Sarc-F and muscle function in community dwelling adults with aged care service needs: baseline and post-training relationship

Justin W L Keogh; Tim Henwood; Paul A Gardiner; Anthony G Tuckett; Sharon Hetherington; Kevin Rouse; Paul Swinton

doi:10.7717/peerj.8140

Sarc-F and muscle function in community dwelling adults with aged care service needs: baseline and post-training relationship

PeerJ. 2019 Nov 27:7:e8140. doi: 10.7717/peerj.8140. eCollection 2019.

Authors

Justin W L Keogh^{1

2

3

4}, Tim Henwood^{1

5

6}, Paul A Gardiner^{7

8}, Anthony G Tuckett^{9

10}, Sharon Hetherington¹¹, Kevin Rouse¹¹, Paul Swinton¹²

Affiliations

¹ Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia.
² Human Potential Centre, Auckland University of Technology, Auckland, New Zealand.
³ Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, India.
⁴ Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia.
⁵ Current affiliation: Southern Cross Care SA and NT, Adelaide, Australia.
⁶ School of Human Movement and Nutritional Science, University of Queensland, Brisbane, Australia.
⁷ Faculty of Medicine, University of Queensland, Brisbane, Australia.
⁸ Mater Research Institute, University of Queensland, Brisbane, Australia.
⁹ School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia.
¹⁰ College of Nursing, Yonsei University, Seoul, South Korea.
¹¹ The Chermside Senior Citizens Centre, Burnie Brae, Brisbane, Australia.
¹² School of Health Sciences, Robert Gordon University, Aberdeen, Scotland.

Abstract

Background: This study sought to better understand the psychometric properties of the SARC-F, by examining the baseline and training-related relationships between the five SARC-F items and objective measures of muscle function. Each of the five items of the SARC-F are scored from 0 to 2, with total score of four or more indicative of likely sarcopenia.

Methods: This manuscript describes a sub-study of a larger step-wedge, randomised controlled 24-week progressive resistance and balance training (PRBT) program trial for Australian community dwelling older adults accessing government supported aged care. Muscle function was assessed using handgrip strength, isometric knee extension, 5-time repeated chair stand and walking speed over 4 m. Associations within and between SARC-F categories and muscle function were assessed using multiple correspondence analysis (MCA) and multinomial regression, respectively.

Results: Significant associations were identified at baseline between SARC-F total score and measures of lower-body muscle function (r = - 0.62 to 0.57; p ≤ 0.002) in 245 older adults. MCA analysis indicated the first three dimensions of the SARC-F data explained 48.5% of the cumulative variance. The initial dimension represented overall sarcopenia diagnosis, Dimension 2 the ability to displace the body vertically, and Dimension 3 walking ability and falls status. The majority of the 168 older adults who completed the PRBT program reported no change in their SARC-F diagnosis or individual item scores (56.5-79.2%). However, significant associations were obtained between training-related changes in SARC-F total and item scores and changes in walking speed and chair stand test performance (r = - 0.30 to 0.33; p < 0.001 and relative risk ratio = 0.40-2.24; p < 0.05, respectively). MCA analysis of the change score data indicated that the first two dimensions explained 32.2% of the cumulative variance, with these dimensions representing whether a change occurred and the direction of change, respectively.

Discussion: The results advance our comprehension of the psychometric properties on the SARC-F, particularly its potential use in assessing changes in muscle function. Older adults' perception of their baseline and training-related changes in their function, as self-reported by the SARC-F, closely matched objectively measured muscle function tests. This is important as there may be a lack of concordance between self-reported and clinician-measured assessments of older adults' muscle function. However, the SARC-F has a relative lack of sensitivity to detecting training-related changes, even over a period of 24 weeks.

Conclusions: Results of this study may provide clinicians and researchers a greater understanding of how they may use the SARC-F and its potential limitations. Future studies may wish to further examine the SARC-F's sensitivity of change, perhaps by adding a few additional items or an additional category of performance to each item.

Keywords: Aged care; Exercise; Physical performance; Sarcopenia; Screening.

Grants and funding

This work was supported by the Commonwealth of Australia Department of Social Services Aged Care Service Improvement and Healthy Ageing Grant round that closed in 2014 [Grant id: 4-Z35FF5, awarded March 2015] and the Australian National Health and Medical Research Council—Australian Research Council [Dementia Research Development Fellowship to Paul Gardiner #1103311]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.