SARC-F has low correlation and reliability with skeletal muscle mass index in older gastrointestinal cancer patients

Siqueira, Jéssika M.; Oliveira, Izabella C.L.; Soares, Jéssika D.P.; Pimentel, Gustavo D.

doi:10.1016/j.clnu.2020.08.018

Cited by 12 publications

(5 citation statements)

References 21 publications

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“…Our findings also show that the SARC-F item “Strength” independently predicts sarcopenia, and that a SARC-F ≥ 4 is clearly associated with muscle strength rather than muscle mass. These results are consistent with those of previous studies showing that the SARC-F score has a higher correlation with muscle strength but a lower correlation with muscle mass [ 28 , 31 , 32 ]. Muscle strength has many advantages over muscle mass assessed by expensive machines in CLD patients.…”

Section: Discussionsupporting

confidence: 93%

Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan

Hanai

Hiraoka

Shiraki

et al. 2021

JCM

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Diagnosing sarcopenia is challenging. This multicenter cross-sectional study aimed to evaluate the utility of the SARC-F score system for identifying sarcopenia in patients with chronic liver disease (CLD). We enrolled 717 patients from five participating centers who completed the SARC-F between November 2019 and March 2021. Sarcopenia was diagnosed based on the Japan Society of Hepatology Working Group on Sarcopenia in Liver Disease Consensus. Muscle strength was estimated using a grip dynamometer, and muscle mass was assessed using computed tomography or bioelectrical impedance analysis. The association between SARC-F and sarcopenia was analyzed using a logistic regression model. The optimal SARC-F cutoff value for identifying sarcopenia was determined using receiver operating characteristic (ROC) curve analysis. Of the 676 eligible patients, 15% were diagnosed with sarcopenia. The SARC-F distribution was 0 points in 63% of patients, 1 point in 17%, 2 points in 7%, 3 points in 4%, and ≥4 points in 8%. The SARC-F items of “Strength” (odds ratio (OR), 1.98; 95% confidence interval (CI), 1.03–3.80) and “Falls” (OR, 2.44; 95% CI, 1.48–4.03) were significantly associated with sarcopenia. The SARC-F value of 1 point showed a higher discriminative ability for identifying sarcopenia than the 4 points that are conventionally used (p < 0.001), with an area under the ROC curve of 0.68, sensitivity of 0.65, specificity of 0.68, positive predictive value of 0.27, and negative predictive value of 0.92. SARC-F is useful for identifying patients with CLD who are at risk of sarcopenia.

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Section: Discussionsupporting

confidence: 93%

Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan

Hanai

Hiraoka

Shiraki

et al. 2021

JCM

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“…However, the finding that the PED-SARC-F is less sensitive for detecting low muscle mass, resembles the results of adult studies concerning community-dwelling elderly [32], patients with chronic kidney disease [33] and cancer patients [34], which also showed that the SARC-F is better in detecting alterations in muscle strength and function rather than muscle mass deterioration.…”

Section: Discussionsupporting

confidence: 71%

Novel Adaption of the SARC-F Score to Classify Pediatric Hemato-Oncology Patients with Functional Sarcopenia

Verwaaijen

Torre

Vormoor

et al. 2023

Cancers

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Sarcopenia in pediatric hemato-oncology patients is undesirable because of the consequences it may have for treatment continuation and outcome, physical abilities and participation in daily life. An easy-to-use screening tool for sarcopenia will facilitate the identification of children at risk who need interventions to prevent serious physical deterioration. In the elderly, the use of the SARC-F score as a case-finding tool for sarcopenia is recommended. The aim of this cross-sectional study was to investigate the accuracy of the pediatric SARC-F (PED-SARC-F) for identifying sarcopenia in pediatric hemato-oncology patients, including the determination of a cut-off point for clinical use. Patients 3–20 years of age, under active treatment or within 12 months after treatment cessation were eligible. Patients had a physiotherapy assessment including a PED-SARC-F (0–10) and measurements of muscle strength (handheld dynamometry), physical performance (various tests) and/or muscle mass (bio-impedance analysis), as part of the standard of care. Spearman’s correlation coefficient (rs) between the PED-SARC-F and physiotherapy outcomes were calculated. Structural sarcopenia was defined as low appendicular skeletal muscle mass (ASMM) in combination with low muscle strength and/or low physical performance. Functional sarcopenia indicated low muscle strength combined with low physical performance. Multiple logistic regression models were estimated to study the associations between the PED-SARC-F and structural/functional sarcopenia. To evaluate which cut-off point provides the most accurate classification, the area under the receiver operating characteristic curve (AUCs), sensitivity and specificity per point were calculated. In total, 215 assessments were included, 62% were performed in boys and the median age was 12.9 years (interquartile range: 8.5–15.8). The PED-SARC-F scores correlated moderately with the measurements of muscle strength (rs = −0.37 to −0.47, p < 0.001) and physical performance (rs = −0.45 to −0.66, p < 0.001), and weakly with ASMM (rs = −0.27, p < 0.001). The PED-SARC-F had an AUC of 0.90 (95% confidence interval (CI) = 0.84–0.95) for functional sarcopenia and 0.79 (95% CI = 0.68–0.90) for structural sarcopenia. A cut-off point of ≥5 had the highest specificity of 96% and a sensitivity of 74%. In conclusion, we adapted the SARC-F to a pediatric version, confirmed its excellent diagnostic accuracy for identifying functional sarcopenia and defined a clinically useful cut-off point in pediatric hemato-oncology patients.

