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SARC-F as a Screening Tool for Sarcopenia and Possible Sarcopenia Proposed by AWGS 2019 in Hospitalized Older Adults

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The journal of nutrition, health & aging

Abstract

Object

The SARC-F questionnaire is a sarcopenia screening tool. However, the validity of the SARC-F score ≥4 (SARC-F≥4) for the evaluation of sarcopenia in the hospital setting has not been investigated. This study investigated the validity of SARC-F≥4 as a screening tool for sarcopenia among hospitalized older adults.

Design

Cross-sectional retrospective study.

Setting

A university hospital.

Participants

This study included older adult patients (age ≥65 years) who were hospitalized at, and subsequently discharged from, the hospital between April and September 2019 and underwent a nutritional assessment by the nutrition support team during their hospitalization.

Measurements

SARC-F was recorded at the time of admission, and the criteria specified by the Asia Working Group for Sarcopenia in 2019 (AWGS 2019) were applied to diagnose sarcopenia and possible sarcopenia. Appendicular muscle mass was estimated through validated equations, and three different models were developed for sarcopenia diagnosis. The sensitivity, specificity, and positive/negative likelihood ratios were calculated to analyze the accuracy of the SARC-F≥4 for sarcopenia and possible sarcopenia. Receiver-operating characteristic analyses were conducted to calculate the area under the curve (AUC).

Results

In total, 1,689 patients (mean age: 77.2±13 years; male: 54.4%) were analyzed, and 636 patients (37.7%) had SARC-F≥4. Patients with SARC-F≥4 had a statistically significant higher prevalence of AWGS 2019-defined sarcopenia than patients with SARC-F <4 in the models (65.4–78.9% vs 40.9–15.2%, p<0.001). The sensitivity, specificity, and positive/negative likelihood ratios of SARC-F≥4 for sarcopenia and possible sarcopenia were 49.1–51.3%, 73.9–81.2%, and 1.88–2.72/0.60–0.69 and 48.0%, 84.5%, and 3.11/0.62, respectively. The AUC for sarcopenia and possible sarcopenia were 0.644–0.695 and 0.708, respectively. The AUC of SARC-F for possible sarcopenia was equivalent to or larger than that for sarcopenia (DeLong test p=0.438, 0.088, and <0.001 vs the three models).

Conclusions

SARC-F≥4 is suitable as a screening tool for sarcopenia in hospitalized older adults. SARC-F assessment could facilitate the detection and exclusion of sarcopenia at hospitalization and may lead to early adoption of a therapeutic and preventive approach.

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Acknowledgments

This work was funded by the Japan Society for the Promotion of Science (grant number: JP20H01144to Ishida Y and 18K11142 to Maeda K)

Author information

Authors and Affiliations

  1. Department of Nutrition, Aichi Medical University Hospital, Nagakute, Aichi, Japan

    Y. Ishida

  2. Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan

    Y. Ishida, Keisuke Maeda, T. Nonogaki, A. Shimizu, R. Matsuyama, R. Kato, J. Ueshima & N. Mori

  3. Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan

    Keisuke Maeda

  4. Department of Pharmacy, Aichi Medical University Hospital, Nagakute, Aichi, Japan

    T. Nonogaki & R. Kato

  5. Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Naka-ku, Hamamatsu, Shizuoka, Japan

    A. Shimizu

  6. Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan

    Y. Yamanaka & R. Matsuyama

  7. Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, Tokyo, Japan

    J. Ueshima

  8. Biostatistics Center, Kurume University, Kurume, Fukuoka, Japan

    K. Murotani

Authors
  1. Y. Ishida
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  2. Keisuke Maeda
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  10. N. Mori
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Corresponding author

Correspondence to Keisuke Maeda.

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Ethical standards: This work was performed according to the ethical standards laid down in the 1964 Declaration of Helsinki and later amendments.

Conflict of Interest: The authors declare that they have no conflict of interest.

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Ishida, Y., Maeda, K., Nonogaki, T. et al. SARC-F as a Screening Tool for Sarcopenia and Possible Sarcopenia Proposed by AWGS 2019 in Hospitalized Older Adults. J Nutr Health Aging 24, 1053–1060 (2020). https://doi.org/10.1007/s12603-020-1462-9

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  • DOI: https://doi.org/10.1007/s12603-020-1462-9

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