Limitations of SARC-F in the diagnosis of sarcopenia in community-dwelling older adults

Kera, Takeshi; Kawai, Hisashi; Hirano, Hirohiko; Kojima, Motonaga; Watanabe, Yutaka; Motokawa, Köiti; Fujiwara, Yoshinori; Osuka, Yosuke; Kojima, Narumi; Kim, Hunkyung; Ihara, Kazushige; Obuchi, Shuichi

doi:10.1016/j.archger.2019.103959

Cited by 29 publications

(25 citation statements)

References 17 publications

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“…It is well known that sarcopenia is under-diagnosed and poorly managed, and applying the case finding approach using SARC-F will fail to identify sarcopenia in up to 75% of pre-frail older adults. Using SARC-F as a screening tool has a low sensitivity and high specificity, and this findings have been replicated in other studies using the EWGSOP2 algorithm with similar case finding approaches which may not necessarily be restricted to high prevalence settings[ 20 - 23 ]. The addition of calf circumference to SARC-F (SARC-CalF) did improve the positive agreement percentage from 33% to 42%.…”

Section: Discussionmentioning

confidence: 62%

Prevalence of sarcopenia in pre-frail community dwelling older adult and utility of SARC-F, SARC-CalF and calf circumference in case finding

Lim

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Merchant

2020

JFSF

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To determine the prevalence of sarcopenia in the pre-frail community dwelling older adults based on the Asian Workgroup for Sarcopenia (AWGS 2019) criteria. In addition, the utility of case finding using the SARC-F, SARC-CalF and calf circumference on impact of prevalence was explored. Methods: 75 older adults ≥65 years old were recruited between October 2019 and March 2020. The algorithms of AWGS 2019 was applied retrospectively to pre-frail participants recruited for an intervention study in primary care setting. In addition to demographics, SARC-F, calf circumference (CC), muscle mass, grip strength, gait speed, 5-time chair stand timing and short physical performance battery test (SPPB) were measured, to determine sarcopenia using AWGS 2019. SARC-CalF was determined using SARC-F and CC. Results: The prevalence of sarcopenia based on AWGS 2019 algorithm was 16.0%, possible sarcopenia 73.3% and severe sarcopenia 12.0%. Using SARC-F for case finding reduced the overall prevalence of sarcopenia to 4.0%, possible sarcopenia to 12.0% and severe sarcopenia to 4.0%. Positive percentage agreement of case finding criteria of SARC-F, SARC-CaIF and calf circumference for sarcopenia was 33%, 42% and 58% respectively. Conclusions: Using the AWGS 2019 without case finding, the prevalence of sarcopenia was 16%. However, using SARC-F for case finding underestimated prevalence in this group by 75%. Utility of SARC-F for case finding in pre-frail requires further evaluation.

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Section: Discussionmentioning

confidence: 62%

Prevalence of sarcopenia in pre-frail community dwelling older adult and utility of SARC-F, SARC-CalF and calf circumference in case finding

Lim

Low

Merchant

2020

JFSF

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“…SARC-F combined with CC or finger-ring testing has been assessed in patients with chronic liver disease as a method of sarcopenia screening (22)(23)(24)(25). Additionally, it has been reported that SARC-F is an inadequate screening method for community-dwelling older adults, but a useful screening method in selected populations, such as adults in hospital (26). Interestingly, SARC-F appears suitable for detecting individuals at risk of adverse outcomes from sarcopenia (27), whereas its use alone showed sarcopenia was independently associated with the risk of mortality compared with combination of SARC-F and CC (28).…”

