Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Sunshine Hospital, 176 Furlong Road, St Albans, VIC, 3021, Australia.
Department of Medicine-Western Health, The University of Melbourne, 176 Furlong Road, St. Albans, 3021, VIC, Australia.
BMC Geriatr. 2020 Jul 13;20(1):242. doi: 10.1186/s12877-020-01642-4.
Sarcopenia is defined as the age-related loss of muscle mass, strength, and physical performance. The original European Working Group on Sarcopenia in Older Persons (EWGSOP1) definition, and its revision (EWGSOP2), provide new cut-points and alternate measures for sarcopenia diagnosis. However, sarcopenia is rarely diagnosed in clinical settings owing to its labor-intensive diagnostic process. Given the Short Physical Performance Battery (SPPB) is a quick, easily administrable, and objective measure of muscle strength and physical performance, both of which are key components of sarcopenia, this study examined the diagnostic value of the SPPB for this muscle disease.
A cross-sectional analysis of 294 community-dwelling older persons (≥65 years) was conducted. Appendicular lean body mass [(ALM) divided by height squared (ALM/h)], muscle strength (handgrip/sit to stand), and physical performance [gait speed, timed up and go (TUG) and SPPB] were assessed using validated procedures, while participants were diagnosed with sarcopenia following the EWGSOP1 and EWGSOP2 criteria. Diagnostic ability of the SPPB independently and combined with ALM/h for sarcopenia was determined using area under the curve (AUC). Potential cut-points were identified, and sensitivity and specificity calculated.
Prevalence of sarcopenia ranged from 4 to 16% depending on the definition. The SPPB demonstrated moderate (AUC = 0.644-0.770) value in diagnosing sarcopenia, and a cut-point of ≤8points in SPPB performance resulted in high sensitivity (82-100%) but low specificity (36-41%) for diagnosing those with severe sarcopenia.
The SPPB displayed acceptable value in diagnosing older adults with severe sarcopenia. Moreover, the high sensitivity of the SPPB when using the cut-point of ≤8 suggests it may be a favorable screening tool for sarcopenia in clinical settings where ALM measurements are not available.
肌少症是指与年龄相关的肌肉质量、力量和身体机能的丧失。最初的欧洲老年人肌少症工作组（EWGSOP1）定义及其修订版（EWGSOP2）为肌少症的诊断提供了新的切点和替代指标。然而，由于其诊断过程繁琐，肌少症在临床环境中很少被诊断出来。鉴于简易体能状况量表（SPPB）是一种快速、易于管理和客观的肌肉力量和身体机能的测量方法，而这两者都是肌少症的关键组成部分，因此本研究检验了 SPPB 对这种肌肉疾病的诊断价值。
对 294 名居住在社区的老年人（≥65 岁）进行了横断面分析。使用经过验证的程序评估四肢瘦体重[（ALM）除以身高平方（ALM/h）]、肌肉力量（握力/坐站）和身体机能[步态速度、计时起立行走（TUG）和 SPPB]，同时根据 EWGSOP1 和 EWGSOP2 标准诊断肌少症。使用曲线下面积（AUC）确定 SPPB 独立和与 ALM/h 联合诊断肌少症的诊断能力。确定潜在的切点，并计算敏感性和特异性。
根据定义，肌少症的患病率在 4%至 16%之间不等。SPPB 在诊断肌少症方面具有中等价值（AUC=0.644-0.770），SPPB 表现≤8 分的切点可使诊断严重肌少症的敏感性（82%-100%）较高，但特异性（36%-41%）较低。
SPPB 在诊断老年严重肌少症方面具有可接受的价值。此外，SPPB 在使用≤8 分的切点时具有较高的敏感性，这表明它可能是在无法进行 ALM 测量的临床环境中筛查肌少症的有利工具。
