1
|
Qaisar R, Khan IM, Karim A, Muhammad T, Ahmad F. Lipid-Lowering Medications are Associated with Reduced Sarcopenia-Related Quality of Life in Older Adults with Hyperlipidemia. Drugs Aging 2024; 41:443-453. [PMID: 38564165 DOI: 10.1007/s40266-024-01111-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE Statins medications negatively affect age-associated loss of muscle mass and strength, termed sarcopenia, and neuromuscular junction (NMJ) integrity. However, their association with the sarcopenia-related-quality-of-life (SarQoL) is unknown. METHODS In this cross-sectional, case control study, we recruited male nonusers (n = 75 and age 75.2 ± 5.9 years) and users (n = 77 and age 77.1 ± 6.2 years) of statins to evaluate SarQoL and handgrip strength (HGS). We also measured plasma C-terminal agrin fragment-22 (CAF22) as a marker of NMJ degradation. RESULTS Statin users had higher CAF22, and lower HGS, and cumulative SarQoL scores than non-users (all p < 0.05). Plasma CAF22 exhibited negative correlations with SarQoL scores for physical and mental health, locomotion, functionality, activities-of-daily-living, and cumulative SarQoL in statins users and non-users (all p < 0.05). Lastly, the cumulative SarQoL scores exhibited positive associations with HGS and gait speed in the study participants (all p < 0.05). CONCLUSIONS Collectively, statin usage was associated with NMJ degradation and reduced SarQoL. Statins should be cautiously prescribed in patients with sarcopenia with reduced QoL.
Collapse
Affiliation(s)
- Rizwan Qaisar
- Department of Basic Medical Sciences, M27-122, College of Medicine, University of Sharjah, 27272, Sharjah, United Arab Emirates.
- Space Medicine Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
- Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - Imran M Khan
- Burn and Plastic Surgery Center, Hayatabad Medical Complex, Hayatabad, Peshawar, Pakistan
| | - Asima Karim
- Department of Basic Medical Sciences, M27-122, College of Medicine, University of Sharjah, 27272, Sharjah, United Arab Emirates
- Iron Biology Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Tahir Muhammad
- Department of Biochemistry, Gomal Medical College, Dera Ismail Khan, Pakistan
| | - Firdos Ahmad
- Department of Basic Medical Sciences, M27-122, College of Medicine, University of Sharjah, 27272, Sharjah, United Arab Emirates
- Space Medicine Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| |
Collapse
|
2
|
Demonceau C, Voz B, Bruyère O, Reginster JY, Beaudart C. Content validity of SarQoL, a quality of life questionnaire specific to sarcopenia. Aging Clin Exp Res 2024; 36:101. [PMID: 38710959 DOI: 10.1007/s40520-024-02756-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/13/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND The Sarcopenia & Quality of Life (SarQoL) questionnaire is a patient-reported outcome measure designed for assessing health-related quality of life in individuals with sarcopenia. Despite its wide acceptance in the scientific literature, its content validity has only been partially demonstrated so far. AIMS To enhance the evidence supporting the content validity of the SarQoL questionnaire. METHODS Following COSMIN methodology, semi-structured interviews were conducted with 17 Belgian older adults who met the EWGSOP2 criteria for the diagnosis of sarcopenia and 11 experts in sarcopenia, with clinical or research background. Comprehensiveness, relevance and comprehensibility of SarQoL content were assessed through individual transcripts and were qualitatively analyzed thematically according to the seven dimensions of SarQoL. RESULTS The majority of the concepts elicited during the semi-structured interviews fitted within existing SarQoL dimensions. Importantly, the different domains of SarQoL were consensually considered as relevant by patients and experts. Some new emergent concepts were identified by the participants. While many of them could be considered as enrichments of existing dimensions or sub-concepts, other new concepts (i.e. self-fulfilment, acceptance of the reduced condition, adaptation/use of strategies, depression) may highlight two potential dimensions not covered by SarQoL, i.e. patient empowerment and depression. Cognitive interviews also highlighted that SarQoL items and instructions were clear and comprehensible. CONCLUSIONS SarQoL, in its current form, demonstrates good evidence of content validity for assessing health-related quality of life in patients with sarcopenia. We do not recommend adding new items or dimensions to SarQoL. Instead, for researchers or clinicians who aim to specifically address self-empowerment or depression of sarcopenic populations, we suggest completing the assessment of quality of life by concurrently using additional validated scales of patient empowerment or depression.
Collapse
Affiliation(s)
- C Demonceau
- Department of Public Health, University of Liège, Liege, Belgium.
| | - B Voz
- Department of Public Health, University of Liège, Liege, Belgium
| | - O Bruyère
- Department of Public Health, University of Liège, Liege, Belgium
| | - J-Y Reginster
- College of Science, King Saud University, Riyadh, Saudi Arabia
| | - C Beaudart
- Clinical Pharmacology and Toxicology Research Unit, Department of Biomedical Sciences, Faculty of Medicine, NAmur Research Institute for LIfe Sciences (NARILIS), University of Namur, Namur, Belgium
| |
Collapse
|
3
|
Yu R, Lai D, Leung G, Tam LY, Cheng C, Kong S, Tong C, Lu Z, Leung JCS, Chan A, Kwok T, Woo J. Translation, Cultural Adaptation, and Validation of the Cantonese Version of SarQoL in Hong Kong's Older Population: An Interviewer-Administered Questionnaire for Assessing Sarcopenia-Specific Quality of Life in Fieldwork Practice. Clin Interv Aging 2023; 18:1851-1861. [PMID: 37965637 PMCID: PMC10642387 DOI: 10.2147/cia.s431218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/10/2023] [Indexed: 11/16/2023] Open
Abstract
Objective This study examined the psychometric properties of the Cantonese version of the SarQoL® questionnaire. Participants A total of 118 (including 60 non-sarcopenic and 58 sarcopenic) community-dwelling older adults aged 65 years or above with Cantonese as their mother tongue. Methods Translation and cultural adaptation of the SarQoL were conducted using a standardized protocol. To validate the Cantonese SarQoL, psychometric properties including discriminative power, reliability (including internal consistency and test-retest reliability), and construct validity (including convergent and divergent validity), as well as floor and ceiling effects, were assessed. Results The translation of the questionnaire was completed without significant difficulties. Results indicated that the Cantonese SarQoL had (1) good discriminative power (sarcopenic participants had lower overall scores, mean = 66.1 vs 75.0, p < 0.001; the overall score was negatively predictive of the presence of sarcopenia, adjusted OR = 0.949, 95% CI = [0.912, 0.983]), (2) good internal consistency (Cronbach's alpha = 0.835; correlations between domain and overall scores ranged from 0.576 to 0.868), (3) excellent test-retest agreement (intraclass correlation coefficient = 0.801), (4) good construct validity (convergent: moderate to strong correlations were found between the overall score and almost all of the SF-36 and EQ-5D domains; divergent: weaker correlations were found between the overall score and SF-36 social functioning, ρ = -0.098, and EQ-5D self-care, ρ = -0.331), and (5) no floor or ceiling effect. Conclusion The Cantonese SarQoL is valid and reliable, and thus can be used as an interviewer-administered questionnaire for assessing sarcopenia-specific quality of life in fieldwork practice.
Collapse
Affiliation(s)
- Ruby Yu
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
- The Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Derek Lai
- The Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Grace Leung
- The Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Lok-Yan Tam
- The Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Clara Cheng
- The Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Sara Kong
- The Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Cecilia Tong
- The Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Zhihui Lu
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Jason C S Leung
- The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Amany Chan
- The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Timothy Kwok
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
- The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
- The Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| |
Collapse
|
4
|
Beaudart C, Reginster JY, Amuthavalli Thiyagarajan J, Bautmans I, Bauer J, Burlet N, Cesari M, Cherubini A, Cooper C, Cruz-Jentoft AJ, Dawson-Hughes B, Fielding RA, Harvey NC, Landi F, Laslop A, Maggi S, Montero-Errasquin B, Concepción PYM, Rolland Y, Rizzoli R, Visser M, Bruyère O. Measuring health-related quality of life in sarcopenia: summary of the SarQoL psychometric properties. Aging Clin Exp Res 2023; 35:1581-1593. [PMID: 37219755 PMCID: PMC10363087 DOI: 10.1007/s40520-023-02438-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/08/2023] [Indexed: 05/24/2023]
Abstract
Patient perspectives are now widely recognized as a key element in the evaluation of health interventions. Therefore, the provision of specific and validated Patient Reported Outcome Measures that emphasize the lived experience of patients suffering from specific diseases is very important. In the field of sarcopenia, the only validated specific health-related quality of life (HRQoL) instrument available is the Sarcopenia Quality of Life questionnaire (SarQoL). This self-administrated HRQoL questionnaire, developed in 2015, consists of 55 items arranged into 22 questions and has currently been translated into 35 languages. Nineteen validation studies performed on SarQoL have consensually confirmed the capacity of SarQoL to detect difference in HRQoL between older people with and without sarcopenia, its reliability and its validity. Two further observational studies have also indicated its responsiveness to change. A short form SarQoL, including only 14 items has further been developed and validated to reduce the potential burden of administration. Research on the psychometric properties of SarQoL questionnaire is still encouraged as the responsiveness to change of SarQoL has not yet been measured in the context of interventional studies, as limited prospective data currently exist and as there is still not cut-off score to define a low HRQoL. In addition, SarQoL has mainly been used in community-dwelling older individuals with sarcopenia and would benefit to be studied in other types of populations. This review aims to provide to researchers, clinicians, regulators, pharmaceutical industries and other stakeholders a clear summary of comprehensive evidence on the SarQoL questionnaire published up to January 2023Query.
