Institute of Medical Physics (IMP), Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
Gerontology. 2017;63(5):411-416. doi: 10.1159/000477935. Epub 2017 Jul 5.
The high relevance of sarcopenia for the aging societies of most developed nations is emphasized by its recent inclusion in the ICD-10-CM (M62.84). However, diagnosing sarcopenia is a daunting task. Apart from varying definitions, the proper assessment of recognized sarcopenia criteria is time and cost consuming. A short and inexpensive screening tool may thus be welcome for clinicians and others working in the area of gerontology. Recently, a simple questionnaire was provided (SARC-F) that may adequately realize this aim.
The purpose of this study is to compare established sarcopenia definitions (European Working Group on Sarcopenia in Older People [EWGSOP], Foundation National Institute of Health [FNIH], International Working Group on Sarcopenia [IWGS]) with the SARC-F. Our hypothesis was that the diagnostic overlap between the SARC-F and sarcopenia as determined by these recognized definitions was too low to reliably diagnose sarcopenia.
Seventy-four community-dwelling German men aged 70 years and older with established sarcopenia according to EWGSOP and/or FNIH and/or IWGS were screened with the SARC-F questionnaire.
Applying the definitions of EWGSOP, IWGS, and FNIH, 66.2, 43.2, and 50% of the cohort were classified sarcopenic, respectively. The SARC-F identified 33.5% of the cohort as sarcopenic. The predictive power of the SARC-F increased when men were classified as sarcopenic according to 2 (57.1%) or all (78.8%) sarcopenia definitions. The diagnostic overlap with the 3 sarcopenia definitions varied between 38.8% (SARC-F-FNIH) and 54.1% (SARC-F-IWGS). In comparison, the overlap of diagnosed sarcopenia ranged from 27.0% (FNIH-IWGS) to 49.0% (IWGS-EWGSOP) among the definitions themselves. Only 12.2% of the men met all 3 sarcopenia definitions.
The diagnostic overlap with respect to sensitivity of the SARC-F and present sarcopenia definitions was at least as high as the range of the diagnostic overlap of these approaches themselves. Thus, although the sensitivity of the SARC-F may be debatable, for want of a better option it seems reasonable to consider the SARC-F as a first simple step within a hierarchical screening procedure. Independently of this procedure, a universally accepted mandatory sarcopenia definition along with comprehensive criteria and fixed cutoff points should be provided promptly.
由于肌肉减少症与大多数发达国家的老龄化社会高度相关，因此最近已将其纳入 ICD-10-CM（M62.84）。然而，诊断肌肉减少症是一项艰巨的任务。除了不同的定义外，适当评估公认的肌肉减少症标准既费时又费钱。因此，对于临床医生和从事老年学领域的其他人来说，一种简短且廉价的筛选工具可能会受到欢迎。最近，提供了一种简单的问卷（SARC-F），该问卷可能可以充分实现这一目标。
本研究的目的是比较已建立的肌肉减少症定义（欧洲老年人肌肉减少症工作组[EWGSOP]、美国国立卫生研究院基金会[FNIH]、国际肌肉减少症工作组[IWGS]）与 SARC-F。我们的假设是，SARC-F 与这些公认的定义确定的肌肉减少症之间的诊断重叠太低，无法可靠地诊断肌肉减少症。
对 74 名年龄在 70 岁及以上的居住在社区的德国男性进行筛查，这些男性根据 EWGSOP 和/或 FNIH 和/或 IWGS 确定患有肌肉减少症，并使用 SARC-F 问卷进行筛查。
根据 EWGSOP、IWGS 和 FNIH 的定义，分别有 66.2%、43.2%和 50%的队列被归类为肌肉减少症。SARC-F 将 33.5%的队列确定为肌肉减少症。当根据 2 个（57.1%）或所有（78.8%）肌肉减少症定义将男性归类为肌肉减少症时，SARC-F 的预测能力会增加。SARC-F 与 3 种肌肉减少症定义之间的诊断重叠度在 38.8%（SARC-F-FNIH）至 54.1%（SARC-F-IWGS）之间不等。相比之下，在这些定义本身之间，诊断性肌肉减少症的重叠度范围为 27.0%（FNIH-IWGS）至 49.0%（IWGS-EWGSOP）。只有 12.2%的男性符合所有 3 种肌肉减少症定义。
就 SARC-F 和现有肌肉减少症定义的敏感性而言，其诊断重叠程度至少与这些方法本身的诊断重叠程度一样高。因此，尽管 SARC-F 的敏感性可能存在争议，但由于缺乏更好的选择，似乎可以合理地将 SARC-F 视为分层筛选程序中的第一个简单步骤。无论是否进行此程序，都应迅速提供一个普遍接受的强制性肌肉减少症定义以及全面的标准和固定的截止值。
