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Sato R, Sawaya Y, Hirose T, Shiba T, Yin L, Ishizaka M, Urano T. Screening for sarcopenia using calf muscle circumference in older adults requiring long-term care. J Nutr Health Aging 2024; 28:100006. [PMID: 38267159 DOI: 10.1016/j.jnha.2023.100006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 01/26/2024]
Affiliation(s)
- Ryo Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan; Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Tamaki Hirose
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan; Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Lu Yin
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan; Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan.
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Huang L, Shu X, Ge N, Gao L, Xu P, Zhang Y, Chen Y, Yue J, Wu C. The accuracy of screening instruments for sarcopenia: a diagnostic systematic review and meta-analysis. Age Ageing 2023; 52:afad152. [PMID: 37596923 DOI: 10.1093/ageing/afad152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 06/09/2023] [Indexed: 08/21/2023] Open
Abstract
OBJECTIVE This review aimed to summarise the diagnostic accuracy of screening tools for sarcopenia. METHODS We conducted a systematic review along with a critical appraisal of published studies on screening tools for sarcopenia. We assessed the measurement properties of screening instruments using the consensus-based standards for selecting health measurement instruments (COSMIN) checklist. We evaluated the risk bias of the included studies using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. The diagnostic test accuracy of instruments for sarcopenia was reported using sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR). RESULTS We screened 7,120 titles and abstracts; 42 studies including five screening tools for sarcopenia were included. The overall study quality assessed by the QUADAS-2 tool was moderate to good. Of the five screening tools, three instruments had specificities ≥85%: 92% [95% confidence interval (CI): 63-99%] for the SARC-F modified version, 87% (95% CI: 82-90%) for the SARC-F and 85% (95% CI: 77-90%) for the Ishii score. Three tools had sensitivity ≥75%, namely, MSRA 82% (95% CI: 69-90%), Ishii score 79% (95% CI: 62-89%) and U-TEST 76%. PLR higher than 5.0 were present for the Ishii score and SARC-F modified versions; the Ishii score also had the best NLR of 0.25 of all scales. CONCLUSION The MSRA and Ishii score had excellent sensitivity for sarcopenia screening at an early stage; SARC-F modified versions and Ishii score had superior specificity for sarcopenia diagnosis.
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Affiliation(s)
- Li Huang
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiaoyu Shu
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ning Ge
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Langli Gao
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ping Xu
- Department of Biomedical Engineering, Sichuan University Library, Chengdu, Sichuan Province, China
| | - Yu Zhang
- Department of Biomedical Engineering, Sichuan University Library, Chengdu, Sichuan Province, China
| | - Yu Chen
- Department of Applied Mechanics, Sichuan University, Chengdu, Sichuan Province, China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu Province, China
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Barreto de Lima A, Dos Santos Ribeiro G, Henriques-Neto D, Rúbio Gouveia É, Baptista F. Diagnostic performance of SARC-F and SARC-CalF in screening for sarcopenia in older adults in Northern Brazil. Sci Rep 2023; 13:11698. [PMID: 37474595 PMCID: PMC10359260 DOI: 10.1038/s41598-023-39002-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/18/2023] [Indexed: 07/22/2023] Open
Abstract
To compare the performance of SARC-F and SARC-CalF as screening tools for sarcopenia. Cross-sectional study with a convenience sample of 312 community-dwelling older people. Sarcopenia was defined as low handgrip strength (HGS) or low gait speed (GS ≤ 0.8 m/s). HGS was measured by dynamometry and GS by the 4-m walking speed test. For HGS, six criteria (C) were used to identify sarcopenia in men/women: CI: < 27 kg/16 kg; CII: < 35.5 kg/20.0 kg; CIII: grip over body mass index < 1.05/< 0.79; CIV: grip strength over total body fat < 1.66/< 0.65; CV: grip over bodyweight < 0.45/< 0.34; CVI: < 27 kg/16 kg and low skeletal muscle mass index (SMMI); CI and CVI defined according to the European Working Group on sarcopenia in older people and the rest according to the sarcopenia definition and outcomes Consortium. For sarcopenia screening, the SARC-F (≥ 4 points) and the SARC-CalF (≥ 11 points) were used. The kappa analysis revealed no agreement between the SARC-F and the various criteria for the identification of sarcopenia in men. The same lack of agreement was observed in women with some exceptions: CI = 0.161 ± 0.074, p = 0.020; GS = 0.209 ± 0.076, p = 0.003. Concerning the Cohen's kappa between the SARC-Calf and the reference criteria of sarcopenia, the following coefficients were observed as significant for women: CI = 0.201 ± 0.069, p = 0.003; CII = 0.186 ± 0.064, p = 0.005; GS = 0.273 ± 0.068, p = 0.0001; and for men: CII = 0.139 ± 0.053, p = 0.021; GS = 0.223 ± 0.099, p = 0.011. ROC curves revealed the SARC-Calf with acceptable discrimination and reasonable sarcopenia predictive capacity considering a cutoff value of 10.5 in both men (AUC: 67.5%, p = 0.022; Se = 52.9%; Sp = 76.8%) and women (AUC: 72.4%, p < 0.001; Se = 63%; Sp = 68.5%) concerning GS. The SARC-CalF performed better than the SARC-F for screening sarcopenia in the population ≥ 60 years of age in the Amazonas, measured through walking slowness.