Collapse
Affiliation(s)
- Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium.
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
| | | | - Ivan Bautmans
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jürgen Bauer
- Center for Geriatric Medicine and Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Nansa Burlet
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | | | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Roger A Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, USA
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Francesco Landi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, 00168, Rome, Italy
| | - Andrea Laslop
- Scientific Office, Austrian Medicines and Medical Devices Agency, Vienna, Austria
| | | | | | | | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, CERPOP UMR 1295, University of Toulouse III, Inserm, Toulouse, France
| | - René Rizzoli
- Service of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam and the Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
| |
Collapse
|
5
|
Kumar P, Umakanth S, Girish N. Psychometric performance of the Kannada version of sarcopenia quality of life questionnaire (SarQoL ®). BMC Musculoskelet Disord 2023; 24:445. [PMID: 37268903 DOI: 10.1186/s12891-023-06559-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 05/20/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND The Sarcopenia Quality of Life (SarQoL®) is a patient reported quality-of-life questionnaire specific to sarcopenia. In the Indian context, its availability is limited to Hindi, Marathi and Bengali vernacular languages. AIMS This study aimed to translate, cross-culturally adapt the SarQoL® questionnaire into Kannada and investigate its psychometric properties. METHODS The SarQoL®-English version was translated into Kannada with the developer's permission and in accordance with their requirements. To validate the discriminative power, internal consistency and floor and ceiling effect of the SarQoL®-Kannada questionnaire were assessed in the first step. In the second step, the construct validity and the test-retest reliability of the SarQoL®-Kannada was determined. RESULT There was no difficulty in the translation process. A total of n = 114 participants (sarcopenic participants n = 45 and n = 69 non-sarcopenic participants) were included. The good discriminative power of the SarQoL®-Kannada questionnaire {quality of life for sarcopenic subjects [56.43 ± 11.32] vs. non-sarcopenic ones [79.38 ± 8.16], p < 0.001}. High internal consistency (Cronbach's alpha coefficient was 0.904) and no ceiling/ floor effect were reflected. Excellent test-retest reliability (intraclass correlation coefficient was 0.97, 95% CI 0.92-0.98) were found. A good convergent and divergent validity with similar and different domains of WHOQOL-BREF was observed, while EQ-5D-3L had good convergent and weak divergent validity. CONCLUSION The SarQoL®-Kannada questionnaire is valid, consistent and reliable for the measurement of quality of life of sarcopenic participants. SarQoL®-Kannada questionnaire is now available to be used in clinical practice and as a treatment outcome indicator in research.
Collapse
Affiliation(s)
- Prabal Kumar
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India
| | - Shashikiran Umakanth
- Department of Medicine, Dr. TMA Pai Hospital, Manipal Academy of Higher Education, Udupi, Karnataka, India
| | - N Girish
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India.
| |
Collapse
|
6
|
Pap Z, Kalabiska I, Balogh Á, Bhattoa HP. Evaluation of the sarcopenia quality of life (SarQoL) questionnaire in community dwelling outpatient postmenopausal hungarian women. BMC Musculoskelet Disord 2023; 24:331. [PMID: 37106363 PMCID: PMC10134597 DOI: 10.1186/s12891-023-06454-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/24/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Sarcopenia is defined as an age-related progressive and systemic loss of muscle mass and function. World Health Organization (WHO) definition of health-related quality of life (QoL) states that health is considered "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity", and a decline in QoL is anticipated in individuals with sarcopenia. Beaudart et al. framed the concept of defining QoL in patients suffering from sarcopenia (SarQoL) based on fundamental procedures of QoL questionnaire development, expert recommendations and studies. The aim of the present study is to evaluate the discriminative power, internal consistency and floor and ceiling effects using data available from a sarcopenia study published recently, where the Hungarian version of the SarQoL questionnaire was also administered. METHODS In this cross-sectional study, data from SarQoL questionnaire administered to a postmenopausal sarcopenia study cohort (n = 100) was scrutinized for evaluation of psychometric properties of the questionnaire. Our verification of the psychometric properties consisted of discriminative power analysis, assessment of internal consistency, and floor and ceiling effects. The homogeneity of the SarQoL questionnaire, i.e., its internal consistency was measured using Cronbach's alpha coefficient. Correlation between the overall and domain SarQoL questionnaire scores and appendicular skeletal muscle mass in sarcopenic individuals was assessed. Furthermore, the difference of SarQoL overall and domain scores between sarcopenic and non-sarcopenic patients was also evaluated. RESULTS The median (interquartile range (IQR)) overall SarQoL questionnaire score was 81.5 (67.1-91.5). There was a statistically significant lower overall SarQoL score comparing sarcopenic and non-sarcopenic subjects median (IQR): 75.3 (62.1-86.3) vs. 83.7 (71.4-92.1); p = 0.041). The sarcopenic subjects showed a statistically significant (p = 0.021) correlation between the overall SarQoL score and appendicular skeletal muscle mass (Spearman's ϱ = 0.412). The overall Cronbach's alpha of 0.937 indicated a high internal consistency of the Hungarian version of the SarQoL questionnaire. No floor or ceiling effects were noted in the overall SarQoL questionnaire score. CONCLUSION In our study on community dwelling outpatient postmenopausal Hungarian women, the overall score of the Hungarian version of the SarQoL questionnaire had significant discriminative power to distinguish between sarcopenic and non-sarcopenic patients, had high internal consistency and no floor or ceiling effects.
Collapse
Affiliation(s)
- Zoltán Pap
- Department of Traumatology and Hand Surgery, Faculty of Medicine, Kalman Laki Doctoral School of the University of Debrecen, University of Debrecen, Debrecen, Hungary
| | - Irina Kalabiska
- Research Center for Sport Physiology, Hungarian University of Sports Science, Budapest, Hungary
| | - Ádám Balogh
- Regional Osteoporosis Center, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei Blvd. 98, Debrecen, H- 4032, Hungary.
| |
Collapse
|
7
|
SarQoL Questionnaire in Community-Dwelling Older Adults under EWGSOP2 Sarcopenia Diagnosis Algorithm: A New Screening Method? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148473. [PMID: 35886318 PMCID: PMC9324056 DOI: 10.3390/ijerph19148473] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 11/25/2022]
Abstract
This article is an observational and cross-sectional study that related the result obtained in the questionnaire for the evaluation of quality of life related to muscle mass (SarQoL) and the prevalence of sarcopenic pathology measured under the EWGSOP2 algorithm. Participants were 202 community-dwelling older adults living in Valencia, Spain. The prevalence of sarcopenia in men was 28.9%, while in women it was 26.2%. In the case of the SarQoL questionnaire, the mean score obtained for men was 75.5 and 72.6 for women, showing significant differences in both sexes between the results obtained by the group with and without sarcopenia. After the exhaustive data analysis, a high discriminative capacity for sarcopenic disease was found in the SarQoL questionnaire total score and in domains 2 (locomotion), 4 (functionality) and 5 (activities of daily living). In accordance with the existing controversy regarding the use of SARC-F as a screening method for sarcopenia, the authors pointed out the capacity of domain 2 (locomotion) in isolation as a possible screening method for this disease, exposing a high risk of suffering sarcopenia when scores in this domain were below 60 points. Further research is needed to develop new lines of research as these showed in this work, as well as new and easily applicable screening methods for sarcopenia in clinical practice, that allow a rapid detection of this disease in the community.
Collapse
|
8
|
Witham MD, Heslop P, Dodds RM, Clegg AP, Hope SV, McDonald C, Smithard D, Storey B, Tan AL, Thornhill A, Sayer AA. Performance of the SarQoL quality of life tool in a UK population of older people with probable sarcopenia and implications for use in clinical trials: findings from the SarcNet registry. BMC Geriatr 2022; 22:368. [PMID: 35477354 PMCID: PMC9043890 DOI: 10.1186/s12877-022-03077-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 04/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background The Sarcopenia Quality of Life (SarQoL) questionnaire is a disease-specific sarcopenia quality of life tool. We aimed to independently assess SarQoL with a particular focus on its suitability as a clinical trial outcome measure. Methods We analysed data from the UK Sarcopenia Network and Registry. Measures of physical performance and lean mass were collected at baseline. SarQoL and the Strength, Assistance, Rise, Climb - Falls (SARC-F) questionnaire (to assess functional ability) were collected at both baseline and six-month follow-up. Global changes in fitness and quality of life at 6 months were elicited on seven-point Likert scales. Internal consistency was assessed using Cronbach’s alpha. Responsiveness (Cohen’s d and Guyatt coefficients) and minimum clinically important differences were calculated for participants reporting slight improvement or worsening in their global scores. Concurrent validity was assessed by correlating baseline SarQoL scores with measures of physical performance and functional ability. Results We analysed data from 147 participants, 125 of whom underwent follow up assessment; mean age 78 years; 72 (49%) were women. Internal consistency was good; Cronbach’s alpha was 0.944 at baseline and 0.732 at telephone follow-up. Correlation between baseline and follow-up SarQoL was weak (r = 0.27; p = 0.03). The minimum clinically important improvement ranged from 5 to 21 points giving trial sample size estimates of 25–100 participants. SarQoL scores were moderately correlated with handgrip (r = 0.37; p < 0.001), SARC-F (r = − 0.45; p < 0.001), short physical performance battery (r = 0.48; p < 0.001) and 4-m walk speed (r = 0.48; p < 0.001). Conclusions SarQoL has acceptable performance in older UK participants with probable sarcopenia and is sufficiently responsive for use in clinical trials for sarcopenia.
