Comparison of four sarcopenia screening tools in nursing home residents

Background Several screening tools have been developed for identifying sarcopenia in elderly nursing home residents. Objective To compare the diagnostic accuracy of four sarcopenia screening tools in nursing homes: Mini Sarcopenia Risk Assessment full version (MSRA-7) and short version ( MSRA-5), SARC-F, and SARC-F combined with calf circumference (SARC- CalF). Methods Elderly nursing home residents (aged >= 65 years) were recruited. Four common diagnostic criteria (EWGSOP, AWGS, IWGS, and FNIH) were separately applied as the gold standard. The sensitivity/specificity analyses of the four tools were calculated. Receiver operating characteristic (ROC) curves and area under the ROC curves (AUC) were applied to compare the overall diagnostic accuracy. Results We included 277 participants aged 81.6 +/- 3.3 years. Using different gold standards, the sensitivity of SARC-CalF, SARC-F, MSRA-7, and MSRA-5 ranged from 55.7 to 64.4%, from 17.0 to 21.8%, from 53.3 to 57.8%, and from 49.1 to 56.7%, respectively, whereas the specificity ranged from 84.5 to 86.5%, from 96.8 to 98.4%, from 80.2 to 84.2%, and from 82.8 to 84.1%, respectively. Regardless of the gold standard, SARC-CalF had the largest AUC (from 0.816 to 0.867) among the tools; the AUC of SARC-F (from 0.769 to 0.791) and MSRA-5 (from 0.713 to 0.767) was not significantly different; whereas MSRA-7 had the smallest AUC (from 0.681 to 0.746). Conclusion Among the four screening tools, SARC-CalF appears to be an optimal choice for screening sarcopenia in nursing home residents. SARC-F and MSRA-5 are alternatives, of which, SARC-F has a better specificity and MSRA-5 has a better sensitivity.