The prevalence and impact of sarcopenia in older cardiac patients undergoing inpatient cardiac rehabilitation - results from a prospective, observational cohort pre-study.

The prevalence of sarcopenia and its impact in older patients undergoing inpatient cardiac rehabilitation (iCR) after cardiac procedure has been insufficiently studied. The main aim of this study was to evaluate the prevalence of sarcopenia and quantify the functional capacity of older sarcopenic and non-sarcopenic patients participating in iCR. Prospective, observational cohort study within the framework of the ongoing multicenter prehabilitation study "PRECOVERY". A sample of 122 patients ≥75 years undergoing iCR after cardiac procedure were recruited in four German iCR facilities and followed up 3 months later by telephone. At iCR (baseline), the Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls (SARC-F) questionnaire was used to identify sarcopenic patients. In addition, Katz-Index, Clinical Frailty Scale (CFS), handgrip strength (HGS), Short Physical Performance Battery (SPPB) and 6-minute walk distance (6MWD) measured functional capacity and frailty at baseline. Outcomes were prevalence of sarcopenia and the correlation of sarcopenia to functional capacity and frailty at baseline as well as the SARC-F score at follow-up. The Wilcoxon test was applied for pre-post-test analysis. Correlation between sarcopenia and 6MWD, SPPB score and HGS was tested with the eta coefficient with one-way ANOVA. Complete assessments were collected from 101 patients (79.9 ± 4.0 years; 63% male). At baseline, the mean SARC-F score was 2.7 ± 2.1; 35% with sarcopenia. Other baseline results were Katz-Index 5.7 ± 0.9, CFS 3.2 ± 1.4, HGS 24.9 ± 9.9 kg, SPPB score 7.5 ± 3.3 and 6MWD 288.8 ± 136.5 m. Compared to baseline, fewer patients were sarcopenic (23% versus 35%) at follow-up. In the subgroup of sarcopenic patients at baseline (n = 35), pre-post comparison resulted in a significant SARC-F improvement (p = 0.017). There was a significant correlation between sarcopenia measured by SARC-F and poor results in the assessments of functional capacity (p < 0.001; r > 0.546). The prevalence of sarcopenia in older patients at iCR after cardiac procedure is high (35%) and remains high at follow-up (23%). Sarcopenia screening is important since the diagnosis of sarcopenia in these patients correlates significantly with poor functional capacity. The results indicate that these patients may benefit from prehabilitation aimed at improving perioperative outcomes, increasing functional capacity and mitigating adverse effects. German Clinical Trials Register (DRKS; http://www.drks.de ; DRKS00032256). Retrospectively registered on 13 July 2023.

Steinmetz C ，Krause L ，Sulejmanovic S ，Kaumkötter S ，Mengden T ，Grefe C ，Knoglinger E ，Reiss N ，Brixius K ，Bjarnason-Wehrens B ，Schmidt T ，von Haehling S ，Sadlonova M ，von Arnim CAF ，Heinemann S ... -  《BMC Geriatrics》

Evaluation of frailty in geriatric patients undergoing cardiac rehabilitation after cardiac procedure: results of a prospective, cross-sectional study.

Steinmetz C ，Krause L ，Sulejmanovic S ，Kaumkötter S ，Hartog J ，Scheenstra B ，Stefan F ，Mengden T ，Grefe C ，Knoglinger E ，Reiss N ，Bjarnason-Wehrens B ，Schmidt T ，Sadlonova M ，von Arnim CAF ，Heinemann S ... -  《BMC Sports Science Medicine and Rehabilitation》

Validation of the Korean Version of the SARC-F Questionnaire to Assess Sarcopenia: Korean Frailty and Aging Cohort Study.