Collapse
Affiliation(s)
- Miles D Witham
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK.
| | - Philip Heslop
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - Richard M Dodds
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - Andrew P Clegg
- Academic Unit for Ageing and Stroke Research, University of Leeds, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Suzy V Hope
- College of Medicine and Health, University of Exeter, and Royal Devon & Exeter NHS Foundation Trust, Exeter, UK
| | - Claire McDonald
- Department of Geriatrics, Gateshead Health NHS Foundation Trust, Gateshead, UK
| | - David Smithard
- Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust and University of Greenwich, London, UK
| | - Bryony Storey
- Department of Geriatrics, Gateshead Health NHS Foundation Trust, Gateshead, UK
| | - Ai Lyn Tan
- NIHR Leeds Biomedical Research Centre, Chapel Allerton Hospital, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Anna Thornhill
- Academy of Research and Improvement, Solent NHS Trust, Portsmouth, UK
| | - Avan A Sayer
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| |
Collapse
|
9
|
Martínez-Fernández MV, Sandoval-Hernández I, Galán-Mercant A, Gonzalez-Sanchez M, Martínez-Cal J, Molina-Torres G. Analysis of Structural Characteristics and Psychometric Properties of the SarQoL® Questionnaire in Different Languages: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084561. [PMID: 35457429 PMCID: PMC9027226 DOI: 10.3390/ijerph19084561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/03/2022] [Accepted: 04/06/2022] [Indexed: 02/05/2023]
Abstract
Background: Sarcopenia is the gradual and global loss of muscle and its functions. Primary sarcopenia is associated with the typical changes of advanced aging and affects approximately 5–10% of the population. The Sarcopenia and Quality of Life (SarQoL®) questionnaire is composed of 55 items, 22 questions, and is organized into seven domains of quality of life. The main objective of this systematic review was to analyze the structural characteristics and psychometric properties of it, as well as to classify its measurement properties, its methodological quality, and the criteria as good measurement properties of the adaptations and validations made on the SarQoL® questionnaire in different languages. Methods: A systematic review was carried out in the PUBMED, Web of Science, Cinahl, LatinIndex, and SCOPUS databases. The keywords used were: “SarQoL”, “assessment”, “sarcopenia”, “geriatric”, “PROM”, “quality of life”, and “questionnaire”, using the Boolean operator “AND”. All articles published up to 15 January 2022 were considered. Methodological quality and psychometric properties were assessed based on the COSMIN guidelines and the guidelines and general recommendations of PRISMA. Documents published in languages other than English were excluded, as well as versions of the SarQoL® published in the form abstracts for conferences when the full text was not available. Results: A total of 133 articles were identified, 14 of which were included. The evaluated questionnaires and the structural characteristics and psychometric properties of each of them were collected. Conclusion: The different cross-cultural versions of the questionnaire showed good basic structural and psychometric characteristics for the evaluation of patients with sarcopenia.
Collapse
Affiliation(s)
| | - Irene Sandoval-Hernández
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada-Campus of Melilla, C/Santander, 1, 52005 Melilla, Spain;
| | - Alejandro Galán-Mercant
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Puerto Real, Spain
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cadiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INIBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, 11009 Cadiz, Spain
- Correspondence:
| | - Manuel Gonzalez-Sanchez
- Institute of Biomedicine of Málaga (IBIMA), 29010 Malaga, Spain;
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Malaga, Spain
| | - Jesús Martínez-Cal
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almeria, Spain; (J.M.-C.); (G.M.-T.)
| | - Guadalupe Molina-Torres
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almeria, Spain; (J.M.-C.); (G.M.-T.)
| |
Collapse
|
10
|
Montero-Errasquín B, Vaquero-Pinto N, Sánchez-Cadenas V, Geerinck A, Sánchez-García E, Mateos-Nozal J, Ribera-Casado JM, Cruz-Jentoft AJ. Spanish translation, cultural adaptation and validation of the SarQoL®: a specific health-related quality of life questionnaire for sarcopenia. BMC Musculoskelet Disord 2022; 23:191. [PMID: 35232420 PMCID: PMC8887022 DOI: 10.1186/s12891-022-05125-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2015, a specific health-related quality of life questionnaire for sarcopenia, SarQoL®, was developed and validated in French. Since then, SarQoL® has been adapted and validated in different languages. We prepared a translation, cultural adaptation and validation of the psychometric properties of the SarQoL® into Spanish. METHODS A cross-sectional study with 86 participants. The translation and adaptation followed international guidelines with two direct translations, a synthesized version of the direct translations, two reverse translations, consensus by an expert committee of a pre-final version, pre-test by end users and final version. The discriminative power (logistic regression analyses), construct validity (Pearson and Spearman´s correlation), internal consistency (Cronbach´s alpha coefficient), test-retest reliability (intraclass correlation coefficient) and ceiling and floor effects were analyzed. RESULTS The Spanish version showed good construct validity (high correlation with comparable domains of the SF-36), high internal consistency (Cronbach's alpha coefficient: 0.84) and excellent test-retest reliability (ICC: 0.967, 95%, CI 0.917 - 0.989). However, it had no discriminative power between sarcopenic and non-sarcopenic participants defined with the EWGSOP and FNIH diagnostic criteria of sarcopenia. It did show discriminative power between patients with decreased vs normal muscle strength (54.9 vs. 62.6, p 0.009) and low vs. normal physical performance (57.3 vs. 70.2; p 0.005). No ceiling or floor effect was found. CONCLUSIONS The Spanish version of SarQoL® has similar psychometric properties to those of the original version of the instrument. It did not discriminate between sarcopenic and non-sarcopenic patients diagnosed according to the EWGSOP or FNIH criteria, but it did with those with low muscle strength and low physical performance.
Collapse
Affiliation(s)
- Beatriz Montero-Errasquín
- Servicio de Geriatría, Hospital Universitario Ramón Y Cajal, IRYCIS Madrid, Ctra Colmenar km 9,100, 28034, Madrid, Spain.
| | - Nieves Vaquero-Pinto
- Servicio de Geriatría, Hospital Universitario Ramón Y Cajal, IRYCIS Madrid, Ctra Colmenar km 9,100, 28034, Madrid, Spain
| | - Vicente Sánchez-Cadenas
- Servicio de Geriatría, Hospital Universitario Ramón Y Cajal, IRYCIS Madrid, Ctra Colmenar km 9,100, 28034, Madrid, Spain
| | - Anton Geerinck
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Place du 20 Août 7, 4000, Liège, Belgium
| | - Elisabet Sánchez-García
- Servicio de Geriatría, Hospital Universitario Ramón Y Cajal, IRYCIS Madrid, Ctra Colmenar km 9,100, 28034, Madrid, Spain
| | - Jesús Mateos-Nozal
- Servicio de Geriatría, Hospital Universitario Ramón Y Cajal, IRYCIS Madrid, Ctra Colmenar km 9,100, 28034, Madrid, Spain
| | - José Manuel Ribera-Casado
- Facultad de Medicina, Universidad Complutense de Madrid, Pl. de Ramón y Cajal, s/n, 28040, Madrid, Spain
| | - Alfonso J Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón Y Cajal, IRYCIS Madrid, Ctra Colmenar km 9,100, 28034, Madrid, Spain
| |
Collapse
|
11
|
Erdogan T, Eris S, Avci S, Oren MM, Kucukdagli P, Kilic C, Beaudart C, Bruyere O, Karan MA, Bahat G. Sarcopenia quality-of-life questionnaire (SarQoL)®: translation, cross-cultural adaptation and validation in Turkish. Aging Clin Exp Res 2021; 33:2979-2988. [PMID: 33538991 DOI: 10.1007/s40520-020-01780-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/11/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND The sarcopenia quality-of-life (SarQoL)® questionnaire is a multidimensional sarcopenia specific tool designed for community dwelling older adults. AIMS The aim of this study was to translate, to cross-culturally adapt and validate the SarQoL® questionnaire to assess sarcopenia-related quality of life in Turkish older adults. METHODS The validation process was performed in two sections: the first section constituted the translation with cross-cultural adaptation of SarQoL® into Turkish. Second section constituted the clinical validation study. To validate the Turkish version of the SarQoL®, we assessed its validity (discriminative power, construct validity), reliability (internal consistency, test-retest reliability) and floor/ceiling effects. RESULTS One hundred community-dwelling subjects (mean age: 74.7 ± 6.1 years) were evaluated. The EWGSOP2 consensus diagnostic criteria were used to diagnose probable sarcopenia. A database including 1437 older adults, with complete evaluation of sarcopenia parameters, served to define low global muscle function. Results revealed a good discriminative power: subjects with probable sarcopenia had higher total scores compared to non-sarcopenic subjects (50 ± 16 vs. 68.9 ± 16.9, p < 0.001) a high internal consistency (Cronbach's alpha: 0.88), consistent construct validity and excellent test-retest reliability (intraclass correlation coefficient: 0.97, 95% confidence interval: 0.94-0.98). There was no floor/ceiling effect. CONCLUSION The Turkish version of the SaQoL® questionnaire was found to be reliable and valid for the measurement of quality of life of sarcopenic patients and is, therefore, available for use in clinical research and practice. This validation could enable use of the SarQoL® tool in the eastern populations more confidently.
