Limitations of SARC-F as a Screening Tool for Sarcopenia in Patients on Hemodialysis

Abstract

<b><i>Introduction:</i></b> There are limited screening tools for sarcopenia in patients undergoing hemodialysis. This study aimed to investigate the reliability and validity of the SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls) questionnaire as a screening tool for sarcopenia (defined by the Asian Working Group for Sarcopenia [AWGS2019]) in patients undergoing hemodialysis. <b><i>Methods:</i></b> This cross-sectional study enrolled 179 patients (mean age: 66.5 ± 12 years, 58% men) undergoing maintenance hemodialysis 3 times per week at a hemodialysis center in Japan. The SARC-F score, handgrip strength, usual gait speed, sit-to-stand test time, short physical performance battery (SPPB), and appendicular skeletal muscle mass were evaluated. The reliability and validity of the SARC-F were analyzed using receiver-operating characteristic curve, area under the curve (AUC), and sensitivity/specificity analyses. <b><i>Results:</i></b> There were 49 (27.4%) patients with sarcopenia. Patients with SARC-F ≥4 (59 patients, 33.0%) had poorer grip strength, lower SPPB score, and slower gait speed than those with SARC-F <4, while the skeletal muscle mass index did not differ significantly between the two groups. The sensitivity and specificity values of the SARC-F for identifying sarcopenia were 42.9% and 70.8%, respectively, while those for identifying severe sarcopenia were 66.7% and 72.3%, respectively. The AUCs of SARC-F were 0.57 for sarcopenia and 0.70 for severe sarcopenia. <b><i>Discussion/Conclusion:</i></b> The SARC-F alone is an inadequate screening tool for sarcopenia in patients undergoing hemodialysis. It should be used in combination with objective assessment measures, rather than as a first-step screening tool, to diagnose sarcopenia.

Possible Sarcopenia and Its Association with Nutritional Status, Dietary Intakes, Physical Activity and Health-Related Quality of Life among Older Stroke Survivors

“… 44 , 45 ) Additionally, the presence of cognitive decline might have influenced the accuracy of the results as the SARC-F is a self-report questionnaire; thus, it depends on a participant’s ability to accurately estimate their physical abilities. 46 ) In contrast, Yao et al 47 ) showed that when validated against the 2019 AWGS diagnostic criteria among patients with stroke in China, the sensitivity and specificity of the sarcopenia screening tools were as follows: SARC-F (sensitivity of 94.7%; specificity of 40.0%), Ishii’s score (sensitivity of 90.1%; specificity of 36.0%), and CC alone (sensitivity of 81.8%; specificity of 90.1%). Ishii’s score was derived from a sex-specific formula that included age, HGS, and CC values.…”

Comparison between magnetic resonance imaging and electrical impedance myography for evaluating lumbar skeletal muscle composition

“…On the other hand, both EIM-derived muscle quality and BF% showed medium correlations with SARC-F scores in the younger patients of our series. Nevertheless, it should be noted that SARC-F questionnaire is a helpful tool to screen for low muscle strength and physical performance, but it has well-known limitations, especially screening ability for identifying patients with sarcopenia [ 1 , 25 , 26 ].…”

Knee Muscles Composition Using Electrical Impedance Myography and Magnetic Resonance Imaging

“…Lastly, concerning clinical features of our series, we observed small correlations of SARC-F scores with BF%, EIM-derived muscle quality, CSA, and SMI. However, it must be considered that SARC-F poll is a useful clinical questionnaire for evaluating low muscle strength and physical performance, but with well-established limitations, particularly for screening patients with sarcopenia [ 1 , 27 , 28 ].…”