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To investigate the association of the sarcopenia index (SI, serum creatinine value/cystatin C value × 100) with 3-year mortality and readmission among older inpatients, we reanalyzed a prospective study in the geriatric ward of a teaching hospital in western China. Older inpatients aged ≥ 60 years with normal kidney function were included. Survival status and readmission information were assessed annually during the 3-year follow-up. We applied Cox regression models to calculate the hazard ratio (HR) and 95% confidence intervals (CIs) of sarcopenia for predicting mortality and readmission. We included 248 participants (mean age: 81.2 ± 6.6 years). During the follow-up, 57 participants (23.9%) died, whereas 179 participants (75.2%) were readmitted at least one time. The SI was positively correlated with body mass index (BMI) (r = 0.214, p = 0.001), calf circumference (CC) (r = 0.253, p < 0.001), handgrip strength (r = 0.244, p < 0.001), and gait speed (r = 0.221, p < 0.001). A higher SI was independently associated with a lower risk of 3-year all-cause mortality after adjusting for potential confounders (HR per 1-SD = 0.80, 95% CI: 0.63-0.97). The SI was not significantly associated with readmission (HR per 1-SD = 0.97, 95% CI: 0.77-1.25). In conclusion, the SI is associated with 3-year all-cause mortality but not readmission in a study population of hospitalized older patients.

Objective: The Mini Sarcopenia Risk Assessment (MSRA), a new sarcopenia screening tool, has 2 versions: MSRA-7 (full version, 7 items) and MSRA-5 (short version, 5 items). We aimed to compare the diagnostic values of MSRA-7 and MSRA-5 to SARC-F for screening sarcopenia., Design: A diagnostic accuracy study., Setting: A community in Chengdu, China., Participants: Older adults., Measurements: Muscle mass, strength, and physical performance were tested using a bioimpedance analysis (BIA) device, handgrip strength, and walking speed, respectively. Using the Asian Working Group for Sarcopenia (AWGS) criteria as the gold standard, the sensitivity/specificity analyses of the 3 scales were assessed. Receiver operating characteristic (ROC) curves and area under the ROC curves (AUC) were used to compare the overall diagnostic accuracy of the 3 scales., Results: We recruited 384 participants. Against the AWGS criteria, SARC-F had a sensitivity of 29.5% and a specificity of 98.1%, and the MSRA-7 had a sensitivity of 86.9% and a specificity of 39.6%, whereas the MSRA-5 had a sensitivity of 90.2% and a specificity of 70.6%. The AUCs of SARC-F, MSRA-7, and MSRA-5 were 0.89 [95% confidence interval (CI), 0.86-0.92], 0.70 (95% CI, 0.65-0.74), and 0.85 (95% CI, 0.81-0.89), respectively. The differences in AUCs between SARC-F and MSRA-7 and in those between MSRA-7 and MSRA-5 were statistically significant (P <.001), but the difference between SARC-F and MSRA-5 was not statistically significant (P = .130)., Conclusion: MSRA-5 may serve as a novel screening tool for sarcopenia in Chinese community-dwelling older adults. SARC-F, a class screening tool, is also suitable for this population. MSRA-5 and SARC-F demonstrated a similar diagnostic accuracy in our study population. MSRA-5 has better sensitivity, whereas SARC-F has better specificity. However, the diagnostic value of MSRA needs to be further validated in different populations., (Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

A new sarcopenia screening tool named Mini Sarcopenia Risk Assessment (MSRA) has recently been developed, which showed a reasonable sensitivity and specificity.We cross-culturally adapted and validated the Chinese version of the MSRA in a population of community-dwelling older adults.We conducted a cross-sectional study in a community in Chengdu, China. Older adults aged 60 years or older were included. A Chinese translation of the MSRA was created. The Chinese version of the MSRA included 2 questionnaires named C-MSRA-7 (containing 7 items) and C-MSRA-5 (containing 5 items). For C-MSRA-7 and C-MSRA-5, total scores of ≤ 30 and 45, respectively, indicate that the subject has sarcopenia. Using 4 common diagnostic criteria of sarcopenia (the European Working Group on Sarcopenia in Older People, Asia Working Group for Sarcopenia, International Working Group on Sarcopenia, and Foundation for the National Institutes of Health criteria) as the "gold standard"; the sensitivity and specificity of the C-MSRA-7 and C-MSRA-5 were examined. We applied the receiver operating characteristic curve to compare the overall accuracy of the C-MSRA-7 and C-MSRA-5 for screening sarcopenia.We recruited 384 participants (mean age: 71.5 ± 5.8 years). Using different criteria as the "gold standard," both C-MSRA-7 and C-MSRA-5 have acceptable sensitivity (ranging from 78.0% [95% confidence interval [CI]: 66.3-87.7] to 86.9% [95% CI: 75.87-94.2] for C-MSRA-7 and from 80.2% [95% CI: 70.8-87.6] to 90.2% [95% CI: 79.8-96.3] for C-MSRA-5) for screening sarcopenia. However, compared with the C-MSRA-7, the C-MSRA-5 is simpler and has better specificity (ranging from 55.9% to 70.6% for C-MSRA-5; and 38.3% to 41.0% for C-MSRA-7) and overall diagnostic accuracy.The MSRA scale was successfully adapted to the Chinese language and validated in Chinese community-dwelling older adults. Compared with C-MSRA-7, C-MSRA-5 is the better tool for screening sarcopenia.