Collapse
Affiliation(s)
- Tugba Erdogan
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Serdar Eris
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Suna Avci
- Division of Geriatrics, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Meryem Merve Oren
- Department of Public Health Istanbul, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Pinar Kucukdagli
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Cihan Kilic
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Charlotte Beaudart
- Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
| | - Olivier Bruyere
- Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
| | - Mehmet Akif Karan
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Gulistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
| |
Collapse
|
12
|
Le X, Wei Y, Hao D, Shan L, Li X, Shi Q, Ding D, Cheng X, Lim HLE, Ng BY. Psychometric Properties of the Chinese Version of the Sarcopenia and Quality of Life, a Quality of Life Questionnaire Specific for Sarcopenia. Calcif Tissue Int 2021; 109:415-422. [PMID: 33991208 DOI: 10.1007/s00223-021-00859-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/22/2021] [Indexed: 12/25/2022]
Abstract
A quality of life questionnaire specific to sarcopenia (SarQoL®) was successfully developed. There is a huge demand for translation and validation in Chinese. The aim of this study was to translate the SarQoL® into Chinese and investigate its psychometric properties. The translation and cross-cultural adaptation process recommended by the developers of the initial questionnaire was followed. A total of 159 participants were investigated. The translation process consists of five steps: (1) two bilinguals independently translate initial English to Chinese; (2) synthesize the two translations into one; (3) backward translations; (4) expert committee review and (5) test of the pre-final version. The validation consists of three parts: (1) validity (discriminative power, construct validity); (2) reliability (internal consistency, test-retest reliability) and (3) floor and ceiling effects. There was no difficulty in translation process. Regarding the validity, good discriminant validity {quality of life for sarcopenic subjects [35.56 (29.73-42.70)] vs. non-sarcopenic ones [73.22 (60.09-82.90)], p < 0.001} and consistent construct validity [high correlations (spearman's r) of SarQoL® with generic Short Form-36 version 2 questionnaire (0.250 to 0.824) and EuroQoL-5-Dimension questionnaire (- 0.114 to - 0.823)] were found in SarQoL®. Regarding reliability, high internal consistency (Cronbach's alpha coefficient was 0.867) and excellent test-retest reliability (intraclass coefficient correlation was 0.997, 95% CI 0.994-0.998) were found. No ceiling/floor effect was reflected. A valid SarQoL® questionnaire is now available for Chinese population. It can provide a better understanding of the sarcopenia disease burden and serve as a therapeutic outcome indicator in research.
Collapse
Affiliation(s)
- Xiaofeng Le
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, No. 555, YouYi East road, Xi'an, 710054, Shaanxi, China
| | - Yao Wei
- Department of Geriatrics, Honghui Hospital, Xi'an Jiaotong University, No. 555, YouYi East road, Xi'an, 710054, Shaanxi, China
| | - Dingjun Hao
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, No. 555, YouYi East road, Xi'an, 710054, Shaanxi, China.
| | - Lequn Shan
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, No. 555, YouYi East road, Xi'an, 710054, Shaanxi, China
| | - Xiaoli Li
- Department of Geriatrics, Honghui Hospital, Xi'an Jiaotong University, No. 555, YouYi East road, Xi'an, 710054, Shaanxi, China
| | - Qifang Shi
- School of Nursing, Xi'an Jiaotong University, No. 28, Xianning West road, Xi'an, 710048, Shaanxi, China
| | - Ding Ding
- Faculty of Humanities and Social Sciences, Xi'an Jiaotong University, No. 28, Xianning West road, Xi'an, 710048, Shaanxi, China
| | - Xiang Cheng
- General Office, Shaanxi Bureau of National Food and Strategic Reserves Administration, No. 369, ChangYing West road, Xi'an, 710012, Shaanxi, China
| | - Hwee Ling Eileen Lim
- Spatial and Furniture Design, Nanyang Academy of Fine Arts' 14, Visenze Pte Ltd, Blk 67 Ayer Rajah Crescent, Singapore, 139950, Singapore
| | - Bao Yi Ng
- Chemistry, National University of Singapore, No. 21, Lower Kent Ridge Road, Singapore, 119077, Singapore
| |
Collapse
|
13
|
Geerinck A, Beaudart C, Reginster JY, Locquet M, Monseur C, Gillain S, Bruyère O. Development and validation of a short version of the Sarcopenia Quality of Life questionnaire: the SF-SarQoL. Qual Life Res 2021; 30:2349-2362. [PMID: 33782793 PMCID: PMC8298237 DOI: 10.1007/s11136-021-02823-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE To facilitate the measurement of quality of life in sarcopenia, we set out to reduce the number of items in the previously validated Sarcopenia Quality of Life (SarQoL®) questionnaire, and to evaluate the clinimetric properties of this new short form. METHODS The item reduction process was carried out in two phases. First, information was gathered through item-impact scores from older people (n = 1950), a Delphi method with sarcopenia experts, and previously published clinimetric data. In the second phase, this information was presented to an expert panel that decided which of the items to include in the short form. The newly created SFSarQoL was then administered to older, community-dwelling participants who previously participated in the SarcoPhAge study. We examined discriminative power, internal consistency, construct validity, test-retest reliability, structural validity and examined item parameters with a graded response model (IRT). RESULTS The questionnaire was reduced from 55 to 14 items, a 75% reduction. A total of 214 older, community-dwelling people were recruited for the validation study. The clinimetric evaluation showed that the SF-SarQoL® can discriminate on sarcopenia status [EWGSOP2 criteria; 34.52 (18.59-43.45) vs. 42.86 (26.56-63.69); p = 0.043], is internally consistent (α = 0.915, ω = 0.917) and reliable [ICC = 0.912 (0.847-0.942)]. A unidimensional model was fitted (CFI = 0.978; TLI = 0.975; RMSEA = 0.108, 90% CI 0.094-0.123; SRMR = 0.055) with no misfitting items and good response category separation. CONCLUSIONS A new, 14-item, short form version of the Sarcopenia Quality of Life questionnaire has been developed and shows good clinimetric properties.
Collapse
Affiliation(s)
- A Geerinck
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium.
| | - C Beaudart
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - J-Y Reginster
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - M Locquet
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - C Monseur
- Department of Education Sciences, University of Liège, Liège, Belgium
| | - S Gillain
- Geriatrics Department, University Hospital of Liège, Liège, Belgium
| | - O Bruyère
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| |
Collapse
|
14
|
Geerinck A, Dawson-Hughes B, Beaudart C, Locquet M, Reginster JY, Bruyère O. Assessment of the performance of the SarQoL ® questionnaire in screening for sarcopenia in older people. Aging Clin Exp Res 2021; 33:2149-2155. [PMID: 34212342 DOI: 10.1007/s40520-021-01913-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/10/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Because of its low prevalence and the need for physical tests to establish a diagnosis, recruiting sarcopenic people for clinical studies can be a resource-intensive process. AIMS We investigated whether the SarQoL®, a 55-item questionnaire designed to measure quality of life in sarcopenia, could be used to identify older people with a high likelihood of being sarcopenic, and to compare its performance to the SARC-F tool. METHODS We performed a secondary analysis of data from older, community-dwelling participants of the SarcoPhAge study, evaluated for sarcopenia according to the EWGSOP2 criteria, and who completed the SarQoL® and SARC-F questionnaires. We determined the optimal threshold to distinguish between sarcopenic and non-sarcopenic people with the Youden index. Screening performance was evaluated with the area under the curve (AUC) and by calculating sensitivity and specificity. RESULTS The analysis of 309 participants provided an optimal threshold value of ≤ 52.4 points for identifying people with sarcopenia with the SarQoL® questionnaire, which resulted in a sensitivity of 64.7% (41.1-84.2%), a specificity of 80.5% (75.7-84.7%) and an AUC of 0.771 (0.652-0.889). Compared to the SARC-F, the SarQoL® has greater sensitivity (64.7% vs 52.39%), but slightly lower specificity (80.5% vs. 86.6%). DISCUSSION The SarQoL® questionnaire showed acceptable screening accuracy, on par with the SARC-F. The optimal threshold of ≤ 52.4 points should be confirmed in other cohorts of older people. CONCLUSIONS This exploratory study showed that the SarQoL® could potentially be applied in a screening strategy, with the added benefit of providing a measure of QoL at the same time.
Collapse
|
15
|
Geerinck A, Locquet M, Bruyère O, Reginster J, Beaudart C. Evaluating quality of life in frailty: applicability and clinimetric properties of the SarQoL ® questionnaire. J Cachexia Sarcopenia Muscle 2021; 12:319-330. [PMID: 33644998 PMCID: PMC8061363 DOI: 10.1002/jcsm.12687] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 12/18/2020] [Accepted: 01/26/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The SarQoL® questionnaire was specifically designed to measure quality of life (QoL) in sarcopenia. Frailty and sarcopenia have areas of overlap, notably weak muscle strength and slow gait speed, which may mean that the SarQoL could provide a measure of QoL in frailty. This study aimed to evaluate the clinimetric properties of the SarQoL questionnaire in physical frailty using the Fried criteria. METHODS Analyses were carried out on data from the Sarcopenia and Physical impairment with advancing Age study. Frailty was assessed with the Fried criteria and QoL with the SarQoL, the Short-Form 36-Item, and the EuroQoL 5-Dimension (EQ-5D) questionnaires. We evaluated discriminative power (with the Kruskal-Wallis analysis of variance test), internal consistency (with Cronbach's alpha), construct validity (through hypotheses testing), test-retest reliability (with the intraclass correlation coefficient), measurement error (calculating standard error of measurement and smallest detectable change), and responsiveness (through hypotheses testing and standardized response mean). RESULTS In total, 382 participants were included for the validation and 117 for the responsiveness evaluation. They had a median age of 73 (69-79) years, took 5 (3-8) drugs, and had 4 (3-5) co-morbidities. There were more women (n = 223; 58.4%) than men and, in total, 172 (45%) robust, 167 (44%) pre-frail, and 43 (11%) frail participants. Discriminative power was confirmed when significantly lower (P < 0.001) overall SarQoL scores, and thus also worse QoL, were observed between robust [77.1 (64.35-85.90)], pre-frail [62.54 (53.33-69.57)], and frail [49.99 (40.45-56.06)] participants. Six of the SarQoL domains performed likewise, with significantly lower scores according to frailty status with Domain 7 (fears) being the exception. Internal consistency was good (α = 0.866). Convergent (using Short-Form 36-Item and EQ-5D) and divergent construct validity (using EQ-5D) was confirmed. Test-retest reliability was excellent [intraclass correlation coefficient = 0.918 (0.834-0.961)], with a standard error of measurement of 3.88 and a smallest detectable change of 10.76 points. We found moderate responsiveness when five of the nine hypotheses were confirmed, coupled with a large effect size for the overall SarQoL score (corrected standardized response mean of -1.44). CONCLUSIONS The SarQoL questionnaire has adequate clinimetric properties for use with frail patients in clinical practice and trials and could provide data that are more appropriate and detailed than the generic questionnaires currently used.
