Translation and Validation of the Spanish Version of the SARC-F Questionnaire to Assess Sarcopenia in Older People.

OBJECTIVES: The revised European consensus on sarcopenia definition and diagnosis (EWGSOP2) includes the SARC-F questionnaire, the most valid and consistent sarcopenia screening tool, as the mandatory first step. Our aim was the translation, cross-cultural adaptation, and validation of the SARC-F questionnaire as a culturally-responsive Spanish-language version for the European population. STUDY DESIGN: Cross-sectional descriptive study, applying the two-step WHO methodology for translation and cross-cultural adaptation of health questionnaires, and harmonization with the Mexican-Spanish version. European Union Geriatric Medicine Society recommendations for SARC-F validation in European languages were considered. PARTICIPANTS: Outpatient clinics of a university hospital. INCLUSION CRITERIA: stable, ambulatory (including aids), community-dwelling population ≥65 years old. MAIN OUTCOME MEASURES: The self-reported 5-item SARC-F questionnaire was administered; scores ≥4 indicated sarcopenia. Sensitivity, specificity, accuracy-likelihood ratios, predictive values, and kappa statistics were calculated and consecutively compared with European Working Group on Sarcopenia in Older People (EWGSOP) and EWGSOP2 criteria. RESULTS: This Spanish version, administered in an average 70s, has adequate internal consistency (Cronbach alpha=0.779). For the validation study, 90 (43.3%) of 208 potentially eligible subjects (81.4 ± 5.9 years old, 75.6% women) were included. SARC-F identified 51 (56.7%) subjects with sarcopenia and 39 (43.3%) without the disease. Prevalence was 17.8% per EWGSOP and 25.6% per EWGSOP2 (58% accuracy and fair agreement: sensitivity, 78.3%; specificity, 50.8%). CONCLUSIONS: SARC-F is a feasible tool, suitable for bedside assessment in community-dwelling older patients. Wide diffusion of this culturally-responsible SARC-F Spanish version is expected as EWGSOP2 is adopted and sarcopenia assessment is broadly implemented in Spain.

[Recent psychophysical deterioration in the elderly patient: a potentially severe medical emergency. Assessment and attitudes]. / Deterioro psicofísico reciente en ancianos: una urgencia médica potencialmente grave. Valoración y actitudes.

An atypical presentation of diseases is common in the elderly patient. Also, a number of conditions in the elderly are commonly associated with deterioration of the functional status, that is, the independence level for daily life activities. This loss of autonomy occasionally calls the physicians attention, masking other symptoms. On the other hand, the high prevalence of social problems in the elderly adds a distorting element to the clinical evaluation of the patient. Four patients with a main complaint of recent physical and psychical deterioration are here reported. The complementary tests were inconclusive and patients were classified as social problems, thus posing the problem of home discharge. All patients were later demonstrated to have potentially severe conditions amenable to hospital admission (hypothyroidism, meningitis, arrhythmia, which prompted the implantation of a pacemaker, and digital intoxication). The recent loss of autonomy should be considered as a potentially severe medical emergency among the elderly. Failure to identify this problem may lead to minimizing the symptoms and overestimating the social problems, thus leading to inappropriate hospital discharges.

Deterioro psicofísico reciente en ancianos: una urgencia médica potencialmente grave. Valoración y actitudes / Recent psychophysical deterioration in the elderly patient: a potentially severe medical emergency. Assessment and attitudes

La presentación atípica de las enfermedades es frecuente en pacientes de edad avanzada. Asimismo, en los ancianos muchos procesos se acompañan con frecuencia de deterioro en la capacidad funcional, entendiendo como tal el nivel de independencia para las actividades de la vida diaria. Esta pérdida de la autonomía en ocasiones puede acaparar toda la atención, enmascarando el resto de síntomas. Por otra parte, la alta prevalencia de problemas sociales en ancianos añade un elemento distorsionador en la valoración clínica del caso. Se presentan 4 pacientes ancianos cuyo motivo principal de consulta a urgencias fue un deterioro reciente físico y psíquico en sus capacidades. Las exploraciones complementarias no fueron concluyentes y fueron catalogados de 'problemas sociales', planteándose el alta al domicilio. Posteriormente se demostró que todos tenían enfermedades potencialmente graves y susceptibles de ingreso hospitalario (hipotiroidismo, meningitis, arritmia que requirió marcapasos e intoxicación digitálica). La pérdida reciente de la autonomía debe ser considerada como una urgencia médica potencialmente grave en pacientes ancianos. La no identificación de este problema puede llevar a la minimización de los síntomas y a la sobrevaloración de la problemática social, pudiéndose producir altas hospitalarias inadecuadas. (AU)

Ancianos en los servicios de urgencias: ¿problema sanitario o social? / Elderly patients in the emergency department: sanitary or social problem?

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