Assessing quality of life with SarQol is useful in screening for sarcopenia and sarcopenic obesity in older women

Abstract

Background Health-related quality of life (HRQoL) may be impaired in the presence of sarcopenia. Since a specific quality of life questionnaire became available for sarcopenia (SarQol), cutoffs to screen for this condition have been proposed, prompting the need to assess them in different populations. Due to the lack of consensus on diagnostic criteria, the tool has not yet been analyzed in screening for sarcopenic obesity. Aim Our aim is to measure the SarQoL’s metric properties and establish a cutoff in QoL assessments that could be used along the diagnostic pathway for sarcopenia and sarcopenic obesity in community-dwelling older women. Methods This cross-sectional study assessed women aged ≥ 70 years using the SarQol, sarcopenia criteria (EWGSOP2) and sarcopenic obesity criteria (ESPEN/EASO). Cutoffs for the SarQol were defined with a receiver-operating characteristics (ROC) curve, and sensitivity and specificity were analyzed. Results Of the 95 included women (mean age 76.0 years, standard deviation [SD] 5.7), 7.3% (n = 7) were classified as having sarcopenic obesity, 22.1% (n = 21) as having sarcopenia, and 70.5% (n = 67) as not having sarcopenia. The total SarQol score was higher in women without sarcopenia (66.5 SD 16.2) versus those with sarcopenia (56.6 SD 15.6) and sarcopenic obesity (45.1 SD 7.9). A cutoff of ≤ 60 points is proposed for sarcopenia screening (area under the ROC curve [AUC] 0.67; 95% confidence interval [CI] 0.53–0.80; sensitivity 61.9%; specificity 62%), and ≤ 50 points for sarcopenic obesity (AUC 0.85; 95% CI 0.74–0.95; sensitivity 71.4%; specificity 76.9%). Conclusions Quality of life is compromised in women with sarcopenia and especially in those with sarcopenic obesity. The SarQol could be useful in screening for these conditions, providing insight into health-related quality of life in older people with sarcopenia.

Prevalence of sarcopenic obesity in the older non-hospitalized population: a systematic review and meta-analysis

“…The total number of participants included in this review was 71,757 from studies with sample sizes ranging from 64 [ 34 ] to 7,852 [ 6 ]. Seven [ 31 , 34 – 35 , 37 – 39 , 50 ] studies included only women, three [ 21 , 24 – 25 ] included only men, and the remaining studies included participants of both sexes. The included studies used varying diagnostic criteria for sarcopenia (low muscle mass, low muscle strength, or low muscle strength and mass) combined with different obesity criteria (percentage of body fat [PBF], BMI, or waist circumference [WC]) to diagnose SO.…”

“…The included studies used varying diagnostic criteria for sarcopenia (low muscle mass, low muscle strength, or low muscle strength and mass) combined with different obesity criteria (percentage of body fat [PBF], BMI, or waist circumference [WC]) to diagnose SO. Among them, 14 [ 6 – 8 , 10 , 13 , 17 , 20 , 22 , 28 , 34 , 45 , 47 , 51 , 54 ] studies used low muscle mass as the diagnostic criterion for sarcopenia, 10 [ 9 , 20 , 26 , 29 , 40 – 41 , 49 – 50 , 55 – 56 ] studies used low muscle strength as the diagnostic criterion for sarcopenia, and 20 [ 14 – 15 , 21 – 25 , 27 , 30 – 31 , 35 – 36 , 39 , 42 – 44 , 46 , 48 , 52 – 53 ] studies used low muscle mass plus low muscle strength as the diagnostic criterion for sarcopenia. In addition, one [ 6 ] study, a multicenter population study, did not provide a specific cutoff for their obesity diagnostic criteria (PBF).…”

“…In addition, one [ 6 ] study, a multicenter population study, did not provide a specific cutoff for their obesity diagnostic criteria (PBF). Two [ 37 – 38 ] studies used the appendicular fat-free mass (calculated as follows: -14.529 + [17.989 × height in meters] + [0.1307 × total fat mass in kg]) truncation value as the diagnostic criterion for SO and did not use the diagnostic method of sarcopenia combined with obesity. Detailed characteristics of the included studies are displayed in Additional File S2 .…”

“…Most studies were of fair [ 6 , 8 , 10 , 2 – 13 , 16 , 19 , 25 – 26 , 29 , 31 , 32 , 35 – 37 , 42 , 48 , 51 – 53 ] or high [ 7 , 9 , 15 , 21 – 25 , 28 – 29 , 31 , 33 , 35 , 36 , 40 – 43 , 45 , 49 , 51 , 52 – 56 ] quality because they scored “yes” for at least five items in the quality assessment checklist. Specifically, 26 [ 7 , 9 , 15 , 21 – 25 , 28 – 29 , 31 , 33 , 35 – 36 , 40 – 43 , 45 – 49 , 51 – 52 , 56 ] studies scored “yes” for 8–9 items, 18 [ 6 , 8 , 13 – 14 , 17 , 20 , 26 – 27 , 30 , 32 , 34 , 37 , 39 , 44 , ...…”

“…The prevalence of SO is higher in South and North America than that in Asia, Europe, and Oceania. The pooled prevalence of SO in Asia, Europe, Eurasia, South America, North America, and Oceania was 12% (95% CI: 9–16%, I 2 = 99%, P < 0.01, 22 studies [ 8 , 10 , 13 – 14 , 17 , 22 , 26 – 27 , 29 , 33 , 41 – 47 , 51 – 54 , 56 ]), 11% (95% CI: 7–15%, I 2 = 97%, P < 0.01, 10 studies [ 23 , 25 , 28 , 30 , 31 , 32 – 35 , 36 , 39 – 48 , 49 ]), 14% (95% CI: 3–31%, I 2 = 98%, P < 0.01, 2 studies [40, 55]), 22% (95% CI: 12–35%, I 2 = 90%, P < 0.01, 6 studies [ 7 , 15 , 34 , 37 – 38 , 50 ]), 16% (95% CI: 10–24%, I 2 = 98%, P < 0.01, 2 studies [ 9 , 19 ]), and 8% (95% CI: 5–11%, I 2 = 88%, P < 0.01, 2 studies [ 21 , 24 ]), respectively (Table 1 ).…”