Collapse
Affiliation(s)
- Anton Geerinck
- Division of Public Health, Epidemiology and Health EconomicsUniversity of Liège, World Health Organization Collaborating Centre for Public Health aspects of musculo‐skeletal health and ageingLiègeBelgium
| | - Médéa Locquet
- Division of Public Health, Epidemiology and Health EconomicsUniversity of Liège, World Health Organization Collaborating Centre for Public Health aspects of musculo‐skeletal health and ageingLiègeBelgium
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health EconomicsUniversity of Liège, World Health Organization Collaborating Centre for Public Health aspects of musculo‐skeletal health and ageingLiègeBelgium
| | - Jean‐Yves Reginster
- Division of Public Health, Epidemiology and Health EconomicsUniversity of Liège, World Health Organization Collaborating Centre for Public Health aspects of musculo‐skeletal health and ageingLiègeBelgium
- Biochemistry Department, College of ScienceKing Saud UniversityRiyadhSaudi Arabia
| | - Charlotte Beaudart
- Division of Public Health, Epidemiology and Health EconomicsUniversity of Liège, World Health Organization Collaborating Centre for Public Health aspects of musculo‐skeletal health and ageingLiègeBelgium
| |
Collapse
|
16
|
Associations between the quality of life in sarcopenia measured with the SarQoL® and nutritional status. Health Qual Life Outcomes 2021; 19:28. [PMID: 33482832 PMCID: PMC7821480 DOI: 10.1186/s12955-020-01619-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 11/04/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the relationship between nutritional status and health-related quality of life after adjusting for essential factors of muscle mass, calf circumference, grip strength, and the timed up and go (TUG) test for diagnosis of sarcopenia. METHODS The subjects of this study were those who visited a health care center or a senior welfare center among the aged 65 years or older living in a community in two counties (Jinju, Sacheon), and the survey was conducted from April to August 2019. Among them, those with cardiovascular disease, cognitive disorder, or malignancy were excluded. To determine the nutritional status of the elderly subjects, a questionnaire-based screening tool called DETERMINE was used. Developed as a health-related quality of life tool for sarcopenia, the Sarcopenia-specific Quality of Life (SarQoL) questionnaire was used. For screening of sarcopenia, a rapid questionnaire based on self-reported information about falls, mobility, and strength known as the SARC-F questionnaire was used. Assessment of sarcopenia included skeletal muscle mass, calf circumference, grip strength, and the TUG test. RESULTS A total of 324 elderly people living in rural villages who were able to move to senior and welfare centers was surveyed. As a result of evaluating the association between SarQoL and nutritional risk in elderly subjects, the association was statistically significant in the moderate-risk group (B = - 5.542, p = 0.001) and in the high-risk group (B = - 8.136, p < 0.001) in comparison to the low-risk group. Significant correlations were found in all seven domains of SarQoL, except the fear domain. CONCLUSIONS This study confirms an association between quality of life dimensions surveyed by the SarQoL questionnaire and nutritional status in elderly subjects. Therefore, appropriate interventions are needed following brief evaluation of sarcopenia and nutritional deficiency among elderly people in communities.
Collapse
|
17
|
Translation and validation of the Korean version of the Sarcopenia Quality of Life (SarQoL-K®) questionnaire and applicability with the SARC-F screening tool. Qual Life Res 2020; 30:603-611. [PMID: 32914375 DOI: 10.1007/s11136-020-02630-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this paper was to translate and validate into the Korea language and setting the Sarcopenia Quality of Life (SarQoL®) questionnaire. METHODS The participants consisted of 450 individuals in Namgaram-2 cohort who were followed up in 2019-2020. The study participants were divided into four groups: (1) SARC-F < 4, (2) SARC-F ≥ 4 and robust grip strength, (3) SARC-F ≥ 4, low grip strength, robust muscle mass, (4) SARC-F ≥ 4, low grip strength, and low muscle mass. To assess construct validity, population with sarcopenia-associated symptoms (SARC-F ≥ 4) apart from the Korean SarQoL (SarQoL-K®) completed the Korean versions of two generic questionnaires, the Short Form-36 and the EuroQoL 5-dimension. To validate the Korean SarQoL®, we assessed its validity (discriminative power, construct validity), reliability (internal consistency, test-retest reliability), and floor/ceiling effects. RESULTS The SarQoL-K® questionnaire was translated without major difficulties. The mean SarQoL-K scores were 72.9 (95%, CI; 71.2-74.6) in SARC-F < 4, 54.6 (95%, CI; 50.7-58.3) in SARC-F ≥ 4 and robust grip strength, 47.0 (95%, CI; 43.8-50.1) in SARC-F ≥ 4, low grip strength, robust muscle mass, 46.6 (95%, CI; 43.0-50.1) in SARC-F ≥ 4, low grip strength, and low muscle mass. The results indicated good discriminative power across each four groups (p < 0.001), high internal consistency (Cronbach's alpha of 0.866), and excellent test-retest reliability (ICC = 0.977, 95% CI 0.975-0.979). No floor- or ceiling-effects were observed. CONCLUSIONS This is the first study to confirm the reliability and validity of the Korean version of the SarQoL®. We demonstrated that the population with sarcopenia-associated symptoms (determined using the SARC-F questionnaire) has a lower quality of life.
Collapse
|
18
|
Dzhus M, Dzhus M, Masnyi M, Kulyk M, Mostbauer H, Ivashkivsky O, Boyko Y, Cherchenko K, Geerinck A, Reginster JY, Bruyere O, Beaudart C. Cross-sectional Evaluation of the Sarcopenia Quality of Life (SarQoL) Questionnaire: Translation and Validation of its Psychometric Properties. Ann Geriatr Med Res 2020; 24:139-147. [PMID: 32743334 PMCID: PMC7370798 DOI: 10.4235/agmr.20.0020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/30/2020] [Accepted: 05/13/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The SarQoL, a quality-of-life questionnaire specific to sarcopenia, was developed in 2015 and has since been translated into a number of other languages. The main reason to introduce this new Ukrainian version of the questionnaire was to measure sarcopenic individuals' perceptions regarding their positions in life in the context of their culture and value systems. METHODS The questionnaire was translated using a forward-backward approach with a pre-test. A total of 49 participants were recruited for the validation study. Sarcopenia was diagnosed according to the Ishii test. The validation analyses included discriminative power, internal consistency, floor and ceiling effects, construct validity, and test-retest reliability. We compared the SarQoL questionnaire to the Short-Form 36 and the EuroQoL-5 Dimensions. RESULTS A total of 28 participants out of 49 were categorized as probably sarcopenic. They had a significantly lower quality of life (overall score 58.43±17.13 vs. 69.89±13.31; p=0.014). The internal consistency was excellent (α=0.898), with none of the domains showing a disproportionate influence on the homogeneity of the questionnaire. Convergent construct validity was also confirmed. The results indicated a near-perfect degree of test-retest reliability. CONCLUSIONS The first Ukrainian version of the questionnaire is equivalent to the available original English version.
