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BackgroundSarcopenia has been reported to be associated with short-term outcomes after gastric endoscopic submucosal dissection (ESD). The “strength, assistance with walking, rising from a chair, climbing stairs, and falls” (SARC-F) questionnaire has been widely used as a screening tool for sarcopenia; however, SARC-F combined with body mass index and age (SARC-F+EBM) has recently been reported to be more useful than SARC-F alone. This study aimed to investigate the association between sarcopenia, measured using SARC-F+EBM, and short-term outcomes after gastric ESD.MethodsPatients who underwent gastric ESD at our institution between May 2020 and June 2023 were included, and their medical records were reviewed retrospectively. A SARC-F+EBM score ≥ 12 indicated sarcopenia. We evaluated the incidence of adverse events and the length of hospital stay in the sarcopenia and non-sarcopenia groups.ResultsOverall, 263 patients (64 and 199 in the sarcopenia and non-sarcopenia groups, respectively) were investigated. The incidence of adverse events with a Common Terminology Criteria for Adverse Events grade ≥ 3 was not significantly different between the sarcopenia and non-sarcopenia groups (6.2% vs. 8.5%, p = 0.791). The proportion of patients with an extended hospital stay (≥ 10 days) was significantly higher in the sarcopenia group than that in the non-sarcopenia group (12.5% [8/64] vs. 3.5% [7/199], p = 0.012). Multivariate analysis showed that sarcopenia and lesions that present technical difficulty in ESD were independent risk factors for extended hospital stays (≥ 10 days). Of the eight cases having extended hospital stays in the sarcopenia group, four were due to the management after gastric ESD, three were due to family circumstances, and one was due to decreased activities of daily living.ConclusionsSarcopenia is not a predictor of adverse events associated with gastric ESD. However, patients with sarcopenia may be hospitalized for longer owing to non-ESD-related factors.

Background Sarcopenia is recognized as an important geriatric condition that is both a consequence of and a contributor to various non-communicable diseases. It is a public health priority to improve early detection. However, there is still no consensus on the optimal diagnostic tools. Aims This study evaluated the diagnostic performance of six sarcopenia screening tools - SARC-F, SARC-Calf, SARC-F + AC, SARC-Calf + AC, Ishii test, and SarSA-Mod in low-income older adults in Brazil. Methods Sarcopenia was diagnosed using the European Working Group on Sarcopenia in Older People (EWGSOP2) and Sarcopenia Definitions and Outcomes Consortium (SDOC) criteria. Muscle mass was estimated through the Lee equation. The specificity, sensitivity, and receiver operating characteristic (ROC) curve analyses were calculated for the screening tools. Results The study included 312 participants (200 women, mean age 72.4 ± 8.1 years). The prevalence of sarcopenia in men was 30.4% (EWGSOP2) and 75.0% (SDOC). In women, the prevalence was 28.5% (EWGSOP2) and 58.0% (SDOC). For men, the sensitivity/specificity of the Ishii test, SarSA-Mod, SARC-F, SARC-Calf, SARC- F + AC, and SARC-Calf + AC in screening for sarcopenia based on EWGSOP2 criteria were 69.2%/97.1%, 39.7%/94.1%, 50.0%/72.5%, 76.9%/38.2%, 85.9%/41.2% and 59.0%/67.7% respectively. Among women, these values were 52.5%/100%, 37.8%/70.2%, 83.2%/68.4%, 66.4%/69.5%, 87.4%/36.8% and 58.7%/63.2% respectively. the AUCs of SARC-F, SARC-Calf, SARC-F + AC, SARC-Calf + AC, SarSA-Mod and Ishii test in men, were 0.558, 0.576, 0.635, 0.633, 0.669, and 0.831, respectively. In women, the AUCs of SARC-F, SARC-Calf, SARC-F + AC, SARC-Calf + AC, SarSA-Mod and Ishii test were 0.574, 0.613, 0.621, 0.609, 0.540, and 0.762, respectively. Conclusions The Ishii test showed the highest diagnostic accuracy for EWGSOP2-defined sarcopenia in community-dwelling older Brazilians.

