title: Enhancing SARC-F: Improving Sarcopenia Screening in the Clinical Practice.
abstract: To validate the (Brazilian) Portuguese-translated version of the SARC-F questionnaire and to verify its performance in the separate sarcopenia screening and muscle function evaluation contexts. In addition, by associating SARC-F to an anthropometric measurement (as an estimate of muscle mass), to test for improvements in its sarcopenia screening efficacy.
  
  
  
  Cross-sectional study.
  
  
  
  Urban population of Pelotas, a middle-sized city in Southern Brazil.
  
  
  
  Subsample of 179 community-dwelling elderly aged 60 years or older derived from a population-based study (COMO VAI?).
  
  
  
  Sarcopenia was evaluated using the European Working Group on Sarcopenia in Older People's diagnostic criteria: dual-energy X-ray absorptiometry, handgrip strength, and walking speed test. Participants also completed SARC-F and their calf circumference (CC) was measured. SARC-F and CC were combined into an original score. The questionnaires' performances were evaluated through receiver operating characteristic curves, sensitivity/specificity analyses, and Pearson χ2.
  
  
  
  Sarcopenia was identified in 15 (8.4%) participants by the European Working Group on Sarcopenia in Older People's criteria. Areas under the receiver operating characteristic curves of SARC-F were 0.592 (95% confidence interval (CI) 0.445, 0.739) screening for sarcopenia and 0.779 (95% CI 0.710, 0.846) evaluating muscle function (P < .001). The SARC-F+CC association significantly improved SARC-F's sarcopenia screening performance [area under the curve: 0.736 (95% CI 0.575, 0.897); comparing with SARC-F alone: P = .027]. A substantial improvement in sensitivity was achieved without compromising the remaining parameters.
  
  
  
  Despite the satisfactory performance evaluating muscle function, SARC-F alone has not achieved adequate results as a sarcopenia screening tool. However, the SARC-F+CC association significantly improved SARC-F's sarcopenia screening performance, enabling its use in the clinical practice.
authors.affiliation: Postgraduate Program in Epidemiology, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil. Electronic address: tgbsilva@hotmail.com.
authors.forename: Thiago Gonzalez
authors.initials: TG
authors.lastname: Barbosa-Silva
authors.affiliation: Postgraduate Program in Epidemiology, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil.
authors.forename: Ana Maria Baptista
authors.initials: AM
authors.lastname: Menezes
authors.affiliation: Postgraduate Program in Epidemiology, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil.
authors.forename: Renata Moraes
authors.initials: RM
authors.lastname: Bielemann
authors.affiliation: Departments of Psychiatry and Internal Medicine, School of Medicine, Saint Louis University, St. Louis, MO.
authors.forename: Theodore K
authors.initials: TK
authors.lastname: Malmstrom
authors.affiliation: Postgraduate Program in Epidemiology, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil; Postgraduate Program in Health and Behavior, Universidade Católica de Pelotas (UCPel), Pelotas, RS, Brazil.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Gonzalez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D058996:Quality Improvement; D055948:Sarcopenia / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: Sarcopenia; body composition; calf circumference; muscle mass; screening; validation study