Abstract

Background: Sarcopenia contributes substantially to disability and mortality among older adults, yet it remains largely undetected in rural India, where the equipment required for formal diagnosis is seldom available. The SARC-F questionnaire requires no instrumentation and has been proposed for use in such settings, but its performance in rural community populations is not well established. Methods: A cross-sectional survey was conducted among 420 community-dwelling adults aged 60 years and above in a rural block. SARC-F was administered by trained interviewers, and handgrip dynamometry and four-metre gait speed were measured in all participants. Probable sarcopenia was defined by Asian Working Group criteria. Diagnostic performance was assessed by receiver operating characteristic analysis and determinants of screen positivity by logistic regression. Results: SARC-F was positive in 20.7%of participants, probable sarcopenia was present in 26.9% and confirmed sarcopenia in 19.5%. At the recommended threshold of four, sensitivity was 39.8% and specificity 86.3%, with an area under the curve of 0.692. A threshold of three maximised the Youden index. Increasing age, a low body mass index and physical inactivity independently predicted screen positivity. Conclusion: SARC-F is highly specific but insensitive, and a lower threshold appears preferable for community screening.

Keywords: Sarcopenia, SARC-F, Rural elderly, Handgrip strength, Gait speed, Diagnostic accuracy