To assess the reliability and validity of Turkish version of SARC-F in regard to screening with current definitions of sarcopenia, muscle mass and functional measures. Cross-sectional study. Community-dwelling older adults aged >=65 years admitting to a geriatric outpatient clinic. Muscle mass (bioimpedance analysis), handgrip strength, usual gait speed, chair sit-to-stand test, functional reach test, short physical performance battery, SARC-F questionnaire, FRAIL questionnaire Sarcopenia was evaluated with 4 current different definitions: European Working Group on Sarcopenia in Older People's (EWGSOP); Foundation for the National Institutes of Health (FNIH), International Working Group on Sarcopenia (IWGS) and Society on Sarcopenia, Cachexia and Wasting Disorders (SCWD). After cross-cultural adaptation, 207 subjects were analysed in the clinical validation study. Mean age was 74.6±6.7 years, 67.6% were women. Against EWGSOP, FNIH, IWGS and SCWD definitions of sarcopenia, sensitivity of SARC-F were %25, 31.6%, 50% and 40%; specificity were 81.4%, 82.4%, 81.8% and 81.7%, respectively. Positive predictive values were between 5.1-15.4% and negative predictive values were 92.3-98.2%. Against parameters of low muscle mass, sensitivity were about 20% and specificity were about 81%. Against parameters of function; for low hand grip strength, sensitivity of SARC-F were 33.7% (for Turkish cut-off); 50% (for FNIH cut-off); specificity were 93.7% (for Turkish cut-off) and 85.8% (for FNIH cut-off). Against low UGS, poor performance in chair sit to stand test, functional reach test, SPPB and presence of positive frailty screening sensitivity were 58.3%, 39.2%, 59.1%, 55.2% and 52.1% while specificity were 97.3%, 97.8%, 88.1%, 99.3% and 91.2%, respectively. The psychometric performance of Turkish SARC-F was similar to the original SARC-F. It revealed low sensitivity but high specificity with all sarcopenia definitions. Sensitivity and specificity were higher for muscle function tests reflecting its inquiry and input on functional measures. Our findings suggest that SARC-F is an excellent test to exclude muscle function impairment and sarcopenia. SARC-F is relatively a good screening test for functional measures.

Our objective was to evaluate if SARC-F, SARC-CalF, SARC-F-EBM, calf circumference (CC), mid-upper-arm circumference (MUAC) and Ishii test can be used to accurately screen for sarcopenia in schizophrenic patients. We enrolled schizophrenic patients aged 50 or older, who were regularly taking antipsychotic medications, at two mental health centres. Bioimpedance-based muscle-mass was analysed with an InBody 770 instrument, while muscle strength was measured with a digital grip-strength dynamometer. The physical performance of the patients was gauged from their gait speed over 6 m. Standard AWGS2019 diagnostic criteria were used, and the accuracies of the six screening methods were indicated by the sensitivity, negative predictive value (NPV), and area under receiver operating characteristic curve (AUC). A total of 339 stable schizophrenic patients were enrolled. The overall prevalence of sarcopenia was 53.1%, and the prevalence was 55.6% and 47.66%, respectively, for males and females. The prevalence of sarcopenia obesity in the total population was 16.22%, and that of males and females was 18.97% and 10.28%, respectively. The SARC-F, SARC-CalF, SARC-F-EBM, CC, MUAC and Ishii test sensitivity/NPV in screening for sarcopenia were 41.86%/0.52, 79.07%/0.7, 28.68%/0.51, 78.3%/0.71, 76.74%/0.7, 89.92%/0.84, respectively, in males and 45.1%/0.59, 94.12%/0.91, 54.9%/0.7, 92.16%/60.91, 74.51%/0.77, 96.08%/0.94, respectively, in females. In males, the AUCs of the SARC-F, SARC-CalF, SARC-F-EBM, CC, MUAC and Ishii test were 0.601 (95%CI, 0.528–0.673), 0.754 (95%CI,0.69–0.817), 0.657 (95%CI,0.588–0.727), 0.8 (95%CI, 0.744–0.856), 0.781 (95%CI, 0.721–0.84) and 0.88 (95%CI, 0.837–0.922), respectively, and in females, they were 0.587(95%CI,0.479–0.696), 0.794 (95%CI,0.709–0.878), 0.799 (95%CI,0.71–0.888), 0.893 (95%CI, 0.833–0.953), 0.843 (95%CI, 0.772–0.915) and 0.855 (95%CI, 0.784–0.926), respectively. The prevalence of sarcopenia in schizophrenic patients is high. Clinical doctors should screen for sarcopenia in schizophrenic patients and provide timely interventions to reduce the occurrence of adverse events. The above six tools can be used as screening tools, and the Ishii test is the most suitable for screening.

