<b>SARC-F with anthropometric add-ons for better sarcopenia detection among elderly outpatients visiting a tertiary care hospital: A cross-sectional study</b>

Background: Early identification of sarcopenia, a progressive skeletal muscle disorder, remains challenging. Although the Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaire is widely recommended for sarcopenia screening, its limited sensitivity reduces its effectiveness in clinical practice. To improve diagnostic performance, modified versions incorporating anthropometric measurements, calf girth (CalF) and including arm circumference (AC), have been developed and validated in different ethnic populations. This study aimed to evaluate the diagnostic accuracy of the SARC-CalF+AC questionnaire among older adults in Indian population. Methods: This cross-sectional study included 360 older adults attending the outpatient department of a tertiary care hospital. Participants with preserved cognitive function and independent walking ability were enrolled. The diagnostic performance of the SARC-F and SARC-CalF+AC screening tools was evaluated against the Asian Working Group for Sarcopenia (AWGS) diagnostic criteria. Results: Approximately one in six were women; Participants mean age was 64 years. Among them 131 were diagnosed with sarcopenia, yielding a prevalence of 36.4% (95% Confidence Interval, 31.6–41.5). The SARC-F questionnaire demonstrated a sensitivity of 22.9% and a specificity of 80.9%. In comparison, the SARC-CalF+AC questionnaire achieved substantially higher sensitivity (75.6%) and specificity (88.2%). Conclusion: The addition of calf girth and arm circumference measurements significantly improved the diagnostic performance of the SARC-F questionnaire, making SARC-CalF+AC a more effective screening tool for sarcopenia in older adults.