Screening Accuracy of SARC-F for Sarcopenia in the Elderly: A Diagnostic Meta-Analysis

Background Sarcopenia is an age-related disease, which is characterized by a decline in muscle mass and function. It is one of the most important health issues in the elderly and often leads to a high rate and variety of adverse outcomes. Objectives To evaluate the screening accuracy of SARC-F for sarcopenia in the elderly. Design We conducted a meta-analysis using articles available in 6 databases including PubMed (Medline), Web of Science, Embase, Cochrane Controlled Register of Trials (CENTRAL), China Knowledge Resource Integrated Database (CNKI), and Wanfang databases from inception to May 2020. Participants: Adults aged 60 years and older. Measurements Sarcopenia was defined by EWGSOP2, EWGSOP, AWGS, FNIH and IWGS. Two authors independently extracted data based on predefined criteria. Where data were available we calculated pooled summary estimates of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and their 95% confidence interval (CI) based on different criteria using the hierarchical logistic regression modeling including bivariate modeling and hierarchical summary receiver operating characteristic (HSROC) modeling. Results We included 20 studies, with the prevalence of sarcopenia ranging from 6.42% to 21.56%. The number of the literatures using EWGSOP, EWGSOP2, AWGS, IWGS and FNIH as diagnostic criteria was 13, 4, 13, 8, 7, respectively. Bivariate analysis yielded a pooled sensitivity of 32% (95%CI: 19%-47%), 77% (95%CI: 49%-92%), 27% (95%CI: 16%-42%), 39% (95%CI: 27%-52%), 35% (95%CI: 23%-49%) and a pooled specificity of 86% (95%CI:77%-92%), 63% (95%CI: 43%-79%), 91% (95%CI: 85%-95%), 86% (95%CI: 76%-92%), 89% (95%CI: 81%-93%), respectively. The area under the HSROC curve were 0.68 (95%CI: 0.64-0.72), 0.75 (95%CI: 0.71-0.78), 0.73 (95%CI: 0.69-0.77), 0.67 (95%CI: 0.62-0.71), 0.70 (95%CI: 0.65-0.73), respectively. Conclusions The screening accuracy of SARC-F was various based on different diagnostic criteria. There were some limitations for SARC-F, however, considering the higher practicability and specificity for screening sarcopenia in practice, SARC-F was still an effective screening tool for sarcopenia in the elderly. And the screening accuracy of SARC-F needs further exploration when EWGSOP2 is applied as diagnostic criteria and geriatric inpatients are the target participants.

Automated summary

The study evaluated the screening accuracy of SARC-F for sarcopenia in the elderly, showing varying effectiveness under different diagnostic criteria, but remaining an effective tool for screening in practice.