Skip to main content
SpringerLink
Log in

Evaluation of Four Methods for the Assessment of Sarcopenia in Older Adults in Nursing Homes

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

We aimed to evaluate the comparative effectiveness and applicability of using calf circumference (CC), strength, need for assistance with walking, rising from a sitting position, climbing stairs, and the incidence of falls (SARC-F), as well as SARC-F plus CC (SARC-CalF) and the Ishii test, for assessing sarcopenia in older adult nursing home occupants.

Method

In this cross-sectional study, the diagnostic criteria of the AWGS2019 were used as the standard, and the accuracy of the four screening methods determined by indicators, including sensitivity, specificity, receiver operating characteristic (ROC) curve, positive predictive values (PPV), and negative predictive values (NPV).

Results

One hundred and ninety-nine older adults, 97 male and 102 female, were included. The prevalence of sarcopenia was 48.7%. Over all the participants, the sensitivity and specificity of CC were 74.22% and 51.96%, respectively, and 40.21% and 83.33%, respectively, for SARC-F. The use of SARC-CalF raised the SARC-F sensitivity (71.14%) while reducing the specificity (60.78%). The Ishii test had a sensitivity of 89.7% and a specificity of 74.51%. The PPV and NPV of CC, SARC-F, SARC-CalF, Ishii test were 0.6/0.68, 0.7/0.59, 0.55/0.63, and 0.77/0.88, respectively. The areas under the curve for CC, SARC-F, SARC-CalF, and the Ishii test were 0.67(95%CI, 0.59–0.74), 0.71(95%CI, 0.64–0.79), 0.71(95%CI, 0.64–0.79), and 0.86 (95% CI,0.81–0.92), respectively. The sensitivity and specificity of CC, SARC-F, SARC-CalF, and the Ishii test for sarcopenia screening in males were 71.69%/56.41%, 29.31%/79.49%, 67.24%/64.10%, and 94.83%/56.41%, respectively, and in females were 79.49%/49.21%, 56.41%/85.71%, 76.92%/58.73%, and 82.05%/85.71%, respectively. The PPV and NPV of CC, SARC-F, SARC-CalF, and the Ishii test in males were 0.71/0.56, 0.68/0.43, 0.74/0.57, and 0.76/0.88, respectively, while in females the values were 0.49/0.79, 0.71/0.76, 0.54/0.8, and 0.78/0.89, respectively. The areas under the curve for CC, SARC-F, SARC-CalF, and the Ishii test in males were 0.7(95%CI, 0.59–0.8), 0.63(95%CI, 0.52–0.75), 0.68(95%CI, 0.57–0.8), and 0.86(95% CI, 0.78–0.94), respectively, and in females 0.69(95%CI, 0.58–0.8), 0.81(95%CI, 0.72–0.89), 0.76(95%CI, 0.67–0.86), and 0.85 (95%CI, 0.77–0.94), respectively.

Conclusion

The overall screening ability of the Ishii test for sarcopenia was superior to that of the CC, SARC-F, and SARC-CalF in older adults in nursing homes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Mo Y H, Zhong J, Dong X, et al. Comparison of Three Screening Methods for Sarcopenia in Community-Dwelling Older Persons[J]. Journal of the American Medical Directors Association, 2021, 22(4):746–750.e1. doi: https://doi.org/10.1016/j.jamda.2020.05.041.

    Article  Google Scholar 

  2. Mk A, Won B W. Sarcopenia in Korean Community-Dwelling Adults Aged 70Years and Older: Application of Screening and Diagnostic Tools From the Asian Working Group for Sarcopenia 2019 Update[J]. Journal of the American Medical Directors Association, 2020, 21(6):752–758. doi:https://doi.org/10.1016/j.jamda.2020.03.018.

    Article  Google Scholar 

  3. Xia L, Zhao R, Wan Q, et al. Sarcopenia and adverse health-related outcomes: An umbrella review of meta-analyses of observational studies. Cancer Med[J]. 2020, 9(21):7964–7978. doi: https://doi.org/10.1002/cam4.3428.

    Article  Google Scholar 

  4. Rizzoli R, Reginster JY, Arnal JF, et al. Quality of life in sarcopenia and frailty. Calcified tissue international[J]. 2013;93(2):101–120. doi:https://doi.org/10.1007/s00223-013-9758-y.

    Article  CAS  Google Scholar 

  5. Cruz-Jentoft AJ, Sayer AA. Sarcopenia. Lancet[J]. 2019; 393: 2636–2646. doi:https://doi.org/10.1016/S0140-6736(19)31138-9.