The SARC-F is a simple sarcopenia screening tool comprising 5 assessment items: strength, assistance walking, rising from a chair, climbing stairs, and falls. The present study aimed to examine the validation of the Korean version of SARC-F for elderly individuals residing in communities. From the first year baseline data of Korean Frailty and Aging Cohort Study, a total of 1222 elderly individuals (70 years and older) who met the study's selection criteria were included in the analysis. The SARC-F was translated into the Korean language in a culturally responsive way. The total score was calculated by adding the scores on the 5 items. The participants were divided into 2 groups according to the total score (SARC-F <4 vs SARC-F ≥4), and its correlations with various factors including walking speed, hand grip, ability to perform everyday activities, and health-related quality of life, were examined by sex. In addition, the tool's validity was analyzed by comparing it with the European, international, and Asian sarcopenia working group diagnostic criteria for sarcopenia. The prevalence of sarcopenia according to the SARC-F was 4.2% in among men and 15.3% in women. The sensitivity of the SARC-F was low compared with the European, international, and Asian criteria of sarcopenia [male (M): 11%-60%, female (F): 28%-34%]. However, SARC-F showed a high specificity (M: 96.6%-98%, F: 85%-87.7%) and a high negative predictive value (M: 89.2%-99.3%, F: 88.5%-98.4%). The participants in the SARC-F ≥4 group had poorer grip strength, slower walking speed, poorer physical performance, poorer cognitive function, and a lower quality of life (a high EuroQol-5 dimension score) than the participants in the SARC-F <4 group. The Korean language version of SARC-F showed a high specificity and high negative predictive value. As such, the tool is useful for briefly ruling out sarcopenia in a clinical setting. In addition, diagnosis of sarcopenia using the SARC-F was found to be associated with physical performance, cognitive function, and the quality of life.

Kim S ，Kim M ，Won CW 《-》

SARC-F Is Inaccurate to Identify Geriatric Rehabilitation Inpatients at Risk for Sarcopenia: RESORT.

Sarcopenia is highly prevalent in geriatric rehabilitation inpatients; screening using the Strength, Assistance in walking, Rise from a chair, Climb stairs, Falls history questionnaire (SARC-F) has been recommended. This study assessed the diagnostic accuracy of the SARC-F in identifying sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP), EWGSOP2, and Asian Working Group for Sarcopenia (AWGS) definitions in geriatric rehabilitation inpatients. REStOring health of acutely unwell adulTs (RESORT) is an observational, longitudinal cohort of geriatric rehabilitation inpatients. The SARC-F was completed for 2 time-points, status at preadmission (1 month before admission) and at admission; a score ≥4 was considered at risk for sarcopenia. Muscle mass (bioelectrical impedance analysis), handgrip strength (handheld dynamometry), and gait speed (4-m walk test) were measured at admission. Diagnostic accuracy was determined by sensitivity, specificity, and area under the curve (AUC). The sarcopenia prevalence (n = 290, median age 84.0 years [IQR 79.0-89.0], 56.9% female) was 40.3% (EWGSOP1), 25.4% (EWGSOP2), and 38.8% (AWGS). For preadmission and admission status, respectively, the SARC-F identified 67.9 and 82.1% (EWGSOP), 66.0 and 81.0% (EWGSOP2), and 67.5 and 81.6% (AWGS) inpatients at risk for sarcopenia. The SARC-F showed fair sensitivity (67-74%), poor specificity (32-37%), and poor AUC (0.411-0.474) to identify inpatients at risk for sarcopenia at preadmission status, and fair-good sensitivity (79-84%), poor specificity (17-20%), and poor AUC (0.401-0.432) to identify inpatients at risk for sarcopenia at admission, according to EWGSOP, EWGSOP2, and AWGS definitions. The SARC-F showed poor diagnostic accuracy in identifying sarcopenia in geriatric rehabilitation inpatients. Assessment of sarcopenia is recommended without screening.

Dedeyne L ，Reijnierse EM ，Pacifico J ，Kay JE ，Maggs P ，Verschueren S ，Tournoy J ，Gielen E ，Lim WK ，Maier AB ... -  《-》

The relationships between sarcopenia, frailty, bioelectrical impedance analysis, and anthropometry in patients with type two intestinal failure.

Sasegbon A ，Weerasinghe P ，Lal S 《Clinical Nutrition ESPEN》