Prevalence of sarcopenia in pre-frail community dwelling older adult and utility of SARC-F, SARC-CalF and calf circumference in case finding
Jia Yi Lim, Nethania Ann Low, Reshma Aziz Merchant
Abstract
Working Group on Sarcopenia in Older People 2 (EWGSOP2) and Asian Workgroup for Sarcopenia (AWGS 2019) Sarcopenia is associated with poor quality of life, depression, falls, functional decline, cognitive impairment and mortality The prevalence of sarcopenia varies depending on the diagnostic criteria and setting, from 5.5% to 25.7% Diagnosis and definition of sarcopenia is continuing to evolve and as yet, there is no single gold standard consensus which can used in both research and clinical environment. The most widely used definition of sarcopenia in Asia was first introduced by the Asian Working Group in 2014 11 . Following the release of EWGSOP2 in 2018 focussing on low muscle strength as key characteristic of sarcopenia, detection of low muscle quantity and quality to confirm diagnosis; and physical performance to stratify severe sarcopenia in addition to incorporating case finding 12 ; the Asian Workgroup subsequently published the AWGS 2019 Consensus Update incorporating the Asian norms 4 . The objective of this cross-sectional analysis was to determine the Abstract Objective: To determine the prevalence of sarcopenia in the pre-frail community dwelling older adults based on the Asian Workgroup for Sarcopenia (AWGS 2019) criteria. In addition, the utility of case finding using the SARC-F, SARC-CalF and calf circumference on impact of prevalence was explored. Methods: 75 older adults 65 years old were recruited between October 2019 and March 2020. The algorithms of AWGS 2019 was applied retrospectively to pre-frail participants recruited for an intervention study in primary care setting. In addition to demographics, SARC-F, calf circumference (CC), muscle mass, grip strength, gait speed, 5-time chair stand timing and short physical performance battery test (SPPB) were measured, to determine sarcopenia using AWGS 2019. SARC-CalF was determined using SARC-F and CC. Results: The prevalence of sarcopenia based on AWGS 2019 algorithm was 16.0%, possible sarcopenia 73.3% and severe sarcopenia 12.0%. Using SARC-F for case finding reduced the overall prevalence of sarcopenia to 4.0%, possible sarcopenia to 12.0% and severe sarcopenia to 4.0%. Positive percentage agreement of case finding criteria of SARC-F, SARC-CaIF and calf circumference for sarcopenia was 33%, 42% and 58% respectively. Conclusions: Using the AWGS 2019 without case finding, the prevalence of sarcopenia was 16%. However, using SARC-F for case finding underestimated prevalence in this group by 75%. Utility of SARC-F for case finding in pre-frail requires further evaluation.