Diagnostic performance of calf circumference, SARC-F, and SARC-CalF for possible sarcopenia screening in Indonesia.

Asian working group for sarcopenia (AWGS) recently introduced "possible sarcopenia" diagnosis for early identification of sarcopenia in the primary healthcare. For initial screening, 3 modalities, i.e. calf circumference (CC) measurement, strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire, and a combination of both (SARC-CalF), are recommended. However, no validation study has been done until now. Therefore, this study aims to evaluate the diagnostic performance of the recommended screening modalities using data from Indonesia. This cross-sectional study included subjects aged ≥ 60 years old who visited primary healthcare in Surabaya, Indonesia. The diagnosis of possible sarcopenia was confirmed with hand-grip strength and repeated chair stand test. Receiver operating characteristic curve analysis was used to evaluate the diagnostic performance. Among 266 subjects, 186 (70%) were diagnosed with possible sarcopenia. Using the recommended cut-off, the area under the curve, sensitivity, and specificity were 0.511, 48.39% and 53.75% for CC, 0.543, 8.60% and 100% for SARC-F, and 0.572, 19.35% and 95% for SACRC-CalF. Our findings indicate that the diagnostic performance of the recommended screening modalities is poor. Multicenter studies from different areas in Indonesia should be done to confirm these findings.

Association between Sarcopenia and Insulin-Like Growth Factor-1, Myostatin, and Insulin Resistance in Elderly Patients Undergoing Hemodialysis.

Sarcopenia is common in hemodialysis patients, especially in the elderly patients undergoing hemodialysis. Various factors may contribute to the occurrence of sarcopenia, such as anabolic and catabolic imbalance. This study aims to investigate the correlation of insulin-like growth factor-1 (IGF-1) levels as an anabolic factor, myostatin levels, and insulin resistance as catabolic factors with sarcopenia in the pathogenesis of sarcopenia in elderly patients undergoing hemodialysis. A total of 40 subjects aged 60 years or more who undergoing hemodialysis in Dr. Soetomo Hospital Surabaya were included in this cross-sectional study. Sarcopenia was diagnosed according to Asian Working Group Sarcopenia 2019 criteria. IGF-1, myostatin, and insulin resistance levels were measured once before hemodialysis. Subjects with sarcopenia diagnosis were 33 (82.5%), that is, 19 (47.5%) men and 14 (35%) women. There were 28 (70%) of the subjects diagnosed with severe sarcopenia. Furthermore, there were significant differences in the characteristics and geriatric parameters between the sarcopenia and nonsarcopenia groups. There were differences between the two groups in hemoglobin levels, IGF-1 levels, myostatin levels, homeostasis model assessment-insulin resistance (HOMA-IR) levels, muscle mass, handgrip strength, body mass index status, mini nutritional assessment status, and physical activity scale for elderly status (all p < 0.05). Correlation analyses showed that IGF-1 levels negatively correlated with sarcopenia status in elderly patients undergoing hemodialysis (p < 0.05). On the contrary, myostatin and HOMA-IR levels were positively correlated with sarcopenia status in elderly patients undergoing hemodialysis (all p < 0.05). Based on this recent study, IGF-1, myostatin, and insulin resistance were significantly correlated with sarcopenia in elderly patients undergoing hemodialysis.

Sarcopenia and Frailty Profile in the Elderly Community of Surabaya: A Descriptive Study.

BACKGROUND: sarcopenia and frailty cause immobility, disability, neuromuscular disorders, and homeostatic balance failure syndrome, characterized by gait and balance abnormalities in the elderly, and an increasing prevalence worldwide. This further contributes to the elevated incidence of falls and fractures, hospitalization, immobilization, and even mortality, hence, a national-level study was conducted on the prevalence rates of sarcopenia and frailty in the elderly. METHODS: this descriptive study used primary data of elderly people (n = 308) in Surabaya, Indonesia. Furthermore, the biopsychosocial data, weight loss, fatigue, and physical activity measurements were obtained through interviews, while handgrip strength, muscle mass, and physical performance (walking speed) were evaluated using instruments. RESULTS: the median age of the subjects was 63 years (60-100 years), and 230 (74.7%) were women. In addition the prevalence rate of sarcopenia was 41.8% (in 86 [27.9%] women), while the prevalence rate of frailty was 36.7% (in 16 [5.2%] men and 97 [31.5%] women). CONCLUSION: the prevalence of sarcopenia and frailty in the elderly is significantly high, thus, it is expected that this study results are used as a basis for subsequent research, especially to determine the sarcopenia cut-off, in accordance with Indonesian sociodemography.