SARC-F for sarcopenia screening in community-dwelling older adults: Are 3 items enough?

A 3-item SARC-F (termed SARC-F-3 in our study) was recently suggested as a screening tool for sarcopenia. The aim of this study was to compare the diagnostic value of SARC-F-3 to SARC-F in community-dwelling older people. We conducted a diagnostic accuracy study in an urban community in Chengdu, China. People aged 60 years or older were included. Muscle mass, strength, and physical performance were measured by a bio-impedance analysis (BIA) device, handgrip strength, and gait speed test, respectively. The Asia Working Group for Sarcopenia (AWGS) criteria were applied as the “gold reference.” The sensitivity/specificity analyses of SARC-F and SARC-F-3 were performed. The receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were applied to compare the overall accuracy of SARC-F and SARC-F-3. The cut-off points of SARC-F-3 for sarcopenia were determined using the Youden index method. A total of 384 older people aged 71.5 ± 5.8 years were included. On the basis of the AWGS criteria, the prevalence of sarcopenia in our study population was 15.9%. The optimal cut-off point of SARC-F-3 for identifying sarcopenia was a total score of ≥ 2. In the whole study population, the sensitivity and specificity of SARC-F were 29.5% [95% confidence interval (95% CI): 18.5–42.6] and 98.1% (95% CI: 96.0–99.3), respectively, whereas the sensitivity and specificity of SARC-F-3 were 13.1% (95% CI: 5.8–24.2) and 97.8% (95% CI: 95.6–99.1), respectively. The AUCs of SARC-F and SARC-F-3 were 0.894 (95% CI: 0.859–0.923) and 0.676 (95% CI: 0.627–0.723), respectively (P < .001). The 3-item SARC-F may not be suitable for screening sarcopenia in community-dwelling older people.