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Screening for Sarcopenia with a Self-Reported Cartoon Questionnaire: Combining SARC-F with Finger-Ring Test

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

No pictorial questionnaire is available for screening sarcopenia. We aimed to develop a self-reported cartoon questionnaire based on the SARC-F and the Finger-Ring test and to compare its diagnostic accuracy with the SARC-F and the SARC-F combined with calf circumference (SARC-CalF).

Design

A diagnostic accuracy study.

Setting

Urban communities in Chengdu, China.

Participants

Older adults aged ≥ 60 years.

Methods

We established a multidiscipline team to design this pictorial questionnaire, entitled Self-Reported Cartoon SARC-CalF (cSARC-CalF). We used the Asian Working Group for Sarcopenia (AWGS) criteria as the “gold standard” of sarcopenia. We performed sensitivity/specificity analyses of the three tools (cSARC-CalF, SARC-CalF, and SARC-F) and applied the receiver operating characteristics (ROC) curves and the area under the ROC curves (AUC) to compare the diagnostic accuracy of the three tools.

Results

We included 1,009 participants. Using the Youden Index method, the cutoff of the cSARC-CalF for identifying sarcopenia was set as ≥11 points. Both the cSARC-CalF and the SARC-CalF showed better sensitivity but similar specificity than the SARC-F for identifying sarcopenia (sensitivity: 33.3%, 41.4%, and 23.0%; specificity: 90.1%, 85.9%, and 88.1%). The AUCs of the cSARC-CalF, SARC-CalF, and SARC-F were 0.74 (95% CI, 0.71 — 0.77), 0.79 (95% CI, 0.76 — 0.81), and 0.67 (95% CI, 0.64 — 0.70), respectively. The difference in AUCs between cSARC-CalF and SARC-F and the difference in AUCs between SARC-CalF and SARC-F was statistically significant (p=0.012 and p<0.001, respectively). However, the difference in AUCs between cSARC-CalF and SARC-CalF was not significant (p=0.109).

Conclusion

The cSARC-CalF showed a better overall diagnostic accuracy than the SARC-F and a similar overall diagnostic accuracy as the SARC-CalF in Chinese community-dwelling older adults. It may serve as a new tool for screening sarcopenia; however, it needs to be validated in other populations.

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References

  1. Drew, L. Fighting the inevitability of ageing. Nature 2018;555,S15–S17, doi:https://doi.org/10.1038/d41S86-018-02479-z.

    Article  CAS  PubMed  Google Scholar 

  2. Anker, S. D., Morley, J. E. & von Haehling S. Welcome to the ICD-10 code for sarcopenia. Journal of Cachexia Sarcopenia and Muscle 2016;7,512–514, doi:https://doi.org/10.1002/jcsm.12147.

    Article  Google Scholar 

  3. Cruz-Jentoft, A. J. & Sayer, A. A. Sarcopenia. The Lancet 2019;393, 2636–2646, doi:https://doi.org/10.1016/s0140-6736(19)31138-9.

    Article  Google Scholar 

  4. Bruyere, O. et al. Sarcopenia as a public health problem. European Geriatric Medicine 2016;7,272–275, doi:https://doi.org/10.1016/j.eurger.2015.12.002.

    Article  Google Scholar 

  5. Offord, N. J. et al. Current practice in the diagnosis and management of sarcopenia and frailty — results from a UK-wide survey. J Frailty Sarcopenia Falls 2019;4, 71–77, doi:https://doi.org/10.22540/JFSF-04-071.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Nawi, S. N. M., Yu, S. & Visvanathan, R. Screening tools for sarcopenia: a scoping review. Australasian Journal on Ageing 2018;37, 70–70.

    Google Scholar 

  7. Malmstrom, T. K. & Morley, J. E. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc 2013;14, 531–532, doi: https://doi.org/10.1016/j.jamda.2013.05.018.

    Article  PubMed  Google Scholar 

  8. Dent, E. et al. (International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnosis and Management. J Nutr Health Aging 2018;22, 1148–1161, doi:https://doi.org/10.1007/s12603-018-1139-9.

    Article  CAS  Google Scholar 

  9. Chen, L.-K. et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. Journal of the American Medical Directors Association, 2020;doi:https://doi.org/10.1016/j.jamda.2019.12.012.

  10. Cruz-Jentoft, A. J. et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and ageing 2019;48, 16–31.

    Article  PubMed  Google Scholar 

  11. Woo, J., Leung, J. & Morley, J. E. Validating the SARC-F: a suitable community screening tool for sarcopenia? J Am Med Dir Assoc 2014;15, 630–634, doi:https://doi.org/10.1016/j.jamda.2014.04.021.

    Article  Google Scholar 

  12. Barbosa-Silva, T. G. et al. Enhancing SARC-F: Improving Sarcopenia Screening in the Clinical Practice. J Am Med Dir Assoc 2016;17, 1136–1141, doi:https://doi.org/10.1016/j.jamda.2016.08.004.