Collapse
Affiliation(s)
- Marta Dzhus
- Department of Internal Medicine, O. Bogomolets National Medical University, Kyiv, Ukraine
| | - Maria Dzhus
- Department of Internal Medicine, O. Bogomolets National Medical University, Kyiv, Ukraine
| | - Marta Masnyi
- Toronto Catholic District School Board, Toronto, Canada
| | - Myroslava Kulyk
- Department of Internal Medicine, O. Bogomolets National Medical University, Kyiv, Ukraine
| | - Halyna Mostbauer
- Department of Internal Medicine, O. Bogomolets National Medical University, Kyiv, Ukraine
| | | | - Yaryna Boyko
- Department of Pediatric, Lviv Regional Specialized Children's Hospital, Lviv, Ukraine
| | | | - Anton Geerinck
- Division of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liege, Liege, Belgium
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liege, Liege, Belgium
| | - Olivier Bruyere
- Division of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liege, Liege, Belgium
| | - Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liege, Liege, Belgium
| |
Collapse
|
19
|
Fábrega-Cuadros R, Martínez-Amat A, Cruz-Díaz D, Aibar-Almazán A, Hita-Contreras F. Psychometric Properties of the Spanish Version of the Sarcopenia and Quality of Life, a Quality of Life Questionnaire Specific for Sarcopenia. Calcif Tissue Int 2020; 106:274-282. [PMID: 31781790 DOI: 10.1007/s00223-019-00635-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/12/2019] [Indexed: 12/12/2022]
Abstract
The Sarcopenia and Quality of Life questionnaire (SarQol®) is a self-administered multidimensional sarcopenia-specific tool designed for community-dwelling subjects aged 65 years and older. The purpose of the present study was to evaluate the psychometric properties of the Spanish version of the SarQoL®. A total of 252 participants aged ≥ 65 years voluntarily participated in this cross-sectional study. Handgrip strength and bioelectrical impedance analysis were used for sarcopenia screening. Discriminative power, internal consistency, test-retest reliability, and floor and ceiling effects were analyzed. The generic 36-item Short-Form Health Survey (SF-36), the European Quality of Life 5-Dimension-3 Level (EQ-5D-3L), and the Hospital Anxiety and Depression Scale (HADS) were also used for convergent and divergent validity. Significant differences between sarcopenic (n = 66) and non-sarcopenic participants were observed for SarQoL® total score (p = 0.008) and for all domains except D2-locomotion. A high internal consistency of SarQoL® total score (Cronbach's alpha = 0.904) was found, and significant domain-to-total score correlations were obtained (all p < .001). Test-retest data showed excellent reliability for SarQoL® total score (ICC = 0.99; 95%CI 0.98-0.99) and in all dimensions, except for D6-leisure and D7-fears activities (substantial). No floor and ceiling effects were observed for SarQoL® total score. SarQoL® total score showed good and acceptable correlations(p < 0.001) with the selected domains of the SF-36 and EQ-5D-3L which have similar dimensions (convergent validity). Low and non-significant correlations existed with anxiety, depression, and EQ-5D-3L self-care and pain/discomfort domains (divergent validity). The Spanish SarQoL® shows satisfactory general psychometric properties in Spanish-speaking older adults from Spain and is able to discriminate between older adults with and without sarcopenia.
Collapse
Affiliation(s)
- Raquel Fábrega-Cuadros
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071, Jaén, Spain
| | - Antonio Martínez-Amat
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071, Jaén, Spain.
| | - David Cruz-Díaz
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071, Jaén, Spain
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071, Jaén, Spain
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071, Jaén, Spain
| |
Collapse
|
20
|
Porter J, Nguo K, Collins J, Kellow N, Huggins CE, Gibson S, Davidson Z, Schoeller D, Prentice R, Neuhouser ML, Snetselaar L, Truby H. Total energy expenditure measured using doubly labeled water compared with estimated energy requirements in older adults (≥65 y): analysis of primary data. Am J Clin Nutr 2019; 110:1353-1361. [PMID: 31504100 PMCID: PMC6885473 DOI: 10.1093/ajcn/nqz200] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 07/25/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Contemporary energy expenditure data are crucial to inform and guide nutrition policy in older adults to optimize nutrition and health. OBJECTIVE The aim was to determine the optimal method of estimating total energy expenditure (TEE) in adults (aged ≥65 y) through 1) establishing which published predictive equations have the closest agreement between measured resting metabolic rate (RMR) and predicted RMR and 2) utilizing the RMR equations with the best agreement to predict TEE against the reference method of doubly labeled water (DLW). METHODS A database consisting of international participant-level TEE data from DLW studies was developed to enable comparison with energy requirements estimated by 17 commonly used predictive equations. This database included 31 studies comprising 988 participant-level RMR data and 1488 participant-level TEE data. Mean physical activity level (PAL) was determined for men (PAL = 1.69, n = 320) and women (PAL = 1.66, n = 668). Bland-Altman plots assessed agreement of measured RMR and TEE with predicted RMR and TEE in adults aged ≥65 y, and subgroups of 65-79 y and ≥80 y. Linear regression assessed proportional bias. RESULTS The Ikeda, Livingston, and Mifflin equations most closely agreed with measured RMR and TEE in all adults aged ≥65 y and in the 65-79 y and ≥80 y subgroups. In adults aged ≥65 y, the Ikeda and Livingston equations overestimated TEE by a mean ± SD of 175 ± 1362 kJ/d and 86 ± 1344 kJ/d, respectively. The Mifflin equation underestimated TEE by a mean ± SD of 24 ± 1401 kJ/d. Proportional bias was present as energy expenditure increased. CONCLUSIONS The Ikeda, Livingston, or Mifflin equations are recommended for estimating energy requirements of older adults. Future research should focus on developing predictive equations to meet the requirements of the older population with consideration given to body composition and functional measures.
Collapse
Affiliation(s)
- Judi Porter
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Victoria, Australia
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Victoria, Australia
| | - Kay Nguo
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Victoria, Australia
| | - Jorja Collins
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Victoria, Australia
| | - Nicole Kellow
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Victoria, Australia
| | - Catherine E Huggins
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Victoria, Australia
| | - Simone Gibson
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Victoria, Australia
| | - Zoe Davidson
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Victoria, Australia
| | - Dale Schoeller
- Nutritional Sciences and Biotechnology Center, University of Wisconsin–Madison, Madison, WI, USA
| | - Ross Prentice
- Fred Hutchinson Cancer Research Center and School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Linda Snetselaar
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Helen Truby
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Victoria, Australia
| |
Collapse
|
21
|
Alekna V, Kilaite J, Tamulaitiene M, Geerinck A, Mastaviciute A, Bruyère O, Reginster JY, Beaudart C. Validation of the Lithuanian version of sarcopenia-specific quality of life questionnaire (SarQoL ®). Eur Geriatr Med 2019; 10:761-767. [PMID: 34652695 DOI: 10.1007/s41999-019-00208-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 05/23/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this study was to translate and culturally adapt the SarQoL® questionnaire into Lithuanian and investigate its main psychometric properties. METHODS A cross-sectional study was performed on community-dwelling Lithuanian people aged ≥ 60 years. The revised criteria of the European Working Group on Sarcopenia in Older People were used. A forward-backward methodology was used for the translation, with a pre-test of the final version of the Lithuanian SarQoL® questionnaire. Adjusted logistic regression analysis was used to compare sarcopenic and non-sarcopenic subjects. Internal consistency was determined using Cronbach's alpha coefficient. The correlation of total score of the SarQoL® and each domain of the Short-form General Health Survey (SF-36) and EuroQol-5D (EQ-5D) questionnaires was measured using Spearman's correlations. Test-retest reliability was measured by the intraclass correlation coefficient. RESULTS The study was performed on 176 subjects. Fifty-eight subjects were diagnosed with sarcopenia. After adjustment for confounders, the total score of the SarQoL® questionnaire was significantly lower for sarcopenic subjects compared to non-sarcopenic subjects (50.32 ± 8.58 vs 73.75 ± 13.51, p < 0.001). Cronbach's alpha coefficient was 0.95. Neither floor nor ceiling effects were found. The SarQoL® questionnaire revealed good correlation with similar domains of the SF-36 and EQ-5D questionnaires for convergent validity and weak correlations with different domains for divergent validity, confirming its construct validity. An excellent agreement between test and retest was found with an ICC of 0.976 (95% CI 0.959-0.986). CONCLUSIONS Lithuanian version of the SarQoL® is valid, reliable and consistent and could be used to assess quality of life in sarcopenic population.
Collapse
Affiliation(s)
| | | | | | - Anton Geerinck
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | | | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Charlotte Beaudart
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| |
Collapse
|
22
|
Geerinck A, Alekna V, Beaudart C, Bautmans I, Cooper C, De Souza Orlandi F, Konstantynowicz J, Montero-Errasquín B, Topinková E, Tsekoura M, Reginster JY, Bruyère O. Standard error of measurement and smallest detectable change of the Sarcopenia Quality of Life (SarQoL) questionnaire: An analysis of subjects from 9 validation studies. PLoS One 2019; 14:e0216065. [PMID: 31034498 PMCID: PMC6488089 DOI: 10.1371/journal.pone.0216065] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/12/2019] [Indexed: 01/06/2023] Open
Abstract
Objectives The Sarcopenia Quality of Life (SarQoL) questionnaire, a sarcopenia-specific patient-reported outcome measure, evaluates quality of life with 55 items. It produces 7 domain scores and 1 overall quality of life score, all between 0 and 100 points. This study aims to contribute to the interpretation of the SarQoL scores by calculating the standard error of measurement (SEM) and smallest detectable change (SDC) in a sample of subjects from 9 studies. Methods Subjects from 9 studies (conducted in Belgium, Brazil, Czech Republic, England, Greece, Lithuania, Poland and Spain) were included. The SEM, a measure of the error in the scores that is not due to true changes, was calculated by dividing the standard deviation of the difference between test and retest scores (SDdiff) by √2. The SDC, defined as change beyond measurement error, was calculated by multiplying SDdiff by 1.96. Bland-Altman plots were assessed for the presence of systematic errors. Results A total of 278 sarcopenic subjects, aged 77.67 ± 7.64 years and 61.5% women, were included. The SEM for the overall SarQoL score ranged from 0.18 to 4.20 points for the individual studies, and was 2.65 points when all subjects were analyzed together. The SDC for the overall score ranged from 0.49 to 11.65 points for the individual studies, and was 7.35 points for all subjects. The Bland-Altman plots revealed no systematic errors in the questionnaire. Conclusion This study shows that, for individual subjects, a change in overall quality of life of at least 7.35 points (on a scale from 0 to 100) would have to be observed to confirm that a true change, beyond measurement error, has occurred. It also demonstrated that the SarQoL questionnaire is a precise instrument, with the observed scores within less than 3 points of the theoretical “true score”.