Key summary points Aim To determine the diagnostic efficacy of six screening tools for sarcopenia. Findings 44.5% were diagnosed as sarcopenia in men and 39.1% in women. SarSA-Mod had a high screening value after redefining the cutoff value, and the Ishii test may be our better screening tool for assessing sarcopenia. The SARC-F’s modified versions showed significantly increased sensitivity. Message The Ishii test is the best tool among the six screening tools for assessing sarcopenia in the study. Objective The objective of this analysis was to determine the diagnostic efficacy of the Ishii test, SarSA-Mod, SARC-F, SARC-Calf, SARC-F+AC, and SARC-Calf+AC for screening for sarcopenia among rural community-dwelling older adults. Methods The AWGS 2019 diagnostic criteria was a diagnostic reference for sarcopenia. There were six screening tools whose accuracy was determined through the use of metrics, including specificity, sensitivity, negative and positive predictive values, and the receiver operating characteristic (ROC) curve. Results The study included 551 participants (304 women, age 70.9 ± 4.9 years). The prevalence of sarcopenia was 44.5% in men and 39.1% in women. In males, the sensitivity/specificity of the Ishii test, SarSA-Mod, SARC-F, SARC-Calf, SARC-F+AC, and SARC-Calf+AC screening sarcopenia were 87.3%/65.7%, 98.2%/21.9%, 6.4%/98.5%, 28.2%/91.2%, 33.6%/83.9%, and 84.6%/43.8%, and in females, they were 68.1%/82.2, 100%/23.2%, 16.0%/90.3%, 35.3%/84.3%, 58.8%/61.1%, and 89.9%/42.2%, respectively. In males, the area under the curves of the Ishii test, SarSA-Mod, SARC-F, SARC-Calf, SARC-F+AC, and SARC-Calf+AC were 0.846 (95% CI 0.795–0.889), 0.800 (95% CI 0.745–0.848), 0.581 (95% CI 0.516–0.643), 0.706 (95% CI 0.645–0.762), 0.612 (95% CI 0.548–0.673), and 0.707 (95% CI 0.646–0.763), respectively, and in females, they were 0.824 (95% CI 0.776–0.865), 0.845 (95% CI 0.799–0.883), 0.581 (95% CI 0.524–0.637), 0.720 (95% CI 0.666–0.770), 0.632 (95% CI 0.575–0.686), and 0.715 (95% CI 0.661–0.765), respectively. Conclusion Our findings demonstrate that the overall accuracy of the Ishii test was best among the six screening tools for sarcopenia screening in rural community-dwelling older adults.

Background and Aims Sarcopenia, a progressive loss of skeletal muscle mass and function, poses a growing public health challenge in low and middle‐income settings. We aimed to quantify its prevalence and identify sex‐specific risk factors among older adults attending a public outpatient clinic in Tegucigalpa, Honduras. Methods In a hospital‐based, age‐stratified random sample, we enrolled 100 participants (73 women and 27 men; mean age = 69.7 ± 6.9 years) during July 2024. Possible sarcopenia and frailty were assessed using SARC‐F and FRAIL questionnaires, respectively. Body mass index was calculated under standardized conditions and mean arterial pressure (MAP) was derived from blood pressure measurements. Normality of continuous variables was evaluated with the Shapiro–Wilk test. Between‐sex differences were analyzed using Welch's t‐test for continuous variables and χ2 test for categorical variables (α = 0.05). Pearson's correlation was employed to assess associations between SARC‐F scores and clinical variables. Results Possible sarcopenia (SARC‑F ≥ 4) was present in 48% of participants (95% CI = 38–58), while 40% met criteria for frailty. Women showed a significantly higher mean BMI than men (28.0 ± 5.7 kg m−2 vs. 24.9 ± 4.5 kg m−2; t = 2.8, p = 0.007) yet a comparable MAP (102 ± 13 mmHg vs. 99 ± 13 mmHg; p = 0.33). Frailty prevalence remained higher in women across all age strata (42.5% vs. 37.0%), although the sex difference was not statistically significant (χ2 = 0.2, p = 0.9). SARC‑F scores correlated modestly with MAP (r = 0.3, p = 0.003) but not with age (r = 0.1, p = 0.3) or BMI (r = 0.1, p = 0.4). Conclusions Nearly half of older adults were at risk of sarcopenia and two‐fifths were frail, with women more affected. Elevated blood pressure was linked to functional decline. Summary In a randomly selected outpatient cohort of older adults in Tegucigalpa, 48% screened positive for possible sarcopenia (SARC‑F ≥ 4) and 40% were classified as frail, underscoring a substantial musculoskeletal health burden. Women exhibited higher frailty prevalence across every age stratum despite a lower mean BMI, whereas men showed greater BMI and arterial‑pressure elevations, highlighting the need for sex‑tailored interventions. Mean arterial pressure displayed a modest but significant positive correlation with SARC‑F scores (r = 0.29, p = 0.003), while age and BMI were not independently associated, suggesting vascular factors may contribute to functional decline beyond traditional anthropometrics. Why Does This Paper Matter? ∘ This study highlights the public health issues of sarcopenia and frailty among older adults, conditions that significantly impact quality of life and healthcare demands in Tegucigalpa, Honduras. By examining the prevalence and associated risk factors, particularly gender differences and socioeconomic variables. The research reveals that women are more susceptible to frailty, even with a lower body mass index (BMI) than men. This finding underscores the influence of hormonal fluctuations and social determinants of health. Despite the prevalence of sarcopenia in the population, there is currently no comprehensive or structured approach to its diagnosis, prevention, or management within the public health system or clinical practice settings in Honduras. This lack of integration impedes early detection and restricts the effectiveness of potential interventions. Understanding these risks is vital for improving health outcomes and alleviating pressure on healthcare systems, particularly in the context of an aging population. This study is especially relevant given the projected demographic shifts, where the proportion of older adults is expected to increase significantly. As the first in a series aimed at characterizing sarcopenia within Honduran society, this work provides essential baseline data. It also emphasizes the national importance of generating regionally specific evidence such as that from Tegucigalpa to inform public health policies and engage academic, regulatory, and healthcare institutions in coordinated strategies.

