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Observational Study
. 2024 Dec 28;24(1):1043.
doi: 10.1186/s12877-024-05637-3.

Evaluating SARC-F, SARC-CalF, and calf circumference as diagnostic tools for sarcopenia in Thai older adults: results from a nationwide study

Ekasame Vanitcharoenkul  1 , Aasis Unnanuntana  1 , Pojchong Chotiyarnwong  1 , Nath Adulkasem  1 , Apichat Asavamongkolkul  1 , Panai Laohaprasitiporn  2
Affiliations
Observational Study

Evaluating SARC-F, SARC-CalF, and calf circumference as diagnostic tools for sarcopenia in Thai older adults: results from a nationwide study

Ekasame Vanitcharoenkul et al. BMC Geriatr. .

Abstract

Background: With the increasing number of older adults, musculoskeletal disorders such as sarcopenia have become increasingly important to research because of their strong association with falls and fractures. Sarcopenia, which is characterized by reduced muscle mass, is common among older adults and significantly increases the risk of falls. This study aimed to assess the effectiveness of the SARC-F and SARC-CalF questionnaires, along with calf circumference measurements, for sarcopenia screening among Thai community-dwelling older adults, following the 2019 criteria of the Asian Working Group for Sarcopenia.

Methods: This analysis drew on data from the Thai Musculoskeletal Diseases Nationwide Study, which included 2543 participants aged 60 years or older. The SARC-F, SARC-CalF, and calf circumference data were evaluated against the 2019 Asian Working Group for Sarcopenia criteria. We calculated the sensitivity, specificity, and area under the curve to determine the diagnostic performance of each tool.

Results: Of the 2455 participants analyzed, 18.1% were diagnosed with sarcopenia. The SARC-F and SARC-CalF questionnaires showed limited effectiveness in diagnosing sarcopenia, with area under the curve values of 0.508 and 0.729, respectively. In contrast, calf circumference demonstrated greater diagnostic accuracy, with area under the curve values of 0.897 in males and 0.878 in females. Adjusting the cutoff points to < 33 cm for males and < 31 cm for females improved the overall diagnostic accuracy from 66.4 to 82%.

Conclusions: Sarcopenia is relatively prevalent in Thailand. The SARC-F and SARC-CalF questionnaires are inadequate for diagnosing sarcopenia, while calf circumference alone is the most effective screening tool. Adding more parameters to the SARC-F questionnaire could enhance its diagnostic accuracy.

Trial registration: This study was registered at ClinicalTrials.gov (NCT06558617). Registration Date 16 August 2024.

Keywords: Calf circumference; Diagnostic test; Elderly; SARC-F questionnaire; Sarcopenia.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted per the Declaration of Helsinki and received ethical approval from the Siriraj Institutional Review Board, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand (COA-715/2024). Trained research assistants obtained written informed consent from all participants before their enrollment. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of participant selection and diagnostic categorization for sarcopenia screening and diagnosis based on AWGS 2019 criteria; Abbreviations: DF-BIA = dual-frequency bioelectrical impedance analysis
Fig. 2
Fig. 2
Receiver operating characteristic curves for detecting possible sarcopenia: (A) SARC-F and SARC-CalF questionnaires and (B) calf circumference measurements
Fig. 3
Fig. 3
Receiver operating characteristic curves for diagnosing sarcopenia: (A) SARC-F and SARC-CalF questionnaires and (B) calf circumference measurements
See this image and copyright information in PMC

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