Collapse
Affiliation(s)
- Anton Geerinck
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | | | - Charlotte Beaudart
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Ivan Bautmans
- Frailty in Aging Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Cyrus Cooper
- MRC Environmental Epidemiology Unit, Southampton General Hospital, Southampton, United Kingdom
| | | | - Jerzy Konstantynowicz
- Department of Pediatric Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, Bialystok, Poland
| | | | - Eva Topinková
- Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Maria Tsekoura
- Department of Physical Therapy, School of Health and Welfare, Technological Institute of Western Greece, Aigio, Greece
| | - Jean-Yves Reginster
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| |
Collapse
|
23
|
Safonova YA, Lesnyak OM, Baranova IA, Suleimanova AK, Zotkin EG. Russian translation and validation of SarQoL® – quality of life questionnaire for patients with sarcopenia. RHEUMATOLOGY SCIENCE AND PRACTICE 2019. [DOI: 10.14412/1995-4484-2019-38-45] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The aim is to carry out language adaptation and validation on the Russian sample of a special SarQoL questionnaire, designed to assess the quality of life of elderly people with sarcopenia. Material and methods. 100 patients over 65 years, mean age 74.0±6.5 years, observed on an outpatient basis were included. 50 from them had sarcopenia and 50 participants were without it. The diagnosis of sarcopenia was based on criteria developed by the European working group on sarcopenia (EWGSOP, 2010). The validation procedure was carried out in accordance with the Protocol. Results and discussion. There was a significant decrease in the overall quality of life according to SarQoL questionnaire in patients with sarcopenia compared with the control group without sarcopenia (50.65±14.23 and 75.10±14.46, respectively; p<0.001). High internal consistency of the SarQoL (Cronbach's á coefficient 0.924) was revealed. A significant positive correlation of domains with the overall SarQoL index in the range from r=0.37, p=0.0083 to r=0.92, p<0.001 was established. Moderate correlations of SarQoL with some domains SF-36 and the EQ-5D questionnaires were revealed. High internal consistency (ICC) of 0.935 (95% CI 0.91-0.96) was found. Conclusion. The Russian version of the SarQoL questionnaire is valid, consistent and reliable and can be used to assess the quality of life in older patients with sarcopenia.
Collapse
Affiliation(s)
- Yu. A. Safonova
- I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia;
SaintPetersburg Clinical Rheumatological Hospital №25
| | - O. M. Lesnyak
- I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia;
SaintPetersburg Clinical Rheumatological Hospital №25
| | - I. A. Baranova
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia;
D.D. Pletnev City Clinical Hospital, Moscow Department of Health
| | - A. K. Suleimanova
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia;
D.D. Pletnev City Clinical Hospital, Moscow Department of Health
| | - E. G. Zotkin
- V.A. Nasonova Research Institute of Rheumatology
| |
Collapse
|
24
|
Geerinck A, Scheppers A, Beaudart C, Bruyère O, Vandenbussche W, Bautmans R, Delye S, Bautmans I. Translation and validation of the Dutch SarQoL ®, a quality of life questionnaire specific to sarcopenia. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2018; 18:463-472. [PMID: 30511950 PMCID: PMC6313042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To translate the Sarcopenia Quality of Life (SarQoL®) questionnaire into Dutch and to evaluate the psychometric properties of the Dutch version of this questionnaire. METHODS The translation was carried out using a 5-step process, with 2 initial translations, a merging of these 2 translations, 2 backwards translations, an expert committee review and a pretest of the questionnaire. Sarcopenia was diagnosed with the EWGSOP algorithm. The validation consisted of an examination of the discriminative power, internal consistency, construct validity, test-retest reliability and floor and ceiling effects. RESULTS No significant problems were encountered during the translation process. A total of 92 subjects were included in the validation part of this study, 30 of which were sarcopenic. Discriminative power between sarcopenic and non-sarcopenic subjects was found for all domains and the Overall score (median overall QoL score: 67.15 vs 79.72; p=0.003). High internal consistency was found (Cronbach's alpha=0.883), as well as good construct validity with 75% of hypotheses confirmed. Test-retest reliability was excellent (ICC=0.976; 95% CI=0.947-0.989) and no floor or ceiling effects were observed. CONCLUSION The Dutch version of the SarQoL® questionnaire is ready for use in clinical and research applications.
Collapse
Affiliation(s)
- Anton Geerinck
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium,Corresponding author: Anton Geerinck, Department of Public Health, Epidemiology and Health Economics - University of Liège, CHU - Sart Tilman - Quartier Hôpital, Avenue Hippocrate 13 (Bât. B23), 4000 Liège, Belgium E-mail:
| | - Annelies Scheppers
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Belgium
| | - Charlotte Beaudart
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium
| | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium
| | | | - René Bautmans
- Gerontology Department, Vrije Universiteit Brussel, Belgium
| | - Sam Delye
- Department of Psychology, University of Liège, Belgium
| | - Ivan Bautmans
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Belgium,Gerontology Department, Vrije Universiteit Brussel, Belgium,Geriatrics Department, University Hospital Brussels, Belgium
| |
Collapse
|
25
|
Tsekoura M, Billis E, Tsepis E, Dimitriadis Z, Matzaroglou C, Tyllianakis M, Panagiotopoulos E, Gliatis J. The Effects of Group and Home-Based Exercise Programs in Elderly with Sarcopenia: A Randomized Controlled Trial. J Clin Med 2018; 7:E480. [PMID: 30486262 PMCID: PMC6306785 DOI: 10.3390/jcm7120480] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/22/2018] [Accepted: 11/23/2018] [Indexed: 01/06/2023] Open
Abstract
Physical exercise is effective for sarcopenic elderly but evidence for the most effective mode of exercise is conflicting. The objective of this study was to investigate the effects of a three-month group-based versus home-based exercise program on muscular, functional/physical performance and quality of life (QoL) across elderly with sarcopenia. 54 elderly (47 women, 7 men aged 72.87 ± 7 years) were randomly assigned to one of three interventions: supervised group (n = 18), individualized home-based exercise (n = 18) and control group (n = 18). Body composition was determined by bioelectrical impedance analysis, calf measurement with inelastic tape and strength assessments (grip and knee muscle strength) via hand-held and isokinetic dynamometers. Functional assessments included four-meter (4 m), Τimed-Up and Go (TUG) and chair stand (CS) tests. QoL was assessed with Greek Sarcopenia Quality of Life (SarQol_GR) questionnaire. Outcomes were assessed at baseline, immediately post-intervention (week 12), and 3 months post-intervention (week 24). Significant group x time interactions (p < 0.001) were observed in QoL, calf circumference, TUG, CS, and 4 m tests, grip and knee muscle strength. Group-based compared to home-based exercise yielded significant improvements (p < 0.05) in muscle mass index, CS and 4 m tests, calf circumference, muscle strength at 12 weeks. Most improvements at 24 weeks were reported with grouped exercise. No changes were found across the control group. Results suggest group-based exercise was more effective than home-based for improving functional performance.
Collapse
Affiliation(s)
- Maria Tsekoura
- Department of Physiotherapy, School of Health and Welfare, Technological Educational Institute (TEI) of Western Greece, 25100 Aigio, Greece.
- Department of Orthopaedics, School of Medicine, University of Patras, 265 04 Patra, Greece.
| | - Evdokia Billis
- Department of Physiotherapy, School of Health and Welfare, Technological Educational Institute (TEI) of Western Greece, 25100 Aigio, Greece.
| | - Elias Tsepis
- Department of Physiotherapy, School of Health and Welfare, Technological Educational Institute (TEI) of Western Greece, 25100 Aigio, Greece.
| | - Zacharias Dimitriadis
- Department of Physiotherapy, General University Hospital Attikon, 12462 Athens, Greece.
| | - Charalampos Matzaroglou
- Department of Physiotherapy, School of Health and Welfare, Technological Educational Institute (TEI) of Western Greece, 25100 Aigio, Greece.
| | - Minos Tyllianakis
- Department of Orthopaedics, School of Medicine, University of Patras, 265 04 Patra, Greece.
| | - Elias Panagiotopoulos
- Department of Orthopaedics, School of Medicine, University of Patras, 265 04 Patra, Greece.
- Rehabilitation Clinic, Department of Medicine, University of Patras, 265 04 Patra, Greece.
| | - John Gliatis
- Department of Orthopaedics, School of Medicine, University of Patras, 265 04 Patra, Greece.
| |
Collapse
|
26
|
Geerinck A, Bruyère O, Locquet M, Reginster JY, Beaudart C. Evaluation of the Responsiveness of the SarQoL ® Questionnaire, a Patient-Reported Outcome Measure Specific to Sarcopenia. Adv Ther 2018; 35:1842-1858. [PMID: 30374809 PMCID: PMC6223987 DOI: 10.1007/s12325-018-0820-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The Sarcopenia Quality of Life (SarQoL®) questionnaire was developed to provide a patient-reported outcome measure specific to sarcopenia. Its psychometric properties indicate that it is a valid and reliable instrument. However, until now, its ability to detect change over time has not been examined. Therefore, the objective of this study is to evaluate the responsiveness (also known as sensitivity to change) of the SarQoL® questionnaire in a prospective, longitudinal cohort of community-dwelling, older, sarcopenic subjects. METHODS Sarcopenic subjects from the SarcoPhAge (Sarcopenia and Physical impairment with advancing Age) study were included. Responsiveness was evaluated with nine pre-specified hypotheses on the correlation between the evolution of the SarQoL® scores after a 2-year interval and the evolution of the scores on the Short Form-36 (SF-36) and the Euroqol 5-dimension (EQ-5D) questionnaires. This technique considers responsiveness to be a form of longitudinal validity. Additionally, standardized response means were also calculated to compare the quantity of change measured by the different questionnaires. RESULTS A total of 42 sarcopenic subjects were included. The median age of the sample was 72.9 (68.9-78.8) years, 59.5% were female, and the mean body mass index was 23.3 (20.4-25.7) kg/m2. A good responsiveness was observed, as evidenced by the confirmation of eight out of nine hypotheses, well above the 75% confirmation threshold. The standardized response mean of the Overall SarQoL® score was significantly higher than those of the SF-36 Physical Component Summary (p = 0.005), the EQ-5D Utility Index (p < 0.001) and the Euroqol visual analogue scale (p = 0.003). CONCLUSION The first data available on the ability of the SarQoL® questionnaire to detect change over time indicates that the questionnaire has good responsiveness. This, together with the previously established psychometric properties, confirms that the SarQoL® questionnaire is a relevant instrument for the assessment of quality of life in sarcopenic populations.
