The identification of probable sarcopenia in early old age based on the SARC-F tool and clinical suspicion: findings from the 1946 British birth cohort

Abstract

Key summary pointsAim To describe the prevalence of probable sarcopenia in a sample of older adults and to investigate (1) the SARC-F tool and (2) clinical risk factors in the identification of probable sarcopenia. Findings The prevalence of probable sarcopenia at age 69 was 19%, and a SARC-F score of ≥ 1 had a reasonable balance of sensitivity (65%) and specificity (72%) for probable sarcopenia. Three clinical risk factors were independently associated with probable sarcopenia: polypharmacy, lower body osteoarthritis and physical inactivity. Message Those with any positive responses to the questions in the SARC-F tool, a history of polypharmacy, lower body osteoarthritis or physical inactivity should be prioritised for the assessment of muscle strength. AbstractPurpose The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) consensus definition introduced the concept of probable sarcopenia as a basis on which to begin treatment. Our aims were to describe the prevalence of probable sarcopenia in older adults and to investigate the utility of (1) the SARC-F tool and (2) clinical risk factors for the identification of those likely to have probable sarcopenia. Methods We used data from the 1946 British birth cohort at age 69, with 1686 participants included in the analyses. We used the EWGSOP2 cut points for weak grip strength and slow chair rise time, with the presence of one or both indicating probable sarcopenia. We examined the sensitivity and specificity of the SARC-F tool for probable sarcopenia. We also examined associations between clinical risk factors and probable sarcopenia. Results The prevalence of probable sarcopenia was 19%. A SARC-F score of ≥ 4 had low sensitivity (15%) and high specificity (99%) for probable sarcopenia, whereas a score of ≥ 1 had higher sensitivity (65%) and reasonable specificity (72%). Three clinical risk factors were independently associated with probable sarcopenia: polypharmacy [OR 2.7 (95% CI 1.7,4.2)], lower body osteoarthritis [OR 1.8 (95% CI 1.3, 2.6)] and physical inactivity [OR of 2.1 (95% CI 1.5, 2.8)]. Conclusion We have shown that EWGSOP2 probable sarcopenia is common in community-dwelling adults in early old age. Those with any positive responses to the questions in the SARC-F tool, a history of polypharmacy, lower body osteoarthritis or physical inactivity should be prioritised for the assessment of muscle strength.

Socioeconomic Inequality and Risk of Sarcopenia in Community-Dwelling Older Adults

“…While Dodds et al estimated a prevalence of 19% amongst the 1946 British birth cohort aged 69 years (n = 1686). 7 Pérez-Sousa et al reported a prevalence of 47% amongst a representative sample of Colombian older adults; however, the prevalence of low socioeconomic status (76%) and physical inactivity (83%) was strikingly higher than in other studies of probable sarcopenia. Assessment of hand grip strength is a simple and inexpensive screening tool for sarcopenia in community-dwelling older populations, given that sarcopenia diagnosis requires more complex diagnostic measures of muscle mass or quality.…”

“… 4 Grip strength was assessed using a Baseline Hydraulic Hand Dynamometer with two measures taken per hand and the maximum value for the dominant hand used in analyses, in line with previous studies. 6 , 7 Studies show that the Baseline Hydraulic Hand Dynamometer measures hand grip strength with the same accuracy as the Jamar Hydraulic Hand Dynamometer. 15 …”

“… 18 , 19 The number of chronic conditions were categorized as none, one or two or more conditions, similar to previous studies. 7 Osteoarthritis was recorded as present if a participant reported that a diagnosis was provided by a physician. Smoking was self-reported and classified as never smoked, past smoker or current smoker.…”

“…Dodds et al found no association between manual occupation class and probable sarcopenia (n= 1686). 7 Recently, a study from Colombia reported a high prevalence of probable sarcopenia (46.5%) in a population which also appeared to have a relatively high proportion of socioeconomic disadvantage. 9 To the best of the authors’ knowledge, this is the first study to specifically investigate probable sarcopenia and socioeconomic disadvantage.…”

Association of sarcopenia with mortality and end‐stage renal disease in those with chronic kidney disease: a UK Biobank study

“…The latest criteria by the EWGSOP, as well as the Sarcopenia Definition and Outcomes Consortium (SDOC), 2 recently supported the use of low muscle strength as the primary parameter of sarcopenia. Termed ‘probable sarcopenia’, its use is intended to allow for simple recognition and better management of sarcopenia, where measurement of muscle mass may not be possible 4,36 …”