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Affiliation(s)
- Alex Barreto de Lima
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal.
- Universidade do Estado do Amazonas, Amazonas, Brazil.
| | - Gustavo Dos Santos Ribeiro
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Duarte Henriques-Neto
- Research Center in Sports Sciences, Health Sciences and Human Development, University of Maia, Maia, Portugal
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, Funchal, Portugal
- LARSYS, Interactive Technologies Institute, Funchal, Portugal
| | - Fátima Baptista
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
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de Lima AB, Baptista F, Henrinques-Neto D, Pinto ADA, Gouveia ER. Symptoms of Sarcopenia and Physical Fitness through the Senior Fitness Test. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2711. [PMID: 36768077 PMCID: PMC9915373 DOI: 10.3390/ijerph20032711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Physical fitness concerns a set of attributes related to the ability to perform physical activity that may justify the symptoms reported by the elderly in the context of sarcopenia. OBJECTIVE This study aimed to investigate the relationship between the perception (symptomatology) of physical functioning (what the person thinks they are capable of) and the capacity itself for physical functioning in elderly people in northern Brazil. METHODS Cross-sectional study that analyzed 312 elderly people (72.6 ± 7.8 years) from the city of Novo Aripuanã, Amazonas, Brazil. Sarcopenia symptomatology was assessed using the SARC-F, a 5-item questionnaire designed for screening sarcopenia in older individuals in five domains: strength, walking aids, difficulty getting up from a chair, difficulty climbing stairs, and falls. Physical fitness was assessed by the Senior Fitness Test (SFT) battery including balance evaluated with the short version of the Fullerton Advanced Balance scale (FAB). RESULTS ROC curve analysis revealed that the tests with the greatest ability to discriminate participants with significant symptoms for sarcopenia (≥4 points on SARC-F) were arm curl and 6 min walk: the probability of suspected sarcopenia increased exponentially with an arm curl < 11.5 reps for men (se = 71%; sp = 69%; AUC = 0.706, 95% CI: 0.612-0.788; p = 0.013) and women (se = 81%; sp = 51%; AUC = 0.671, 95% CI: 0.601-0.735; p ≤ 0.001) or with a 6-min walk <408.5 m for men (se = 71%; sp = 63%; AUC = 0.720, 95% CI: 0.628-0.690; p = 0.001) and <366.0 m for women (se = 69%; sp = 58%; AUC = 0.692, 95% CI: 0.623-0.755; p = 0.0001). CONCLUSIONS Physical fitness assessed through the senior fitness test, particularly the 30-s-arm curl test and the 6-min walk test, can discriminate for suspected symptoms of sarcopenia.
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Affiliation(s)
- Alex Barreto de Lima
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Cruz-Quebrada, Portugal
- Course of Physical Education, Universidade do Estado do Amazonas, Manaus 69065-001, AM, Brazil
| | - Fátima Baptista
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Cruz-Quebrada, Portugal
| | - Duarte Henrinques-Neto
- Research Center in Sports Sciences, Health Sciences and Human Development, Maia University, 4475-690 Maia, Portugal
- School of Higher Education, Polytechnic Institute of Porto, 4200-465 Porto, Portugal
| | - André de Araújo Pinto
- Department of Physical Education, Universidade Estadual de Roraima, UERR, Boa Vista 69306-530, RR, Brazil
| | - Elvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, 9000-072 Funchal, Portugal
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal
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Graungaard S, Geisler L, Andersen JR, Rasmussen HH, Vinter-Jensen L, Køhler M, Holst M. Prevalence of sarcopenia in patients with chronic intestinal failure-how are SARC-F and the EWGSOP algorithm associated before and after a physical exercise intervention. JPEN J Parenter Enteral Nutr 2023; 47:246-252. [PMID: 36121140 PMCID: PMC10092247 DOI: 10.1002/jpen.2449] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/01/2022] [Accepted: 09/15/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Patients with chronic intestinal failure (IF) have a low degree of physical activity, decreased muscle mass, and decreased muscle strength, leading to a high risk of sarcopenia. We aimed to test the prevalence of sarcopenia by the use of SARC-F and EWGSOP and to investigate the association between the two at baseline and after 12 weeks of an exercise intervention. METHODS Thirty-one patients with chronic IF completed 12 weeks of three weekly home-based individualized exercise sessions. Body composition was measured by bioimpedance analysis and physical function by handgrip strength (HGS) and timed up-and-go (TUG). Sarcopenia was assessed by SARC-F and EWGSOP. Multiple regression analysis was used to test for the association between the two tools. RESULTS The prevalence of sarcopenia measured by EWGSOP was 59%. This prevalence did not change after the intervention. At baseline, 38.8% of patients were screened as at risk for sarcopenia by SARC-F. This decreased to 29.0% after the intervention (P < 0.001). A statistically significant increase was achieved in muscle mass (P = 0.017) and muscle mass index (P = 0.016). Furthermore, both TUG (P = 0.033) and HGS (P = 0.019) improved. CONCLUSIONS Sarcopenia is prevalent in patients with chronic IF. EWGSOP finds more patients to be at risk of sarcopenia than SARC-F but was not sufficiently sensitive to measure changes induced by the physical intervention. The significant change in SARC-F may illustrate that patients, themselves, find an improvement in self-perceived health.