Background Sarcopenia is the pathologic loss of muscle strength and mass. SARC‐F screener for sarcopenia has been criticized for its low sensitivity. The Parker Mobility Score (PMS) is widely used to assess mobility in older adults. This study evaluates PMS's ability to detect sarcopenia. Methods We used data from the Paint II clinical trial, which examined the effects of art therapy in community‐dwelling older individuals. Sarcopenia was defined using EWGSOP2 criteria: probable sarcopenia as handgrip strength < 27 kg (men) or < 16 kg (women) and/or chair stand test > 15 s. Sarcopenia was confirmed in patients with probable sarcopenia when their appendicular skeletal muscle mass index was below 7 kg/m² for men or 5.5 kg/m² for women. The PMS's diagnostic performance was assessed using ROC analysis. Results Data from 255 participants (200 (78%) female, median age 81) were analyzed. 196 (77%) participants had probable sarcopenia and 26 (10%) were sarcopenic. PMS showed moderate discrimination for probable sarcopenia, with an AUC of 0.75 (95% CI: 0.68–0.81). The cutoff (< 8) provided a sensitivity of (77%) and specificity of (64%). For sarcopenia, the AUC was 0.61 (95% CI: 0.52–0.69), indicating low to moderate discrimination. The PMS cutoff of < 8 showed high sensitivity (92%), but low specificity (36%). Similar results were observed for sarcopenic obesity, with an AUC of 0.61. Conclusion PMS demonstrated moderate accuracy for identifying probable sarcopenia and high sensitivity for detecting sarcopenia. Although this high sensitivity is linked to a lower specificity, the trade‐off is acceptable because the follow‐up diagnostic tests are non‐invasive with low costs. Due to its widespread use and feasibility in clinical practice, PMS may represent a practical tool for case finding. Further research is required to confirm its accuracy in different populations. Why does this paper matter? Sarcopenia often remains underdiagnosed. The Parker Mobility Score, which is already part of standard geriatric assessments, could enable earlier and broader identification of older adults at risk.

