Comparison of four sarcopenia screening tools in nursing home residents

Abstract

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.