Diagnostic accuracy of sarcopenia screening tools in low-income older adults in Amazonas, Brazil

Sarcopenia is recognized as an important geriatric condition that is both a consequence of and a contributor to various non-communicable diseases. It is a public health priority to improve early detection. However, there is still no consensus on the optimal diagnostic tools.

This study evaluated the diagnostic performance of six sarcopenia screening tools - SARC-F, SARC-Calf, SARC-F + AC, SARC-Calf + AC, Ishii test, and SarSA-Mod in low-income older adults in Brazil.

Sarcopenia was diagnosed using the European Working Group on Sarcopenia in Older People (EWGSOP2) and Sarcopenia Definitions and Outcomes Consortium (SDOC) criteria. Muscle mass was estimated through the Lee equation. The specificity, sensitivity, and receiver operating characteristic (ROC) curve analyses were calculated for the screening tools.

The study included 312 participants (200 women, mean age 72.4 ± 8.1 years). The prevalence of sarcopenia in men was 30.4% (EWGSOP2) and 75.0% (SDOC). In women, the prevalence was 28.5% (EWGSOP2) and 58.0% (SDOC). For men, the sensitivity/specificity of the Ishii test, SarSA-Mod, SARC-F, SARC-Calf, SARC- F + AC, and SARC-Calf + AC in screening for sarcopenia based on EWGSOP2 criteria were 69.2%/97.1%, 39.7%/94.1%, 50.0%/72.5%, 76.9%/38.2%, 85.9%/41.2% and 59.0%/67.7% respectively. Among women, these values were 52.5%/100%, 37.8%/70.2%, 83.2%/68.4%, 66.4%/69.5%, 87.4%/36.8% and 58.7%/63.2% respectively. the AUCs of SARC-F, SARC-Calf, SARC-F + AC, SARC-Calf + AC, SarSA-Mod and Ishii test in men, were 0.558, 0.576, 0.635, 0.633, 0.669, and 0.831, respectively. In women, the AUCs of SARC-F, SARC-Calf, SARC-F + AC, SARC-Calf + AC, SarSA-Mod and Ishii test were 0.574, 0.613, 0.621, 0.609, 0.540, and 0.762, respectively.

The Ishii test showed the highest diagnostic accuracy for EWGSOP2-defined sarcopenia in community-dwelling older Brazilians.