    Article  Google Scholar 

  6. O Bruyère, Beaudart C, Reginster J Y, et al. Assessment of muscle mass, muscle strength and physical performance in clinical practice: An international survey[J]. European Geriatric Medicine, 2016,7(3):243–246. doi:https://doi.org/10.1016/j.eurger.2015.12.009.

    Article  Google Scholar 

  7. Barreto, Erin F, Poyant, et al. Validation of the sarcopenia index to assess muscle mass in the critically ill: A novel application of kidney function markers. Clin Nutr[J]. 2019,38(3):1362–1367. doi: https://doi.org/10.1016/j.clnu.2018.05.031.

    Article  Google Scholar 

  8. Jones KI, Doleman B, Scott S, et al: Simple psoas cross-sectional area measurement is a quick and easy method to assess sarcopenia and predicts major surgical complications. Colorectal Dis[J], 2015,17:O20–O26. doi:https://doi.org/10.1111/codi.12805.

    Article  CAS  Google Scholar 

  9. Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc[J]. 2020;21(3):300–307. https://doi.org/10.1016/j.jamda.2019.12.012.

    Article  Google Scholar 

  10. Chen X, Hou L, Zhang Y, et al. The accuracy of the Ishii score chart in predicting sarcopenia in the elderly community in Chengdu[J]. BMC Geriatrics, 2021, 21(1):296. doi:https://doi.org/10.1186/s12877-021-02244-4.

    Article  Google Scholar 

  11. Ida S, Kaneko R, Murata K. SARC-F for screening of sarcopenia among older adults: a meta-analysis of screening test accuracy. J Am Med Dir Assoc. 2018;19(8):685–689. doi:https://doi.org/10.1016/j.jamda.2018.04.001.

    Article  Google Scholar 

  12. Barbosa-Silva TG, Menezes AM, Bielemann RM, et al. Enhancing SARC-F: Improving Sarcopenia Screening in the Clinical Practice. J Am Med Dir Assoc. 2016 Dec 1;17(12):1136–1141. doi: https://doi.org/10.1016/j.jamda.2016.08.004.

    Article  Google Scholar 

  13. Chen C Y, Tseng W C, Yang Y H, et al. Calf Circumference as an Optimal Choice of Four Screening Tools for Sarcopenia Among Ethnic Chinese Older Adults in Assisted Living[J]. Clinical Interventions in Aging, 2020, 15:2415–2422. doi:https://doi.org/10.2147/CIA.S287207.

    Article  Google Scholar 

  14. Ishii S, Tanaka T, Shibasaki K, et al. Development of a simple screening test for sarcopenia in older adults. Geriatr Gerontol Int[J]. 2014;14(1):93–101. doi:https://doi.org/10.1111/ggi.12197.

    Article  Google Scholar 

  15. Hax V, Santo R, Santos L, et al. Practical screening tools for sarcopenia in patients with systemic sclerosis[J]. PLoS ONE, 2021, 16(1):e0245683. doi:https://doi.org/10.1371/journal.pone.0245683.

    Article  CAS  Google Scholar 

  16. DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: A nonparametric approach. Biometrics[J], 1988;44:837e845. doi:https://doi.org/10.2307/2531595.

    Google Scholar 

  17. Shen Y, Chen J, Chen X, et al. Prevalence and associated factors of sarcopenia in nursing home residents: a systematic review and meta-analysis. J Am Med Dir Assoc. 2019;20(1):5–13. doi:https://doi.org/10.1016/j.jamda.2018.09.012.

    Article  Google Scholar 

  18. Florkowski CM, Sensitivity Specificity, Receiver-Operating Characteristic(ROC) curves and likelihood ratios: communicating the performance of diagnostic tests. Clin Biochem Rev. 2008;29(Suppl 1):83–7.

    Google Scholar 

Download references

Funding

Funding: 2020 Zigong City Key Technology Support Plan (Project No. 2020YLSF19).

Author information

Authors and Affiliations

  1. Southwest Medical University Zigong Affiliated Hospital, Zigong Mental Health Center, Zigong, Sichuan Province, China

    X. Lin, M. Li, Z. Li, L. Zhu, L. Liu & Xiaoyan Chen

Authors
  1. X. Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Z. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L. Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xiaoyan Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xiaoyan Chen.

Ethics declarations

Declaration of conflicting interest: The authors declare that there are no conflicts of interest.

Ethical standards: The study was conducted in accordance with the Declaration of Helsinki and the Institutional Review Board of Zigong Medical Foundation approved the study design protocol (IRB number:20191001).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lin, X., Li, M., Li, Z. et al. Evaluation of Four Methods for the Assessment of Sarcopenia in Older Adults in Nursing Homes. J Nutr Health Aging 25, 1119–1123 (2021). https://doi.org/10.1007/s12603-021-1680-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-021-1680-9

Key words

Search

Navigation