Screening Tools for Sarcopenia in Mild to Moderate Parkinson's Disease: Assessing the Accuracy of SARC-F and Calf Circumference

Background: Parkinson's disease (PD) and sarcopenia share similar pathophysiological mechanisms. Objective: Estimate the prevalence of sarcopenia in PD patients and describe clinical and demographic features associated with sarcopenia. Methods: A cross-sectional study was carried out at a tertiary public hospital in Brazil. A modified HY scale of stage 1 to 3, being at least 40 years old and having the ability to stand and walk unassisted were required for eligibility. We evaluated physical performance and muscle mass using DEXA. Results: The study population comprised 124 patients, of which 53 (42.7%) were women. The mean age and mean disease duration were 65.8 +/- 10.5 and 10.1 +/- 5.8 years, respectively. The mean handgrip strength of 20.4 +/- 6.9 in woman and 34.6 +/- 8.4 kg in men. Moreover, 50.8% patients had positive SARC-F, 20% patients had probable sarcopenia, 9.6% confirmed sarcopenia, and 16.8% patients showed low muscle mass quantity measured by DEXA. Lower Levodopa Equivalent Dosage (LED) and calf circumference (CC) were independently associated with confirmed sarcopenia. LLED, higher MDS-UPDRS Part III, and lower MMSE scores were independently associated with probable sarcopenia. The CC demonstrated accuracy to identify PD patients with confirmed sarcopenia with a cut-off of <31 cm in women and <34 cm in men. Conclusion: We found low prevalence of confirmed sarcopenia among PD patients. We propose that healthcare providers introduce measuring CC, which is a quick and inexpensive method to assess for sarcopenia in PD patients.