Reliability and Concurrent Validity of the SARC-F and Its Modified Versions: A Systematic Review and Meta-Analysis.
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.
Systematic review and meta-analyses.
Adults (all ages) from any study population.
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.
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).
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.
Voelker SN
，Michalopoulos N
，Maier AB
，Reijnierse EM
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Screening Sarcopenia in Community-Dwelling Older Adults: SARC-F vs SARC-F Combined With Calf Circumference (SARC-CalF).
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.
A diagnostic accuracy study.
A community in Chengdu, China.
Older adults aged 60 years or older.
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.
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.
SARC-CalF significantly improves the sensitivity and overall diagnostic accuracy of SARC-F for screening sarcopenia in community-dwelling older adults.
Yang M
，Hu X
，Xie L
，Zhang L
，Zhou J
，Lin J
，Wang Y
，Li Y
，Han Z
，Zhang D
，Zuo Y
，Li Y
，Wu L
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