サルコペニアへの対処：高齢者における効果的なスクリーニングの必要性

タイトル: Comparative accuracy of five screening tools for sarcopenias in community older adults:a systematic review and a network meta-analysis

概要: BackgroundSarcopenia, a prevalent and serious condition among community older adults, often remains unnoticed. The use of systematic screening has the potential to enhance detection rates; however, there is currently no consensus on the most effective approach. This study ai med to assess the diagnostic test accuracy of five simple sarcopenia screening tools and determine which test has the highest accuracy. ObjectiveTo assess and compare the accuracy of five screening tools for sarcopenia in community older adults. DesignA systematic review and a network meta analysis. MethodsA systematic search was conducted in various databases including Pubmed, The Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and Sinomed up to September 2023. Studies reporting on the accuracy of diagnostic testing for sarcopenia in community-dwelling older adults using one or more of the following sarcopenia screening tools were included: Sarcopenia Simple Five-Item Rati ng Scale (SARC-F), SARC-F combined with calf circumference (SA RC-CalF), SARC-F combined with older adults and BMI (SARC-F+ EBM), Mini sarcopenia risk assessment-5 (MSRA-5), and Mini sarcopenia risk assessment-7 (MSRA-7). The reference standard was the Asian Working Group on Sarcopenia (AWGS), the European Working Group on Sarcopenia on Older People (EWGSOP), the Foundation for National Institutes of Health (FNIH), or the International Working Group on Sarcopenia (IWGS). Random-effects bivariate binomial model meta-analyses, meta-regressions and a network meta-analysis were used to estimate the pooled and relative sensitivities and specificities. ResultsWe identified and evaluated 22 papers focused on SARC-F, S ARC-CalF, MSRA-5, and MSRA-7. Traditional meta-analysis sorting results showed summary sensitivities of 0.25, 0.59, 0.43, 0.82, and 0.51, summary specificities of 0.94, 0.82, 0.81, 0.39, and 0.85, summary AUC of 0.80, 0.76, 0.70, 0.68, and 0.75, and summary DOR of 5, 7, 3, 3, and 6. The network meta-analysis ranking results showed that MRSA-5 had the highest sensitivity (92.27) and SARC-F had the highest specificity (99.81) under the cumulative ranking. Linking evidence to actionThe MSRA can be used as a tool for screening sarcopenia in community older adults, while the SARC-F can be used for first-time diagnosis of sarcopenia in this population. However, it is important to interpret the results with caution due to the variability among different studies analyzing the accuracy of this diagnostic test. Future research should focus on obtaining additional evidence from large sample sizes and high-quality studies.