The Accuracy of the Ishii Score Chart in Predicting Sarcopenia in the Elderly Community in Chengdu

Abstract Background: Sarcopenia is an age-related disorder that results in loss of skeletal muscle mass, loss of muscle strength, and/or reduced physical performance . It leads to a high incidence of falls, fractures, hospitalizations, a loss of mobility, and subsequently reduced quality of life.Therefore, it is crucial to find effective screening tools for early screening in the elderly community. Many studies had shown the Ishii score chart predicts sarcopenia with high sensitivity and specificity. But, the Ishii score chart is mainly based on the European Working Group on Sarcopenia in Older People (EWGSOP) consensus. Now, the Asian Working Group for Sarcopenia (AWGS)2019 consensus has changed its previous diagnostic criteria, so whether the Ishii score chart is suitable for China needs to be verified. This study, intends to verify the accuracy of the Ishii score chart within the Chinese elderly community in an effort to find a suitable model of screening for sarcopenia.Methods: Using the AWGS2019 sarcopenia diagnostic criteria as a reference, the accuracy of the Ishii score chart among the elderly community was evaluated using indicators such as sensitivity, specificity, the ROC curve (receiver operating characteristic curve), and the area under the curve (AUC) .Results: 1.The prevalence rate of sarcopenia in the Chengdu elderly community was 18.38%, of which 19.87% were males and 16.91% were females. 2. The Ishii score chart predicted sarcopenia when the AUC was 0.84 with 95% confidence interval (CI) of 0.80-0.89 for females and 0.81 with 95% CI of 0.75-0.86 for males. According to original cut-off, which was set at 120 points for females, the corresponding sensitivity was 45.7% and the specificity was 93.2%. The 105 cut-off points set for males revealed a corresponding sensitivity of 53.3% and the specificity of 88.9%. 3. After adjusting the cut-off and maximizing the sum of sensitivity and specificity, sensitivity, specificity, and positive and negative predictive values for sarcopenia were 75.3%, 80.2%, 43%, and 94% for females, and 70.7%, 81.6%, 49%, and 92% for males respectively. 4.The Ishii score chart predicted severe sarcopenia when the AUC was 0.96 with 95% CI of 0.94-0.98 for females and 0.93 with 95% CI of 0.89-0.98 for males. When the sum of sensitivity and specificity was maximized, sensitivity, specificity, and positive and negative predictive values for severe sarcopenia were 100%, 88.6%, 33%, and 99% for females, and 91.7%, 87.0%, 21%, and 97% for males respectively. Conclusion: After adjusting the cut-off values, the Ishii score chart had high predictive value for both sarcopenia and severe sarcopenia among the elderly Chengdu community.