SARC-F: an effective screening tool for detecting sarcopenia and predicting health-related quality of life in older women in Sri Lanka.

Abstract

Objective: The "Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls" (SARC-F) is a simple, five-item tool used to identify individuals with suggestive signs of sarcopenia. This study assessed the validity of the Sinhala version of the SARC-F, evaluating its ability to detect sarcopenia in older women and its potential to predict health-related quality of life (HRQoL).

Methods: The culturally adapted Sinhala version of the SARC-F, along with the Short Form-36 (SF-36) survey, was administered among 350 older women (aged ≥ 65) attending medical clinics at National Hospital Galle, Sri Lanka. Handgrip strength (HGS) was measured using a handheld dynamometer, and relative appendicular skeletal muscle mass index (RSMI) was estimated with a Sri Lankan-specific anthropometry-based equation. Gait speed (GS) was assessed using 4-m customary-paced walk test.

Results: The mean (± SD) age of the participants was 72 (± 5) years, with 56.3% (n = 197) having sarcopenia based on a SARC-F score of ≥ 4. The Sinhala version of SARC-F demonstrated a good internal consistency (Cronbach's alpha = 0.72). A significant positive correlation between SARC-F and HGS indicated concurrent validity (r = 0.23, p < 0.001). Women with sarcopenia had significantly lower HRQoL scores, HGS and GS compared to those without, confirming discriminant validity (p < 0.01). The sensitivity, specificity, and accuracy of the Sinhala SARC-F were 54.8%, 67.3%, and 60.3%, respectively, with an Area Under the Curve (AUC) of 0.61 (95% CI: 0.55-0.67) in detecting probable sarcopenia. The HRQoL domains of SF-36 (excluding emotional well-being), HGS and GS were inversely correlated with SARC-F (Spearman's rho range: -0.19 to -0.56, p < 0.001). SARC-F significantly associated with the physical function and pain domains of SF-36 explained 42% of the variance in the model (r = 0.65, R2 = 0.42).

Conclusions: The Sinhala version of SARC-F is a reliable and valid tool for screening sarcopenia in Sinhala-speaking older women in Sri Lanka. It can be integrated into clinical practice to identify those with suggestive signs of sarcopenia and to predict HRQoL enabling timely interventions. Future studies with larger, more diverse populations, including men, are needed to enhance the tool's generalizability and diagnostic accuracy.