Diagnostic accuracy of the SARC-CalF in community-dwelling older adults: a systematic review and meta-analysis

Abstract

Background and objectives: The Sarcopenia and Calf Circumference (SARC-CalF) tool has been proposed to enhance the detection of sarcopenia. A comprehensive systematic review evaluating the diagnostic performance of the SARC-CalF could support its broader adoption as a valid screening instrument. Thus, this study aimed to assess the diagnostic accuracy of the SARC-CalF in detecting sarcopenia risk among older adults.

Research design and methods: A systemic review was conducted in six electronic databases and Google Scholar. The values of sensitivity, specificity, and area under the curve were estimated simultaneously using a bivariate model. Evaluation of the quality of individual studies included in this review was conducted with the Quality Assessment of Diagnostic Accuracy Studies-2 tool.

Results: Our systematic review included 18 studies, with 10,367 older adults. The pooled sensitivity and specificity of the SARC-CalF were 53.3% (95% confidence interval [CI]: 0.46-0.60) and 87.3% (95% CI: 0.84-0.90), respectively. The pooled diagnostic odds ratio was 7.34 (95% CI: 5.87-9.19), and the area under the curve was 0.78 (95% CI: 0.73-0.81), indicating moderate diagnostic accuracy. Subgroup analyses revealed variations based on reference standards and calf circumference cutoff values.

Discussion and implications: This study highlights the SARC-CalF as a practical, cost-effective screening scale for sarcopenia of older people in community settings. Further research is required to establish optimal calf circumference cutoff values and validate its utility in various clinical environments. Combining the SARC-CalF scale with other functional measures may be useful and optimal tools for sarcopenia among older adults.

Keywords: Aging; Diagnostic techniques and procedures; Sarcopenia.