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Affiliation(s)
- Signe Graungaard
- Department of Health Promotion, Aalborg University Hospital, Aalborg, Denmark
| | - Lea Geisler
- Department of Gastroenterology, Centre for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg, Denmark
| | - Jens R Andersen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Henrik H Rasmussen
- Department of Gastroenterology, Centre for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Lars Vinter-Jensen
- Department of Gastroenterology, Centre for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg, Denmark
| | - Marianne Køhler
- Department of Gastroenterology, Centre for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Holst
- Department of Gastroenterology, Centre for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
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Suzan V, Yavuzer H, Bag Soytas R, Bektan Kanat B, Arman P, Emiroglu Gedik T, Unal D, Atar O, Bolayirli IM, Doventas A. The relationship between primary sarcopenia and SARC-F, serum MMP9, TIMP1 levels, and MMP9/TIMP1 ratio in the geriatric patients. Eur Geriatr Med 2021; 12:1229-1235. [PMID: 34106445 DOI: 10.1007/s41999-021-00519-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE The purpose of this study is to evaluate the relationship between serum MMP9 (Matrix metalloproteinase), TIMP1 (Tissue inhibitor of metalloproteinase) levels and MMP9/TIMP1 ratio and primary sarcopenia in geriatric patients, and compare the diagnostic accuracy of such biomarkers with that of the SARC-F score. METHODS A total of 88 patients aged 65 years and older were assessed in the study. Comorbidities and geriatric syndromes were determined and patients with secondary sarcopenia were excluded. EWGSOP2 criteria were used as diagnostic criteria for sarcopenia and SARC-F questionnaire was used to find individuals at risk for sarcopenia. Serum MMP9 and TIMP1 levels were analyzed by ELISA method. RESULTS SARC-F, serum MMP9 and MMP9/TIMP1 ratio were significantly higher in the group with sarcopenia compared to the group without sarcopenia (p = 0.001, p = 0.026 and p = 0.006, respectively). In univariate logistic regression analysis, while SARC-F score and MMP9/TIMP1 ratio were significant, MMP9, TIMP1, age and gender were not. In the multivariate logistic regression analysis of the SARC-F score and the MMP9/TIMP1 ratio, it was determined that both of them were associated with sarcopenia [Odds ratio (OR) 1.447 (95%) confidence interval (CI) 1.170-1.791, p = 0.001; OR 1.127, (95%) CI 1.016-1.249, p = 0.023, respectively]. ROC curve analysis showed that the area under ROC curve (AUC) of SARC-F and MMP9/TIMP1 was 0.703 (p = 0.001, %95 CI 0.594-0.812) and 0.670 (p = 0.006, %95 CI 0.557-0.783), respectively. CONCLUSION Although this study supports the use of SARC-F questionnaire in daily practice; if SARC-F can't be applicable, the MMP9/TIMP1 ratio could be an alternative choice to the SARC-F.
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Affiliation(s)
- Veysel Suzan
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey.
| | - Hakan Yavuzer
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
| | - Rabia Bag Soytas
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
| | - Bahar Bektan Kanat
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
| | - Pinar Arman
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
| | - Tugce Emiroglu Gedik
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
| | - Damla Unal
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
| | - Oguz Atar
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ibrahim Murat Bolayirli
- Department of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Alper Doventas
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Cerrahpaşa mahallesi Kocamustafapaşa Caddesi no:34/E Fatih, Istanbul, Turkey
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Affiliation(s)
- J E Morley
- John E. Morley, MD, BCh, Division of Geriatric Medicine, Saint Louis University, SLUCare Academic Pavilion, Section 2500, 1008 S. Spring Ave., 2nd Floor, St. Louis, MO 63110, USA, , Twitter: @drjohnmorley
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