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“…In 596 cases of non-valvular atrial fibrillation, the SARC-F has been reported to be useful in predicting mortality (53). A study in 108 gastrointestinal cancers reported a low concordance between the SARC-F and SMI (kappa coefficient=0.2) (54). In a study of 77 cancer patients, a significant correlation between the SARC-F and the Charlson comorbidity index, a prognostic score, was noted (55).…”

Section: Clinical Significance Of the Sarc-f According To Diseasesmentioning

confidence: 98%

Screening Tools for Sarcopenia

Nishikawa

Asai

Fukunishi

et al. 2021

In Vivo

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The elderly people are characterized by multiple comorbidities, dementia, and are at risk of developing sarcopenia and frailty. Sarcopenia is defined by loss of muscle mass and muscle strength or physical decline. Sarcopenia is a main component of physical frailty. Screening tools for sarcopenia that can be easily determined in daily practice are useful and include the SARC-F screening tool. SARC-F is a questionnaire consisting of five questions: Strength (S), Assistance walking (A), Rising from a chair (R), Climbing stairs (C), and Falls (F) on a scale of 0 to 2. The recommended cutoff value is ≥4 points. The SARC-F has been shown to correlate well with clinical outcomes in the elderly and various underlying diseases, while it is also true that the SARC-F has its shortcomings such as low sensitivity for sarcopenia. In this review, we mainly outline the SARC-F and mention other screening tools for sarcopenia.The aging of Japan's population continues to accelerate (1). According to the Japanese government report, the aging rate (65 years old or older) was 15.1% of the total population in 1996, but it increased significantly to 28.4% in 2019 (2). In addition, the estimated aging rate as of January 1997 is projected to be 27.4% in 2025, but as of 2019, it has already exceeded the projection. The number of people aged 65 or older will continue to increase, and is estimated to reach 33.3% in 2036 and 38.4% in 2065. In order to improve the quality of life (QOL) of the increasing number of elderly people, efforts have been made in the fields of health, medical care, and welfare to extend healthy life expectancy (the period of time during which there are no limitations in daily life), but there are still many issues to be addressed. The elderly people are characterized by multiple comorbidities, dementia, and risk of sarcopenia and frailty (3). In 2019, the Ministry of Health, Labour and Welfare (MHLW) in Japan published the "Guidelines for Health Services Based on the Characteristics of the Elderly, Version 2", and announced the strengthening of measures against frailty, especially for elderly people aged 75 or older. The guidelines newly added the implementation of "health checkups for frailty" with the aim of integrating health guidance and care prevention. Specifically, the report has recommended the use of a "questionnaire for the elderly aged 75 or older" focusing on frailty in health checkups and other examinations conducted by municipalities since fiscal 2020. This questionnaire is expected to help prevent and raise awareness of frailty among many elderly people. Early intervention through such efforts will lead to a prolongation in healthy life expectancy. In addition, sarcopenia is a condition that forms the basis of physical frailty (4). Sarcopenia leads to decreased physical activity, and decreased physical activity leads to sarcopenia. Both are involved in frailty, forming the so-called "frailty cycle" (4). On the other hand, the number of people aged 60 or older in the world was estimated to be 600 million ...

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SARC-F has low correlation and reliability with skeletal muscle mass index in older gastrointestinal cancer patients

Cited by 12 publications

References 21 publications

Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan

Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan

Novel Adaption of the SARC-F Score to Classify Pediatric Hemato-Oncology Patients with Functional Sarcopenia

Screening Tools for Sarcopenia

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