Date Published: December 1, 2017
Publisher: Springer International Publishing
Author(s): Charlotte Beaudart, Médéa Locquet, Jean-Yves Reginster, Laura Delandsheere, Jean Petermans, Olivier Bruyère.
The SarQoL® is a recently developed quality of life questionnaire specific to sarcopenia.
To compare the quality of life (QoL) of subjects identified as sarcopenic with that of non-sarcopenic subjects when using six different operational definitions of sarcopenia.
Participants of the SarcoPhAge study (Belgium) completed the SarQoL®. Among the six definitions used, two were based on low lean mass alone (Baumgartner, Delmonico), and four required both low muscle mass and decreased performance (Cruz-Jentoft, Studenski, Fielding, Morley). Physical assessments included measurements of muscle mass with dual energy X-ray absorptiometry, muscle strength with a handheld dynamometer and gait speed over a 4-m distance.
A total of 387 subjects completed the SarQoL®. Prevalence of sarcopenia varied widely across the different definitions. Using the SarQoL®, a lower QoL was found for sarcopenic subjects compared to non-sarcopenic subjects when using the definitions of Cruz-Jentoft (56.3 ± 13.4 vs 68.0 ± 15.2, p < 0.001), Studenski (51.1 ± 14.5 vs 68.2 ± 14.6, p < 0.001), Fielding (53.8 ± 12.0 vs 68.3 ± 15.1, p < 0.001), and Morley (53.3 ± 12.5 vs 67.1 ± 15.3, p < 0.001). No QoL difference between sarcopenic and non-sarcopenic subjects was found when using the definitions of Baumgartner or Delmonico, which were only based on the notion of decreased muscle mass. The SarQoL® was able to discriminate sarcopenic from non-sarcopenic subjects with regard to their QoL, regardless of the definition used for diagnosis as long as the definition includes an assessment of both muscle mass and muscle function. Poorer QoL, therefore, seems more related to muscle function than to muscle mass.
Sarcopenia, defined by a progressive loss of muscle mass and muscle function with advancing age, has been shown to be associated with several health consequences, such as a higher risk of functional decline, hospitalization, falls, fractures and death [1–4]. All of these consequences are likely to have a detrimental effect on health-related quality of life (HRQoL) [5–7]. Unfortunately, a very limited number of studies reported data for quality of life with sarcopenia through “Patient Reported Outcome” (PRO) tools. HRQoL assessments through PRO are increasingly important in research and clinical practice. The different purposes of PRO tools include obtaining accurate self-reported assessments of well-being and physical function and of the psychological and social implications of sarcopenic subjects but also increasing healthcare providers and regulatory agencies’ understanding of the needs and preoccupation of important segments of this population, such as elderly subjects suffering from sarcopenia.
The SarQoL® questionnaire developed in 2014 has been cross-sectionally administered to all subjects of the SarcoPhAge study seen during their second year of follow-up. Among the 534 subjects recruited initially in 2013 for the SarcoPhAge study, several subjects (n = 139) were not interviewed the second year of follow-up in 2014 for various reasons: physical or mental inability (n = 55), death (n = 6), refusal to participate again (n = 64) or loss of contact (n = 14). A total of 395 participants were then identified as available for this ancillary analysis. Among the remaining 395 subjects, 387 presented sufficient clinical data to be included in the present study (Fig. 1).
The co-existence of different diagnostic criteria for sarcopenia represents a major public health issue. Indeed, several studies have shown considerable variation in the prevalence of sarcopenia when using a different definition of sarcopenia [20, 27, 28]. The present study also highlights the variation in the prevalence of sarcopenia when using six operational definitions of sarcopenia. This prevalence varied in our sample from 4.39 to 32.8%. Obtaining a prevalence that is dependent on the diagnostic criteria used for the diagnosis could lead to important consequences from a public point of view. For example, an over- or underestimation of the prevalence of sarcopenia could impact therapeutic or preventive interventions by increasing the risk of giving unnecessary treatment to a false positive subject (i.e., without sarcopenia) and depriving a false negative patient (i.e., with sarcopenia) of effective treatment [29, 30].