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Roma Krzymińska-Siemaszko, Ewa Deskur-Śmielecka, Aleksandra Kaluźniak-Szymanowska, Marta Lewandowicz, Katarzyna Wieczorowska-Tobis Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, PolandCorrespondence: Roma Krzymińska-SiemaszkoDepartment of Palliative Medicine, Poznan University of Medical Sciences, Os. Rusa 55, Poznan 61-245, PolandTel/Fax +48 61 8738303Email romakrzyminska@interia.plPurpose: Older adults should be routinely screened for sarcopenia, which threatens healthy, independent aging. The most popular screening tool is the SARC-F questionnaire. As its sensitivity is unsatisfactory, two modified versions of the questionnaire have been published: SARC-CalF (including calf circumference as an additional item) and SARC-F+EBM (assessing additionally age and Body Mass Index). The diagnostic performance of the three versions of the questionnaire has not been compared. The analysis aimed to assess the diagnostic value of SARC-F, SARC-CalF, and SARC-F+EBM questionnaires, and to compare their psychometric properties against two reference standards of sarcopenia diagnosis, ie, EWGSOP1 and modified EWGSOP2 criteria.Materials and Methods: We performed the sensitivity/specificity analysis and compared the overall diagnostic accuracy of SARC-F, SARC-CalF (31cm) (cut-off point 31 cm for both genders), SARC-CalF (33/34cm) (cut-off points: 33 cm for women and 34 cm for men), and SARC-F+EBM in 115 community-dwelling volunteers aged ≥ 65yrs from Poland.Results: Depending on the version of the SARC-F questionnaire used, from 10.4% [SARC-CalF (31cm)] to 33.0% (SARC-F+EBM) were identified as having an increased risk of sarcopenia. Sarcopenia was identified in 17.4% by the EWGSOP1 criteria and in 13.9% by the modified EWGSOP2 criteria. With respect to the two reference standards used, the sensitivity of SARC-F, SARC-CalF (31cm), SARC-CalF (33/34cm), and SARC-F+EBM ranged 30.0– 37.5%, 35.0– 37.5%, 60.0– 62.5%, 55.0% (the same value for both reference standards), respectively. The specificity ranged 85.3– 85.9%, 93.9– 94.7%, 88.4– 86.9%, 70.7– 71.6%, respectively. The AUC of SARC-F, SARC-CalF (31cm), SARC-CalF (33/34cm) and SARC-F+EBM ranged 0.644– 0.693, 0.737– 0.783, 0.767– 0.804, 0.714– 0.715, respectively.Conclusion: The modified versions of SARC-F have better diagnostic performance as compared to the original questionnaire. Since an ideal screening tool should have reasonably high sensitivity and specificity, and an AUC value above 0.7, the SARC-CalF (33/34cm) seems to be the best screening tool for sarcopenia in community-dwelling older adults.Keywords: sarcopenia, screening, older individuals, SARC-F, ROC analysis

Introduction: Research has shown that nutrition is an important factor in the complex etiology of age-related decline of muscle mass (presarcopenia). For the maintenance of muscle mass the amount of energy and dietary protein consumed is of primary importance. Furthermore in 2010 Scott et al. showed that higher intakes of calcium, magnesium, phosphorus, potassium, zinc and riboflavin and niacin, were positive predictors of change in appendicular lean mass (ALM) over 2.6 years. Objecitve: Relatively little is known about dietary intake of older people with presarcopenia with respect to elderly without presarcopenia. The aim of this study is to fill this gap. Material and Methods: We conducted case–control study. 15 presarcopenic women (PW) and 15 age-matched nonpresarcopenic women (NPW) were included for this analysis. Inclusion criteria for both groups were as follows: age 60 or more, lack of cognitive function disorders. Furthermore for PW: low ALM index (≤5.52 kg/m2 ), in turn for NPW: normal ALM index (>5.52 kg/m2 ). All participants completed at least 3-day dietary intake records. The dietary intakes of all nutrients were compared with Polish nutrition recommendations. Results: An average energy intake was lower over 200 kcal in PW compared to NPW (1486.1 vs 1695.8 kcal respectively; p=0.095). Protein intake was significantly lower in PW (58.5 vs 71.2g respectively; p