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• Report of diagnostic accuracy of possible sarcopenia against sarcopenia by AWGS 2019. • Diagnostic accuracy of possible sarcopenia for definitive sarcopenia is excellent. • Definitive sarcopenia may be missed in case-finding with extremely reduced CC. • Possible sarcopenia is appropriate for the detection of definitive sarcopenia. The Asian Working Group for Sarcopenia 2019 (AWGS 2019) proposed a simple assessment of sarcopenia called "possible sarcopenia" for the purpose of early detection and intervention of sarcopenia. The purpose of this study was to report the accuracy of possible sarcopenia against definitive sarcopenia and the characteristics of false-negative cases. This was a cross-sectional study using a research registry with outpatients aged ≥65 years who visited a frailty clinic at a geriatric hospital. The diagnosis of possible sarcopenia and sarcopenia was performed according to the AWGS 2019 criteria, using calf circumference (CC) for case-finding. The accuracy of the diagnosis of sarcopenia in participants with possible sarcopenia was evaluated by calculating sensitivity, specificity, and F-value. Of the 349 patients (mean age, 78.0±6.0 years; 63% women) analyzed, 86 (24.6%) revealed possible sarcopenia. Possible sarcopenia predicted sarcopenia with a sensitivity of 0.893 and 0.921, specificity of 0.990 and 0.870, and F-values of 0.926 and 0.714 for men and women, respectively. When either the grip strength test or 5-time chair stand test result was examined, the sensitivity of possible sarcopenia to predict sarcopenia decreased, whereas the specificity remained at 0.990–1.000 in men and 0.890–0.940 in women. An extremely decreased CC was identified as a significant characteristic of patients with sarcopenia not detected in the simplified assessment. The diagnostic accuracy of possible sarcopenia for definitive sarcopenia is excellent. Sarcopenia should be actively examined in patients with extremely decreased CC. [ABSTRACT FROM AUTHOR]

• More than half of the older patients with stroke have sarcopenia. • The AWGS 2019 recommended CC cut-off values are valid for case-finding of sarcopenia. • Predictive characteristics of sarcopenia were different among men and women. The Asia Working Group for Sarcopenia 2019 (AWGS) recommended using the calf circumference (CC) cut-off values to facilitate the case-finding of sarcopenia. However, the validity of the proposed cut-offs has not been examined in older patients with stroke. This study investigated the validity of the AWGS-recommended CC cut-off values for identifying sarcopenia among older patients with stroke. This cross-sectional study enrolled consecutive patients with stroke, aged 65 years and older, admitted to a convalescent rehabilitation ward. Sarcopenia was diagnosed based on the AWGS 2019 criteria. We drew a receiving operating characteristic curve to assess the ability of CC to predict sarcopenia diagnosis. Subsequently, we estimated the sensitivity, specificity, accuracy, F-value, and Matthews correlation coefficient (MCC) of the considered cut-off values. We enrolled 256 patients (43 % women) (mean age, 76.6 ± 7.5 years). The prevalence of sarcopenia was 63.7 %. Among men who presented with CC < 34 cm (the AWGS-recommended cut-off value), sensitivity and specificity were 85 % and 66 %, respectively. Concurrently, estimates of accuracy, F-value, and MCC were the highest at cut-off value <34 cm. Among women, at <33 cm of the AWGS-recommended cut-off value, the sensitivity and specificity were 91 % and 28 %, respectively. At cut-off value <32 cm, sensitivity was maintained at 80 %, while specificity increased to 56 %; suggesting that this cut-off value might be a useful indicator for the case-finding of sarcopenia. The AWGS-recommended CC cut-off values are valid. The predictive characteristics of sarcopenia differed among men and women with stroke. [ABSTRACT FROM AUTHOR]