SARC-F with SARC-CalF for screening sarcopenia in advanced cancer patients. Fu Xiaofen,Tian Zhen,Thapa Sudip,Sun Huihui,Wen Su,Xiong Huihua,Yu Shiying Clinical nutrition (Edinburgh, Scotland) BACKGROUND & AIMS:Sarcopenia is a commonly prevalent malnutrition condition and serves as a valuable adverse prognostic indicator for survival in patients with cancer. A rapid and convenient screening test for sarcopenia would be helpful for patients. Aim of the study was to evaluate the diagnostic value of SARC-F and SARC-F combined with calf circumference (SARC-CalF) for screening cancer-related sarcopenia in cancer population. METHODS:A total of 309 patients with cancer who had routine abdominal comptued tomography (CT) images within 30 days were enrolled in this cross-sectional cohort. Sarcopenia was determined as the presence of both low muscle mass (LMM) and low muscle strength; muscle mass was evaluated by CT-scan, and muscle strength was evaluated by handgrip strength (HGS). Two different diagnostic criteria (Western criteria and Eastern criteria) were used as the reference standards. The sensitivity and specificity analyses of the SARC-F and SARC-CalF were calculated. The receiver operating characteristic (ROC) curves and the area under the ROC curves (AUC) were used to compare the diagnostic value of SARC-F and SARC-CalF for sarcopenia. RESULTS:The prevalence of LMM and sarcopenia in the patient group was 85.1% and 50.5% by Western criteria. Corresponding figures were lower as 42.4% and 26.2% by Eastern criteria. In the overall study population, when sarcopenia defined by the Eastern criteria, sensitivity and specificity of SARC-CalF were 66.6% and 70.1%, whereas that of SARC-F were 32.1% and 90.7%, respectively. The AUCs for SARC-CalF and SARC-F were 0.75 (95% confidence interval (CI) 0.70-0.80) and 0.70 (95% CI 0.64-0.75), respectively (P = 0.003). Against the Western criteria, SARC-CalF also had better sensitivity (55.1% vs. 22.4%) but lower specificity (76.4% vs. 92.1%) than that of SARC-F. The AUCs of SARC-CalF and SARC-F were 0.70 (95% CI 0.65-0.75) and 0.68 (95% CI 0.62-0.73), respectively, but the difference was not significant (P = 0.211). CONCLUSIONS:SARC-CalF significantly increases the sensitivity and overall diagnostic accuracy of SARC-F for screening sarcopenia. SARC-CalF can be a rapid screening tool for sarcopenia in patients with cancer. 10.1016/j.clnu.2020.02.020
    GripBMI - A fast and simple sarcopenia screening tool in post acute inpatient rehabilitation. Churilov Irina,Churilov Leonid,Brock Kim,Murphy David,MacIsaac Richard J,Ekinci Elif I Clinical nutrition (Edinburgh, Scotland) BACKGROUND & AIMS:Sarcopenia is prevalent in post acute inpatient rehabilitation. An easy to administer screening test may improve identification of sarcopenia in this population, which may promote its early detection and treatment. THE AIMS OF THIS STUDY WERE: a) To investigate clinical utility of SARC-F as a European Working Group on Sarcopenia in Older People2 (EWGSOP2) recommended tool for sarcopenia case finding in post acute inpatient rehabilitation. b) To develop an easy and pragmatic screening test for sarcopenia in healthcare settings with limited ability to measure the patients' muscle mass for confirmation of the sarcopenia diagnosis. METHODS:This cross-sectional study with prospective data collection recruited patients admitted to a general inpatient rehabilitation unit in a metropolitan tertiary referral hospital in Australia. Participant's true sarcopenia status was ascertained, as per EWGSOP2, from their grip strength and muscle mass. Two SARC-F questionnaires were administered, for participants' current and, by recall, premorbid status. To develop GripBMI screening tool, BMI test positivity cut off was established on training sample and validated in conjunction with the established grip strength cut off on validation sample using area under the Receiver Operating Curve (ROC) analysis. RESULTS:True prevalence of sarcopenia in 277 participants (median age 64 years (IQR 53-72), 52% male) was 14% (95%CI 11%-19%). Screening utility of SARC-F positive status at the time of admission for sarcopenia had ROC of 0.50, and of premorbid SARC-F positive status had ROC of 0.51. Out of 42 participants positive on the GripBMI screen, 33 had sarcopenia, and out of 235 participants negative on the GripBMI screen, 7 participants had sarcopenia, resulting in GripBMI ROC area 0.89, sensitivity 83%, specificity 96%, positive predictive value 79%, negative predictive value 97%, diagnostic odds ratio 119 (95% CI 42-338). CONCLUSIONS:The GripBMI screening tool uses the combination of EWGSOP2 recommended low grip strength cut offs and Body Mass Index of less than 25 as a positive screening test for sarcopenia. It may assist in promoting early detection and management of sarcopenia in post acute inpatient rehabilitation. 10.1016/j.clnu.2020.06.034