Screening Tools for Sarcopenia in Community-Dwellers: A Scoping Review

Introduction: Sarcopenia is characterised by a progressive and generalised loss of skeletal muscle mass, strength and/or performance. It is associated with adverse health outcomes such as increased morbidity, functional decline and death. Early detection of sarcopenia in community-dwelling older adults is important to prevent these outcomes. Our scoping review evaluates validated screening tools that are used to identify community-dwelling older individuals at risk of sarcopenia and appraises their performance against international consensus definitions. Materials and Methods: A systematic search on MEDLINE, PubMed and EMBASE was performed for articles that evaluated the predictive validity measures of screening tools and validated them against at least 1 internationally recognised diagnostic criterion for sarcopenia. Results: Of the 17 articles identified in our search, 8 used questionnaires as screening tool, 2 utilised anthropometric measurements, 3 used a combination of questionnaire and anthropometric measures and 1 used a physical performance measure (chair stand test). The questionnaire Strength, Assistance with walking, Rising from chair, Climbing stairs and Falls (SARC-F) has the highest specificity (94.4-98.7%) but low sensitivity (4.2-9.9%), with the 5-item questionnaire outperforming the 3-item version. When SARC-F is combined with calf circumference, its sensitivity is enhanced with improvement in overall diagnostic performance. Although equation-based anthropometric screening tools performed well, they warrant external validation. Conclusion: Our scoping review identified 6 candidate tools to screen for sarcopenia. Direct comparison studies in the community would help to provide insights into their comparative performance as screening tools. More studies are needed to reach a consensus on the best screening tool(s) to be used in clinical practice. Key words: Low muscle function, Low muscle mass, Older adults, Sensitivity, Specificity