Abstract
Objective
The 2019 Asian Working Group on Sarcopenia in Older People (AWGS 2019) recommends
using either calf circumference or the strength, assistance in walking, rising from
a chair, climbing stairs, and falls (SARC-F) or SARC-F combined with calf circumference
(SARC-CalF) questionnaires for sarcopenia screening. The aim of this study was to
compare the ability and applicability of calf circumference, SARC-F, and SARC-CalF
for screening sarcopenia among community-dwelling older adults.
Design
Cross-sectional study.
Setting and Participants
A total of 1050 community-dwelling older people were enrolled.
Methods
Sarcopenia was diagnosed according to the AWGS 2019 criteria: bioimpedance analysis
for appendicular skeletal muscle index, hand grip, and 6-m gait speed test. Participants
also completed the SARC-F questionnaire and calf circumference measurement. The screening
tools’ performances were evaluated through receiver operating characteristic (ROC)
curves, area under the ROC curves (AUC), and sensitivity/specificity analyses.
Results
Sarcopenia was identified in 263 (25.0%) participants by the AWGS 2019 criteria. Calf
circumference had a sensitivity of 81.4% and a specificity of 77.0%. Sensitivity and
specificity of SARC-F for screening sarcopenia were 17.9% and 93.7%, respectively.
SARC-CalF improved the sensitivity of SARC-F (47.5%) while keeping similar specificity
(92.0%). The AUCs of calf circumference, SARC-F, and SARC-CalF were 0.79 [95% confidence
interval (CI), 0.77–0.82], 0.56 (95% CI, 0.52–0.59), and 0.70 (95% CI, 0.67–0.73),
respectively. The differences across ROC curves were statistically significant among
3 screening tools (P < .001).
Conclusions and Implications
The overall screening ability of calf circumference was better than that of SARC-F
and SARC-CalF for sarcopenia in community-dwelling older persons despite gender, age,
and cognitive function. SARC-F and SARC-CalF have high specificity but are susceptible
to the preceding factors.
Keywords
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Article info
Publication history
Published online: July 12, 2020
Footnotes
The authors declare no conflicts of interest.
This work was supported by the Central South University (Grant 2019zzts1036); the Science and Technology Department of Hunan provincial (Grant 2018SK21312) and Finance Department of Hunan Provincial (Grant 2050204–30299). The sponsor had no role in the design, methods, subject recruitment, data collections, analysis and preparation of paper.
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© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