    Article  Google Scholar 

  13. Yang, M. et al. Screening Sarcopenia in Community-Dwelling Older Adults: SARC-F vs SARC-F Combined With Calf Circumference (SARC-CalF). J Am Med Dir Assoc 2018; 19, 277.e271–277.e278, doi:https://doi.org/10.1007/s40520-018-1083-x.

    Article  Google Scholar 

  14. Tanaka, T., Takahashi, K., Akishita, M., Tsuji, T. & Iijima, K. (2018) “Yubi-wakka” (finger-ring) test: A practical self-screening method for sarcopenia, and a predictor of disability and mortality among Japanese community-dwelling older adults. Geriatrics & gerontology international 2018;18, 224–232, doi:https://doi.org/10.1111/ggi.13163.

    Article  Google Scholar 

  15. Bahat, G. et al. Comparing SARC-F with SARC-CalF to Screen Sarcopenia in Community Living Older Adults. J Nutrition Heal Aging 2018;22, 1034–1038, doi:https://doi.org/10.1007/s12603-018-1072-y PMTD — 30379299.

    Article  CAS  Google Scholar 

  16. Krzymińska-Siemaszko, R., Deskur-Śmielecka, E., Kaluźniak-Szymanowska, A., Lewandowicz, M. & Wieczorowska-Tobis, K. Comparison of Diagnostic Performance of SARC-F and Its Two Modified Versions (SARC-CalF and SARC-F+EBM) in Community-Dwelling Older Adults from Poland. Clin Interv Aging Volume 2020; 15, 583–594, doi:https://doi.org/10.2147/cia.s250508.

    Article  Google Scholar 

  17. Chen, L. K. et al. Sarcopenia in Asia: consensus report of the asian working group for sarcopenia. J Am Med Dir Assoc 2014; 15, 95–101.

    Article  PubMed  Google Scholar 

  18. General Administration of Sport of China. Chinese National Physical Fitness Evaluation Standard (CNPFES). 15 (People’s Sports Press, 2003).

  19. Fluss, R., Faraggi, D. & Reiser, B. Estimation of the Youden Index and its associated cutoff point. Biom J 2005;47, 458–472.

    Article  PubMed  Google Scholar 

  20. Linden, A. Measuring diagnostic and predictive accuracy in disease management: an introduction to receiver operating characteristic (ROC) analysis. J Eval Clin Pract 2006;12,132–139, doi:https://doi.org/10.1111/j.1365-2753.2005.00598.x.

    Article  PubMed  Google Scholar 

  21. Mo, Y., Dong, X. & Wang, X.-h. Screening Accuracy of SARC-F Combined With Calf Circumference for Sarcopenia in Older Adults: A Diagnostic Meta-Analysis. Journal of the American Medical Directors Association, 2019;doi:https://doi.org/10.1016/j.jamda.2019.09.002 PMTD — 31672568.

  22. Hiraoka, A. et al. Easy surveillance of muscle volume decline in chronic liver disease patients using finger-circle (yubi-wakka) test. Journal of cachexia, sarcopenia and muscle 2019;10, 347–354, doi:https://doi.org/10.1002/jcsm.12392.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Fujii, H. et al. “Yubi-wakka” (Finger-Ring) Test: A Tool to Detect Prefrailty in Elderly Populations, a Pilot Study. J Clin Med Res 2019;11, 623–628, doi:https://doi.org/10.14740/jocmr3917.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Sosa, A. L. et al. Prevalence, distribution, and impact of mild cognitive impairment in Latin America, China, and India: a 10/66 population-based study. PLoS Med 2012;9, e1001170, doi:https://doi.org/10.1371/journal.pmed.1001170.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

We deeply appreciate Mr. Geshu Liu and Mrs. Lili Fan for their great efforts to design and draw the representational cartoons.

Funding

This work is supported by the National Key R&D Program of China [Grant number: 2018YFC2002104] and and the Sichuan Provincial Science and Technology Department [2019JDK0064]. The sponsors played no role in the design, methods, data collection, analysis, or preparation of this work.

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Authors and Affiliations

  1. Health Management Center, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China

    R. Li

  2. Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China

    X. Hu, L. Tan, L. Xie & Ming Yang

  3. Health Management Center, Shangjin Nanfu Hospital, No. 253 Shangjin Street, Chengdu, Sichuan, China

    X. Hu, L. Zhang & J. Zhou

  4. National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China

    Ming Yang

  5. Precision Medicine Research Center, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China

    Ming Yang

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  1. R. Li
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  2. X. Hu
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  3. L. Tan
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  4. L. Xie
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Corresponding author

Correspondence to Ming Yang.

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The authors declare that this study complies with the current laws of China.

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Li, R., Hu, X., Tan, L. et al. Screening for Sarcopenia with a Self-Reported Cartoon Questionnaire: Combining SARC-F with Finger-Ring Test. J Nutr Health Aging 24, 1100–1106 (2020). https://doi.org/10.1007/s12603-020-1445-x

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  • DOI: https://doi.org/10.1007/s12603-020-1445-x

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