The SARC-F Questionnaire: Diagnostic Overlap with Established Sarcopenia Definitions in Older German Men with Sarcopenia

Abstract

Background: The high relevance of sarcopenia for the aging societies of most developed nations is emphasized by its recent inclusion in the ICD-10-CM (M62.84). However, diagnosing sarcopenia is a daunting task. Apart from varying definitions, the proper assessment of recognized sarcopenia criteria is time and cost consuming. A short and inexpensive screening tool may thus be welcome for clinicians and others working in the area of gerontology. Recently, a simple questionnaire was provided (SARC-F) that may adequately realize this aim. Objective: The purpose of this study is to compare established sarcopenia definitions (European Working Group on Sarcopenia in Older People [EWGSOP], Foundation National Institute of Health [FNIH], International Working Group on Sarcopenia [IWGS]) with the SARC-F. Our hypothesis was that the diagnostic overlap between the SARC-F and sarcopenia as determined by these recognized definitions was too low to reliably diagnose sarcopenia. Methods: Seventy-four community-dwelling German men aged 70 years and older with established sarcopenia according to EWGSOP and/or FNIH and/or IWGS were screened with the SARC-F questionnaire. Results: Applying the definitions of EWGSOP, IWGS, and FNIH, 66.2, 43.2, and 50% of the cohort were classified sarcopenic, respectively. The SARC-F identified 33.5% of the cohort as sarcopenic. The predictive power of the SARC-F increased when men were classified as sarcopenic according to 2 (57.1%) or all (78.8%) sarcopenia definitions. The diagnostic overlap with the 3 sarcopenia definitions varied between 38.8% (SARC-F-FNIH) and 54.1% (SARC-F-IWGS). In comparison, the overlap of diagnosed sarcopenia ranged from 27.0% (FNIH-IWGS) to 49.0% (IWGS-EWGSOP) among the definitions themselves. Only 12.2% of the men met all 3 sarcopenia definitions. Conclusion: The diagnostic overlap with respect to sensitivity of the SARC-F and present sarcopenia definitions was at least as high as the range of the diagnostic overlap of these approaches themselves. Thus, although the sensitivity of the SARC-F may be debatable, for want of a better option it seems reasonable to consider the SARC-F as a first simple step within a hierarchical screening procedure. Independently of this procedure, a universally accepted mandatory sarcopenia definition along with comprehensive criteria and fixed cutoff points should be provided promptly.

Calf and arm circumference as simple markers for screening sarcopenia in patients with chronic liver disease

“…SARC‐F is a self‐reported five‐item questionnaire that can be performed rapidly without any invasion 25,26 . A previous study found that SARC‐F demonstrated high specificity for identifying sarcopenia in community‐based elderly people 27–29 . However, the low sensitivity of SARC‐F restricted its clinical usefulness.…”

Possible sarcopenia: early screening and intervention-narrative review

“…In SARC-F (Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls) questionnaire, each of the five items has 2 points for a total of 10 points, and a total score ≥4 points indicates that the risk of sarcopenia is increased. The latest research on SARC-F shows that compared with diagnostic criteria proposed by authoritative sarcopenia-working groups, such as EWGSOP, IWGS, and FNIH, SARC-F has a higher detection overlap and higher specificity for the muscle function test, which is an excellent test for identifying muscle function damage and muscle atrophy (20,21). Thus, SARC-F is a better screening test for functional measures and it is reasonable to regard SARC-F as the first simple step in the hierarchical screening process.…”

Association between suicide risk severity and sarcopenia in non-elderly Chinese inpatients with major depressive disorder

“…In 2013, Malmstrom and Morley developed this questionnaire to screen sarcopenia simply, rapidly and conveniently, and suggested that a total score of ≥4 points was considered to indicate sarcopenia [27]. The SARC-F has been evaluated in three large populations including Chinese, The SARC-F has been validated in different ethnic populations and countries including Chinese, and has been proven valid and consistent for identifying those at risk of sarcopenia in these populations [13], with high specificity but relatively low sensitivity [28][29][30][31].…”