Section: Discussionmentioning

confidence: 99%

Comparison of calculated body muscle mass and SARC‑F as methods of screening for sarcopenia in patients with chronic liver disease

et al. 2021

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A simple method is required to screen for sarcopenia in patients with chronic liver disease. In the present study, the value of the existing SARC-F questionnaire as well as calculated body muscle mass (CBMM) approaches were assessed for screening of sarcopenia. A total of 482 patients with chronic liver disease underwent CBMM, grip strength (GS) and SARC-F score assessments. Cross-sectional computed tomography images of the third lumbar vertebrae were analyzed to determine the skeletal muscle (SM) mass in 303 patients. Cutoff CBMM values for sarcopenia were <27.903 in females and <39.731 in males. The cutoff SARC-F score for sarcopenia was ≥4 points. Sarcopenia was diagnosed using the criteria described in the Japan Society of Hepatology. GS was moderately correlated with SARC-F score (females, R=-0.578; males,-0.453) and CBMM (females, R=0.497; males, 0.548). The SM index was moderately correlated with CBMM for both sexes (females, R=0.546; males, 0.612), but not with SARC-F score in females (females, R=-0.132; males,-0.246). The area under the curve (AUC) for CBMM against sarcopenia (0.85964) was significantly larger than that for SARC-F score (0.72013) amongst males (P=0.03577) but not females. The AUCs for a modified SARC-F questionnaire (encompassing the SARC-F questionnaire, CBMM, sex and age; mSARC-F) against sarcopenia were 0.864 in males and 0.78185 in females. As a screening method, SARC-F is less useful than CBMM. However, the AUC for mSARC-F is greater than SARC-F and CBMM.

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“…However, the diagnostic performance of the test varies across studies [ 20 ]. As an example, the sensitivity of the test varies considerably across studies, with values ranging from 3.9 to 95.4% [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

SARC-F as a case-finding tool for sarcopenia according to the EWGSOP2. National validation and comparison with other diagnostic standards

et al. 2021

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Background Sarcopenia is a potentially reversible condition, which requires proper screening and diagnosis. Aims To validate a Polish version of sarcopenia screening questionnaire (SARC-F), and assess its clinical performance. Methods Cross-sectional validation study in community-dwelling subjects ≥ 65 years of age. Diagnosis of sarcopenia was based on the 2018 2nd European Working Group on Sarcopenia in Older People (EWGSOP2) consensus. Hand grip and 4-m gait speed were measured, and the Polish version of SARC-F was administered. Results The mean (SD) age of 73 participants (21.9% men) was 77.8 (7.3) years. Seventeen participants (23.3%) fulfilled the EWGSOP2 criteria of sarcopenia, and 9 (12.3%) criteria for severe sarcopenia. Fourteen (19.2%) participants fulfilled the SARC-F criteria for clinical suspicion of sarcopenia. The Cronbach’s alpha coefficient for internal was 0.84. With EWGSOP2 sarcopenia as a gold standard, the sensitivity of SARC-F was 35.3% (95% CI 14.2–61.7, p = 0.33), specificity was 85.7% (95% CI 73.8–93.6, p < 0.0001). The corresponding positive and negative predictive values were 42.9% (p = 0.79) and 81.4% (p < 0.0001), respectively. The probability of false-positive result was 14.3% (95% CI 6.4–26.2, p < 0.0001) and the probability of false-negative result was 64.7% (95% CI 38.3–85.8, p = 0.33). Overall the predictive power of SARC-F was low (c-statistic 0.64). Discussion SARC-F is currently recommended for sarcopenia case finding in general population of older adults. However, its sensitivity is low, despite high specificity. Conclusions At present SARC-F is better suited to rule out sarcopenia then to case-finding. Further refinement of screening for sarcopenia with the use of SARC-F seems needed.

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Limitations of SARC-F in the diagnosis of sarcopenia in community-dwelling older adults

Cited by 29 publications

References 17 publications

Prevalence of sarcopenia in pre-frail community dwelling older adult and utility of SARC-F, SARC-CalF and calf circumference in case finding

Prevalence of sarcopenia in pre-frail community dwelling older adult and utility of SARC-F, SARC-CalF and calf circumference in case finding

Comparison of calculated body muscle mass and SARC‑F as methods of screening for sarcopenia in patients with chronic liver disease

SARC-F as a case-finding tool for sarcopenia according to the EWGSOP2. National validation and comparison with other diagnostic standards

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