The aim of this study was to evaluate the diagnostic value of the sarcopenia index (serum creatinine [mg/dl]/cystatin C [mg/dl] × 100) for estimating low muscle mass and sarcopenia in community-dwelling older adults. We included 371 older adults (≥60 years) with normal kidney function. Four common diagnostic criteria (the European Working Group on Sarcopenia in Older People (EWGSOP), Asia Working Group for Sarcopenia (AWGS), International Working Group on Sarcopenia (IWGS), and Foundation for the National Institutes of Health (FNIH) criteria) were separately applied as the "gold standard". The receiver operating characteristic (ROC) curves and the area under the ROC curves (AUC) were applied to evaluate the overall diagnostic accuracy. For identifying low muscle mass, the AUC ranged from 0.505 (95% confidence interval [CI] 0.453-0.557) to 0.558 (95% CI 0.506-0.609). For identifying sarcopenia, the AUC ranged from 0.555 (95% CI 0.503-0.606) to 0.618 (95% CI 0.566-0.668). Subgroup analyses according to gender showed similar results. In conclusion, the sarcopenia index based on serum creatinine and cystatin C may not serve as biomarkers of either low muscle mass or sarcopenia in urban community-dwelling older people with normal kidney function.

Objectives: To investigate the prevalence and associated factors of sarcopenia defined by different criteria in nursing home residents., Design: A cross-sectional study., Setting: Four nursing homes in Chengdu, China., Participants: Elderly adults aged 65 years or older., Measurements: We applied 4 diagnostic criteria [European Working Group on Sarcopenia in Older People (EWGSOP), Asia Working Group for Sarcopenia (AWGS), International Working Group on Sarcopenia (IWGS), and Foundation for the National Institutes of Health (FNIH)] to define sarcopenia. Muscle mass, strength, and function were measured based on bioimpedance analysis, handgrip strength, and walking speed, respectively. Nutrition status, activities of daily living, calf circumference (CC), and other covariates were evaluated., Results: We included 277 participants. The prevalence of sarcopenia was 32.5%, 34.3%, 38.3%, and 31.4% according to the EWGSOP, AWGS, IWGS, and FNIH criteria, respectively. Fifty-eight participants (20.9%) were sarcopenic by all the 4 criteria. Regardless of the diagnostic criteria of sarcopenia, malnutrition was independently associated with sarcopenia [EWGSOP: odds ratio (OR) 4.02, 95% confidence interval (CI) 1.05-15.39; IWGS: OR 2.46, 95% CI 1.23-4.90; AWGS: OR 3.29, 95% CI 1.49-7.28; FNIH: OR 4.52, 95% CI 1.28-16.00], whereas CC was negatively associated with sarcopenia [EWGSOP: OR per standard deviation (SD) 0.32, 95% CI 0.20-0.52; IWGS: OR per SD 0.26, 95% CI 0.15-0.43; AWGS: OR per SD 0.32, 95% CI 0.19-0.52; FNIH: OR per SD 0.39, 95% CI 0.25-0.60]. Furthermore, falls ≥1 time in the past year were associated with AWGS-defined sarcopenia (OR 2.92, 95% CI 1.04-8.22)., Conclusion/implications: Sarcopenia is highly prevalent in elderly Chinese nursing home residents regardless of the diagnostic criteria. Malnutrition and CC are associated with sarcopenia defined by different criteria. Therefore, it is important to assess sarcopenia and malnutrition in the management of nursing home residents. Prospective studies addressing the outcomes of sarcopenia in nursing home residents are warranted., (Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Objectives: To compare the diagnostic value of the 5-component questionnaire that measures strength, assistance walking, rise from a chair, climb stairs, and falls (SARC-F) and SARC-F combined with calf circumference (SARC-CalF) for screening sarcopenia in community-dwelling older adults., Design: A diagnostic accuracy study., Setting: A community in Chengdu, China., Participants: Older adults aged 60 years or older., Measurements: Muscle mass, muscle strength, and physical performance were estimated using a bioimpedance analysis device, handgrip strength, and gait speed, respectively. Four commonly used diagnostic criteria [European Working Group on Sarcopenia in Older People (EWGSOP), Asian Working Group for Sarcopenia (AWGS), International Working Group on Sarcopenia (IWGS), and Foundation for the National Institutes of Health (FNIH) criteria] were applied as the reference standard, separately. The sensitivity/specificity analyses of the SARC-F and SARC-CalF methods were evaluated. The receiver operating characteristics curves and the area under the receiver operating characteristics curves were used to compare the overall diagnostic accuracy of the SARC-F and SARC-CalF for identifying sarcopenia., Results: We included 160 men and 224 women. Based on the 4 diagnostic criteria, the prevalence of sarcopenia ranged from 11.7% to 25.0%. Using the AWGS criteria as the reference standard, the SARC-CalF had a sensitivity of 60.7% and a specificity of 94.7% in the whole study population, whereas the SARC-F had a sensitivity of 29.5% and a specificity of 98.1%. The area under the receiver operating characteristics curves for SARC-CalF and SARC-F were 0.92 (95% confidence interval 0.89‒0.94) and 0.89 (95% confidence interval 0.86‒0.92), respectively (P = .003). We obtained similar results when using the other 3 criteria as the reference standard. Subgroup analyses revealed similar results in both men and women., Conclusions: SARC-CalF significantly improves the sensitivity and overall diagnostic accuracy of SARC-F for screening sarcopenia in community-dwelling older adults., (Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)