Collapse
Affiliation(s)
- Anton Geerinck
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
| | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Médéa Locquet
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Charlotte Beaudart
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| |
Collapse
|
27
|
Konstantynowicz J, Abramowicz P, Glinkowski W, Taranta E, Marcinowicz L, Dymitrowicz M, Reginster JY, Bruyere O, Beaudart C. Polish Validation of the SarQoL ®, a Quality of Life Questionnaire Specific to Sarcopenia. J Clin Med 2018; 7:E323. [PMID: 30287728 PMCID: PMC6210457 DOI: 10.3390/jcm7100323] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/27/2018] [Accepted: 10/01/2018] [Indexed: 02/06/2023] Open
Abstract
Recently, SarQoL® (Sarcopenia and Quality of Life), a quality of life (QoL) questionnaire specific to sarcopenia, was successfully developed. For practical reasons, there is a great interest in validating this questionnaire in other populations. The aim of this cross-sectional study was to translate and adjust the SarQoL® into Polish and to standardize the validity of this method for the assessment of sarcopenic individuals in Poland with regard to psychometric properties. The English version was used for the translation process. A total of 106 community-dwelling Caucasian subjects aged 73.3 ± 5.94 years (65.1% females) were studied, with 60 participants being diagnosed sarcopenic. The translation and cross-cultural adaptation was carried out in five phases according to specific standard guidelines. There were no major linguistic issues in the translation process. The data confirmed a good discriminant validity, i.e., significantly lower scores for all domains (reduced global QoL in sarcopenic subjects compared to non-sarcopenic ones; 54.9 ± 16.5 vs. 63.3 ± 17.1, p = 0.013), and high internal consistency (Cronbach's alpha coefficient was 0.92). The significant correlation of the SarQoL® scores with those of other questionnaires (SF-36v2® Health Survey and EuroQoL-5-Dimension) that are supposed to have similar dimensions indicated the consistent construct validity of the SarQoL®-PL questionnaire. No floor/ceiling effects were found. An excellent agreement was found between the test and the re-test (intraclass coefficient correlation (ICC): 0.99). The first Polish version of the SarQoL® questionnaire is valid and consistent and therefore may be used with reliability for clinical and research purposes regarding QoL assessment of sarcopenic individuals. However, further research, in particular prospective studies, is needed to determine potential limitations and the suitability of the new tool for the Polish scenario and specificity.
Collapse
Affiliation(s)
- Jerzy Konstantynowicz
- Department of Pediatrics, Rheumatology, Immunology, and Metabolic Bone Diseases, Medical University of Bialystok, 15-274 Bialystok, Poland.
| | - Pawel Abramowicz
- Department of Pediatrics, Rheumatology, Immunology, and Metabolic Bone Diseases, Medical University of Bialystok, 15-274 Bialystok, Poland.
| | - Wojciech Glinkowski
- Polish Telemedicine Society, Center of Excellence "TeleOrto" for Telediagnostics and Treatment of Injuries and Disorders of the Locomotor System, 02-091 Medical University of Warsaw, Warsaw, Poland.
| | - Ewa Taranta
- Department of Primary Health Care, Medical University of Bialystok, 15-054 Bialystok, Poland.
| | - Ludmila Marcinowicz
- Department of Primary Health Care, Medical University of Bialystok, 15-054 Bialystok, Poland.
| | | | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, 4000 Liège, Belgium.
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, 4000 Liège, Belgium.
| | - Olivier Bruyere
- Department of Public Health, Epidemiology and Health Economics, University of Liège, 4000 Liège, Belgium.
| | - Charlotte Beaudart
- Department of Public Health, Epidemiology and Health Economics, University of Liège, 4000 Liège, Belgium.
| |
Collapse
|
28
|
Beaudart C, Locquet M, Reginster JY, Delandsheere L, Petermans J, Bruyère O. Quality of life in sarcopenia measured with the SarQoL®: impact of the use of different diagnosis definitions. Aging Clin Exp Res 2018; 30:307-313. [PMID: 29197020 PMCID: PMC5876340 DOI: 10.1007/s40520-017-0866-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 11/23/2017] [Indexed: 12/13/2022]
Abstract
Background The SarQoL® is a recently developed quality of life questionnaire specific to sarcopenia. Aim To compare the quality of life (QoL) of subjects identified as sarcopenic with that of non-sarcopenic subjects when using six different operational definitions of sarcopenia. Methods Participants of the SarcoPhAge study (Belgium) completed the SarQoL®. Among the six definitions used, two were based on low lean mass alone (Baumgartner, Delmonico), and four required both low muscle mass and decreased performance (Cruz-Jentoft, Studenski, Fielding, Morley). Physical assessments included measurements of muscle mass with dual energy X-ray absorptiometry, muscle strength with a handheld dynamometer and gait speed over a 4-m distance. Results A total of 387 subjects completed the SarQoL®. Prevalence of sarcopenia varied widely across the different definitions. Using the SarQoL®, a lower QoL was found for sarcopenic subjects compared to non-sarcopenic subjects when using the definitions of Cruz-Jentoft (56.3 ± 13.4 vs 68.0 ± 15.2, p < 0.001), Studenski (51.1 ± 14.5 vs 68.2 ± 14.6, p < 0.001), Fielding (53.8 ± 12.0 vs 68.3 ± 15.1, p < 0.001), and Morley (53.3 ± 12.5 vs 67.1 ± 15.3, p < 0.001). No QoL difference between sarcopenic and non-sarcopenic subjects was found when using the definitions of Baumgartner or Delmonico, which were only based on the notion of decreased muscle mass. Discussion and conclusions The SarQoL® was able to discriminate sarcopenic from non-sarcopenic subjects with regard to their QoL, regardless of the definition used for diagnosis as long as the definition includes an assessment of both muscle mass and muscle function. Poorer QoL, therefore, seems more related to muscle function than to muscle mass.
Collapse
|
29
|
Chang SF, Lin PC, Yang RS, Yang RJ. The preliminary effect of whole-body vibration intervention on improving the skeletal muscle mass index, physical fitness, and quality of life among older people with sarcopenia. BMC Geriatr 2018; 18:17. [PMID: 29343219 PMCID: PMC5773163 DOI: 10.1186/s12877-018-0712-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 01/09/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Studies have shown that sarcopenia easily leads to difficulty moving, disability, and poor quality of life. However, researches on the use of whole-body vibration for older adults with sarcopenia living in institutions have been lacking. Therefore, the main objective of the present study was to investigate the effect of whole-body vibration intervention on improving the skeletal muscle mass index, physical fitness, and quality of life of older adults with sarcopenia living in institutions. METHODS This study adopted a quasi-experimental, single-group, pretest-posttest design. The whole-body vibration intervention was performed over a 3-month period, in which the older adults trained 3 times per week; each training lasted 60 s with a break of 30 s for 10 repetitions. The older adults' skeletal muscle mass index, physical fitness and quality of life before and after the intervention of the whole-body vibration was collected. Concerning the statistical methods adopted, nonparametric method-based tests were employed. RESULTS According to the results of analysis, after the intervention of the 12-week whole-body vibration, the skeletal muscle mass index (z = - 3.621, p = 0.000), physical fitness on standing on one foot (z = - 2.447, p = 0.014), shoulder-arm flexibility (z = - 3.159, p = 0.002), 8-ft up and go test (z = - 2.692, p = 0.009), hand grip strength (z = - 3.388, p = 0.009), and five repeated sit-to-stand tests (z = - 2.936, p = 0.003), all improved significantly. Furthermore, concerning the quality of life of the older adults in the pretest and posttest, the improvements were statistically significant (z = - 2.533, p = 0.011). CONCLUSIONS The study results showed the effect of whole-body vibration intervention on improving the skeletal muscle mass index, physical fitness, and quality of life of sarcopenic older people living in institutions and could serve as a crucial reference to health care professionals.
Collapse
Affiliation(s)
- Shu-Fang Chang
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming Te Road, Pei-Tou, Taipei, 112 Taiwan, Republic of China
| | - Pei-Chen Lin
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming Te Road, Pei-Tou, Taipei, 112 Taiwan, Republic of China
| | - Rong-Sen Yang
- Department of Orthopaedics, National Taiwan University & Hospital, No.7, Chung-Shan S. Rd, Taipei, Taiwan, Republic of China
| | - Rea-Jeng Yang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, No. 365, Ming Te Rd., Peitou, Taipei City, 112 Taiwan, Republic of China
| |
Collapse
|
30
|
Kilsby AJ, Sayer AA, Witham MD. Selecting Potential Pharmacological Interventions in Sarcopenia. Drugs Aging 2017; 34:233-240. [DOI: 10.1007/s40266-017-0444-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|