title: SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes.
abstract: A brief, inexpensive screening test for sarcopenia would be helpful for clinicians and their patients. To screen for persons with sarcopenia, we developed a simple five-item questionnaire (SARC-F) based on cardinal features or consequences of sarcopenia.
  
  
  
  We investigated the utility of SARC-F in the African American Health (AAH) study, Baltimore Longitudinal Study of Aging (BLSA), and National Health and Nutrition Examination Survey (NHANES). Internal consistency reliability for SARC-F was determined using Cronbach's alpha. We evaluated SARC-F factorial validity using principal components analysis and criterion validity by examining its association with exam-based indicators of sarcopenia. Construct validity was examined using cross-sectional and longitudinal differences among those with high (≥4) vs. low (<4) SARC-F scores for mortality and health outcomes.
  
  
  
  SARC-F exhibited good internal consistency reliability and factorial, criterion, and construct validity. AAH participants with SARC-F scores ≥ 4 had more Instrumental Activity of Daily Living (IADL) deficits, slower chair stand times, lower grip strength, lower short physical performance battery scores, and a higher likelihood of recent hospitalization and of having a gait speed of <0.8 m/s. SARC-F scores ≥ 4 in AAH also were associated with 6 year IADL deficits, slower chair stand times, lower short physical performance battery scores, having a gait speed of <0.8 m/s, being hospitalized recently, and mortality. SARC-F scores ≥ 4 in the BLSA cohort were associated with having more IADL deficits and lower grip strength (both hands) in cross-sectional comparisons and with IADL deficits, lower grip strength (both hands), and mortality at follow-up. NHANES participants with SARC-F scores ≥ 4 had slower 20 ft walk times, had lower peak force knee extensor strength, and were more likely to have been hospitalized recently in cross-sectional analyses.
  
  
  
  The SARC-F proved internally consistent and valid for detecting persons at risk for adverse outcomes from sarcopenia in AAH, BLSA, and NHANES.
authors.affiliation: Department of Neurology & Psychiatry Saint Louis University School of Medicine St. Louis MO 63104 USA; Division of Geriatric Medicine, Department of Internal Medicine Saint Louis University School of Medicine St. Louis MO 63104 USA.
authors.forename: Theodore K
authors.initials: TK
authors.lastname: Malmstrom
authors.affiliation: Regenstrief Institute, Inc. and Center for Aging Research Indiana University School of Medicine Indianapolis IN 46202 USA.
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Miller
authors.affiliation: National Institute on Aging, Translational Gerontology Branch Biomedical Research Center Baltimore MD 21224 USA.
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.affiliation: National Institute on Aging, Translational Gerontology Branch Biomedical Research Center Baltimore MD 21224 USA.
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine Saint Louis University School of Medicine St. Louis MO 63104 USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Morley
keywords: Function; Mobility; Sarcopenia; Screening