Screening Sarcopenia in Community-Dwelling Older Adults: SARC-F vs SARC-F Combined With Calf Circumference (SARC-CalF)

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 bio-impedance analysis device, handgrip strength, and gait speed, respectively. Four commonly used diagnostic criteria [EuropeanWorking 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. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.