Original Study
German Version of SARC-F: Translation, Adaption, and Validation

https://doi.org/10.1016/j.jamda.2019.12.011Get rights and content

Abstract

Objectives

Translation, adaptation, and validation of the German version of the SARC-F for community-dwelling older adults in Germany.

Design

Cross-sectional.

Setting and Participants

117 community-dwelling outpatients with a mean age of 79.1 ± 5.2 years were included in the study; 94 (80.4%) of them were female. Sixty-three (53.8%) had a positive SARC-F score of ≥4 points. According to the definition of sarcopenia from the European Working Group on Sarcopenia in Older People (EWGSOP2), 8 patients (6.8%) were identified as sarcopenic and 57 (48.7%) as probable sarcopenic.

Methods

According to EWGSOP2, probable sarcopenia was defined for patients with reduced hand grip strength (women: <16.0 kg; men: <27.0 kg) and/or impaired chair-rise time (both genders: >15 seconds). Patients with additional low skeletal muscle index were classified as sarcopenic (women: <5.5 kg/m2; men: <7.0 kg/m2). Translation and cultural adaption was composed of 7 different steps that were in general based on the guidelines put forward by the World Health Organization. Validation include test-retest and the inter-rater reliability (intraclass correlation coefficient) as well as internal consistency (Cronbach alpha). Furthermore, sensitivity, specificity, positive predictive value, and negative predictive value of the SARC-F were calculated. Receiver-operating characteristic analysis was performed to calculate the area under the curve.

Results

The translated and culturally adapted version of the SARC-F for the German language has shown excellent inter-rater reliability and good test-retest reliability. The internal consistency is acceptable. Sensitivity (63%) and specificity (47%) for sarcopenia is low. For detecting patients with probable sarcopenia, the SARC-F in the German version has shown 75% sensitivity and 67% specificity.

Conclusions and Implications

Because of a low sensitivity for detecting sarcopenia but an acceptable sensitivity for identifying probable sarcopenia, the German version of the SARC-F is a suitable tool for case finding of probable sarcopenia.

Section snippets

Methods

The validation process was organized in 2 phases as suggested by the EUGMS SIG methodological report.8 In the first phase, the German translation and cultural adaptation was conducted. In the second phase, the clinical validation was performed.

First Phase (Translation and Cultural Adaption)

The first 5 steps of the translation were performed without difficulties. Step 6 resulted in some modifications. The item “strength” was evaluated by asking for difficulties lifting or carrying 10 lb. The weight specification in pounds (10 lb) was converted into kilograms (5 kg). A footnote "corresponds to carrying a water box with two hands or half a box with one hand" was introduced as an example for 5 kg. For question 5 of the SARC-F, the footnote "in the last 12 months" was added in order

Discussion

The translated and culturally adapted version of the SARC-F for the German language showed excellent inter-rater reliability and good test-retest reliability. The internal consistency was acceptable. As already shown in other language validation studies of the SARC-F, the sensitivity of the German version for sarcopenia was low, and the NPV was high. Therefore, the German version of the SARC-F might not be a useful tool for screening sarcopenia. However, for detecting patients with probable

Conclusions and Implications

The German version of the SARC-F shows good reliability and internal consistency. Because of a low sensitivity for detecting sarcopenia but a higher sensitivity for identifying probable sarcopenia, the German version of the SARC-F is a suitable tool for case finding of probable sarcopenia in community-dwelling older adults.

Acknowledgments

Thanks to all study participants.

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    M.D. and U.F. contributed equally to the study.

    The authors declare no conflicts of interest.

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