A total of 204 older inpatients participated in the present study, comprising 81 males and 123 females, with a median age of 79 (12). Figure 1 illustrates the hospitalization etiologies of the participants, with infections being the most prevalent cause, observed in 43 (21%) participants. The prevalence of sarcopenia in the study population is 41.4%, with 46.7% of men and 37.9% of women affected. Table 1 presents the demographic and clinical characteristics of the participants stratified by gender. The most common comorbidities among the participants are hypertension and diabetes. SARCF screening yielded positive results for 64.4% of all participants, with 49.3% of men and 74.1% of women screening positive. SARC-CalF indicated positive results for 49.2% of all participants, with 48.3% of women and 50.7% of men, respectively. Ishii's score was positive for 79.5% of all participants, with 83.6% of women and 73% of men, respectively.
Table 1
The demographic and clinical characteristics of the participants
Characteristics | All participants (204) | Men (81) | Women (123) |
Age (years) (median(IQR)) | 79(12) | 77(12) | 80(12) |
BMI (kg/m2) (median(IQR)) | 42(12) | 41.7(8.3) | 42(14.8) |
Diabetes (%) | 53.8 | 45.7 | 59.2 |
Hypertension (%) | 64 | 68 | 66 |
CKD (%) | 23 | 26.9 | 19.1 |
HF (%) | 14.7 | 15.2 | 14 |
Dementia (%) | 19.7 | 17.4 | 21 |
COLD (%) | 20.5 | 31 | 10 |
CHD (%) | 21.4 | 30.4 | 15.5 |
CVI (%) | 15.4 | 17.4 | 14.1 |
Osteoarthritis (%) | 17.1 | 6.5 | 23.9 |
Cancer (%) | 6.3 | 13 | 8.5 |
Interquartile range, body mass index, chronic kidney disease, heart failure, chronic obstructive lung disease, coronary heart disease, cerebrovascular incident.
Table 2 displays the geriatric assessment of the study participants, both in the entire population and categorized by gender.
Table 2
Geriatric assessment of the participants
Tests | All participants (204) | Men (81) | Women (123) |
Katz ADL (n) (median(IQR)) | 5(4) | 5(2.75) | 5(5) |
Lawton IADL (n) (median(IQR)) | 4(7) | 5.5(6.25) | 4.5(7) |
MMSE (n) (median(IQR)) | 23.5(8) | 24(7) | 21(10.25) |
MNA-SF(n) (median(IQR)) | 10(4) | 10(4) | 10(4) |
Nutrition status Normal nutrition (%) Malnutrition risk (%) Malnutrition (%) | 32.1 49.4 18.5 | 34.6 46.2 19.2 | 27.6 55.2 17.2 |
SARC-F score (n) (median(IQR)/mean ± SD) | 5(6) | 4.5 ± 3.2 | 5.6 ± 2.9 |
SARC-F classfication Sarcopenia (%) | 64.4 | 49.3 | 74.1 |
CC (cm) (median(IQR)) | 33(5) | 32(5) | 33(7.5) |
SARC-CalF (n) (median(IQR)) | 11(11) | 10.5(13.25) | 10.5(11.25) |
SARC-CalF classfication Sarcopenia (%) | 49.2 | 50.7 | 48.3 |
Ishii’s score (n) (mean ± SD) | 146.31 ± 36.84 | 142.87 ± 40.36 | 151.3 ± 37 |
Ishii’s score claafication Sarcopenia (%) | 79.5 | 73 | 83.6 |
HGS (kg) (median(IQR)) | 14(10.6) | 21.6(12.4) | 12(6) |
SMI (kg/m2) (median(IQR)) | 8.52(2.61) | 9.44(2.24) | 7.96(2.37) |
Gait speed (m/s) (median(IQR)) | 0.3(0.5) | 0.4(0.49) | 0.26(0.46) |
Activities of daily living, interquartile range, instrumental activities of daily living, mini mental state examination, mini nutritional assessment-short form,standard deviation, calf circumference, handgrip strength, skeletal muscle index.
The sensitivity, specificity, positive and negative likelihood ratios, and area under the curve (AUC) values for SARC-F, SARC-CalF, and Ishii's score are presented in Table 3. Additionally, ROC curves depicting the performance of SARC-F, SARC-CalF, and Ishii's score are shown in Fig. 2 for the overall study population and in Fig. 3 when stratified by gender.
SARC-F showed a sensitivity of 72% and a specificity of 41% for whole study population. Specifically for men, the sensitivity and specificity were 62.8% and 62.5% respectively. On the other hand, for women, the sensitivity and specificity were found to be 83.3% and 29.1% respectively.
SARC-CalF showed a sensitivity and specificity of 88.6% and 78.5% respectively for whole study population. In the case of men, the sensitivity and specificity of SARC-CalF were found to be 91.4% and 75% respectively. Similarly, for women, the sensitivity and specificity of SARC-CalF were determined as 86.3% and 75% respectively.
The sensitivity and specificity of Ishii's score are 93.5% and 30.3%, respectively. For men, the sensitivity and specificity of Ishii's score are 91% and 42.5%. For women, the sensitivity and specificity are 95.5% and 10.5%, respectively. The AUC values, which serve as indicators of the diagnostic accuracy of screening tests, are statistically significant for all the tests. However, the SARC-CalF test consistently demonstrates the highest performance among all the tests in the study, regardless of gender.
Table 3
Sensitivity/Specificity Anaylses and AUC values for SARC-F, SARC-CalF and Ishii’s score in the study population and according to gender
| Sensitivity (%) | Specifity (%) | PPV (%) | NPV (%) | AUC | P |
SARC-F | 72 | 41 | 46.3 | 67.4 | 0.63(0.54–0.7) | 0.003 |
SARC-F (females) | 83.3 | 29.1 | 41.76 | 74.06 | 0.62(0.52–0.73) | 0.025 |
SARC-F (males) | 62.8 | 62.5 | 59.47 | 65.7 | 0.66(0.54–0.8) | 0.017 |
SARC-CalF | 88.6 | 78.5 | 74.4 | 90.7 | 0.81(0.75–0.88) | < 0.001 |
SARC-CalF (females) | 86.3 | 75 | 67.8 | 89.7 | 0.8(0.7–0.87) | < 0.001 |
SARC-CalF (males) | 91.4 | 85 | 84.2 | 91.7 | 0.87(0.78–0.96) | < 0.001 |
Ishii’s score | 93.5 | 30.3 | 48.6 | 86.8 | 0.69(0.61–0.76) | < 0.001 |
Ishii’s score (females) | 95.5 | 10.5 | 39.44 | 79.3 | 0.72(0.63–0.81) | < 0.001 |
Ishii’s score (males) | 91 | 42.5 | 58.1 | 84.3 | 0.65(0.53–0.77) | 0.025 |
Positive predictive value, negative predictive value, area under curve.