SARC-F score compared with hand grip strength for screening possible sarcopaenia among community-dwelling older adults: A multi-centre cross-sectional study in Malaysia.

Authors

Chai Li Tay, Chai Chen Ng, Chee Cheong Kee, Nor Faizah Ghazali, Zaleha Jusoh, Thenmoli Palaniyappan, Sie Zin Kong, Boon Kiew Lee, Lorna Kin Tze Chin, Ai Lee Ding, Khalilati Barizah Md Salimun, Srinevasarao Ramanaidu

Published in

Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia. Volume 21. Pages 33. Epub Jun 26, 2026.

Abstract

Sarcopaenia is underdiagnosed in primary care due to limitations in available tools. The SARC-F questionnaire is a recommended screening tool, but its diagnostic accuracy among Malaysian community-dwelling older adults is not well established. This study aimed to determine the diagnostic accuracy of the SARC-F score against hand grip strength (HGS) for identifying possible sarcopaenia among community-dwelling older adults.
A cross-sectional study was conducted from January to November 2024 across 11 public health clinics. Community-dwelling older adults aged ≥60 years were recruited. Sarcopaenia risk was assessed using the SARC-F questionnaire, with scores of ≥4 indicating a high risk. HGS was measured using a Jamar dynamometer, with possible sarcopaenia defined according to the Asian Working Group for Sarcopenia 2019 criteria (<28 kg for men, <18 kg for women). Statistical analysis included the Mann-Whitney U test to compare mean rank distributions of HGS between SARC-F risk groups and Cohen's kappa to assess the agreement between the SARC-F score- and HGS-based classifications. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminatory performance of the SARC-F score in identifying possible sarcopaenia, using HGS as the reference standard.
Among 578 participants, the median HGS was significantly lower in the high-risk SARC-F group for both men (19.0 kg vs 28.0 kg, P<0.001) and women (14.0 kg vs 18.0 kg, P<0.001). The agreement between the SARC-F score- and HGS-based classifications was poor to fair (kappa=0.219). The SARC-F score demonstrated low sensitivity (34.7%) but high specificity (87.5%); it showed poor discriminative ability in detecting possible sarcopaenia (area under the ROC curve=0.67; 95% confidence interval=0.622-0.710; P<0.001). The positive predictive value was 74.6%; negative predictive value, 55.9%; and overall accuracy, 60.4%.
While a high SARC-F score is significantly associated with low HGS, the low sensitivity of the SARC-F score limits its use as a standalone screening tool in primary care. A two-step approach, using the SARC-F questionnaire followed by objective HGS measurement, may enhance early detection efforts in primary care.

PMID:
42437303
Bibliographic data and abstract were imported from PubMed on 12 Jul 2026.

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