Background The European Working Group on Sarcopenia in Older People (EWGSOP) recommends SARC‐F as a tool for identifying sarcopenia among older adults. However, the role of SARC‐F among older adults with cancer remains unexplored. We aimed to evaluate the diagnostic utility of SARC‐F to identify those with sarcopenia, or low muscle mass (using skeletal muscle index [SMI]), and myosteatosis (using skeletal muscle density [SMD]) from computed tomography (CT) imaging and the association of SARC‐F with all‐cause mortality. Methods Older adults (≥60 years) presenting for initial consultation at UAB medical oncology clinic who underwent geriatric assessment were enrolled in a prospective cohort study. We identified study participants who completed SARC‐F screening and had available CT imaging within 60 days of study enrollment. Using single‐slice CT images at the L3 vertebral level, we computed SMI and SMD using published methods. Sarcopenia and myosteatosis were defined using published cutpoints. We calculated the sensitivity and specificity of SARC‐F for detecting low muscle mass and low muscle density using published thresholds. Finally, we computed the impact of SARC‐F and CT measures on overall survival using Kaplan–Meier curves and Cox regression models, after adjusting for age, sex, cancer type, and cancer stage. Results We identified 212 older adults with a median age of 68.8 years; with 60.8% males, 76.6% whites, and pancreatic cancer (21.2%) being the most common malignancy. In the overall cohort, 30.7% had abnormal SARC‐F using published cutpoints. SARC‐F ≥ 4 had a sensitivity of 35% and a specificity of 76% to identify low muscle mass. SARC‐F ≥ 4 had a sensitivity of 38% and a specificity of 74% to identify low muscle density. Those with SARC‐F ≥ 4 and low SMI/SMD had worse survival compared to those with low SMI/SMD alone. Incorporating SARC‐F improved survival prognostication beyond SMI and SMD (HR = 3.1; p < 0.001; Harrel's C from 0.73 to 0.76). Conclusions SARC‐F as a screening tool has limited diagnostic utility for identifying older adults with low muscle mass and/or density. However, SARC‐F retains prognostic value independent of CT‐based muscle measures in predicting mortality among older adults with cancer. Patient‐reported measures such as SARC‐F have been used to identify sarcopenia in community‐dwelling adults, but the utility of SARC‐F to identify sarcopenia and myosteatosis among older adults with cancer remains unknown. Herein, we show that SARC‐F and computed tomography analysis identify distinct populations, and they can be used together to better predict overall survival among older adults with cancer.

We sought to elucidate the prognostic impact of the SARC-F score among patients with gastrointestinal advanced malignancies (n = 421). A SARC-F score ≥ 4 was judged to have a strong suspicion for sarcopenia. In patients with ECOG-PS 4 (n = 43), 3 (n = 61), and 0–2 (n = 317), 42 (97.7%), 53 (86.9%) and 8 (2.5%) had the SARC-F score ≥ 4. During the follow-up period, 145 patients (34.4%) died. All deaths were cancer-related. The 1-year cumulative overall survival (OS) rate in patients with SARC-F ≥ 4 (n = 103) and SARC-F < 4 (n = 318) was 33.9% and 61.6% (p < 0.0001). In the multivariate analysis for the OS, total lymphocyte count ≥ 1081/μL (p = 0.0014), the SARC-F score ≥ 4 (p = 0.0096), Glasgow prognostic score (GPS) 1 (p = 0.0147, GPS 0 as a standard), GPS 2 (p < 0.0001, GPS 0 as a standard), ECOG-PS 2 (p < 0.0001, ECOG-PS 0 as a standard), ECOG-PS 3 (p < 0.0001, ECOG-PS 0 as a standard), and ECOG-PS 4 (p < 0.0001, ECOG-PS 0 as a standard) were independent predictors. In the receiver operating characteristic curve analysis on the prognostic value of the SARC-F score, the sensitivity/specificity was 0.59/0.70, and best cutoff point of the SARC-F score was two. In conclusion, the SARC-F score is useful in patients with gastrointestinal advanced malignancies.

•Sarcopenia predicts poor outcomes in elderly patients with cardiovascular disease.•Prestroke sarcopenia is an independent predictor of functional outcome after a stroke.•Prestroke sarcopenia should be assessed in elderly patients who have had a stroke. The association between prestroke sarcopenia and functional outcomes in patients who have had a stroke has not, to our knowledge, been evaluated to date. We aimed to investigate the prevalence of prestroke sarcopenia, and determine whether prestroke sarcopenia is associated with functional outcomes in elderly patients who have suffered an acute stroke. We assessed prestroke sarcopenia in elderly patients with acute stroke using the SARC-F questionnaire. Patients were divided into two groups according to their SARC-F score: non-sarcopenia (SARC-F score <4) and prestroke sarcopenia (SARC-F score ≥4). The study endpoint was the modified Rankin Scale score at 3 mo after the stroke (0–3, good outcome; 4–6, poor outcome). The Mann-Whitney U-test, Pearson χ2 test, Fisher exact test, and logistic regression were used in the statistical analyses. Of the 152 patients (81 men; median age [interquartile range]: 76 [11] y) enrolled, the prevalence rate of prestroke sarcopenia was 18% (27 patients). These 27 patients showed poor functional outcome at 3 mo after the stroke (50% versus 12%, prestroke sarcopenia versus nonsarcopenia; P < 0.001). After adjusting for variables, prestroke sarcopenia was an independent predictor of poor functional outcome at 3 mo after stroke (odds ratios: 7.39, 95% confidence interval: 1.47–37.21, P = 0.02). Prestroke sarcopenia is an independent predictor of functional outcome at 3 mo after a stroke. Our findings highlight the importance of detecting prestroke sarcopenia in elderly patients with acute stroke.