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See detailAdaptation interculturelle du questionnaire"Kujala Anterior Knee Pain Scale » pour les patients francophones
Buckinx, Fanny ULg; Remy, Gaël; Bornheim, Stephen ULg et al

in 10ème Congrès Commun SFMES-SFTS (2017, September)

Introduction : Le syndrome fémoro-patellaire est l'un des problèmes du genou les plus fréquemment rencontrés. Il se caractérise par une douleur antérieure du genou dans les activités mettant en charge l ... [more ▼]

Introduction : Le syndrome fémoro-patellaire est l'un des problèmes du genou les plus fréquemment rencontrés. Il se caractérise par une douleur antérieure du genou dans les activités mettant en charge l'articulation fémoro-patellaire. Le Kujala Anterior Knee Pain Scale (Kujala AKPS) est un questionnaire utilisé pour évaluer les symptômes subjectifs, telles que les limitations fonctionnelles et la douleur antérieure du genou. Le questionnaire a déjà été traduit et validé en turc, en portugais brésilien, en persan, en chinois, et en néerlandais. Le but de cette étude est de traduire ce questionnaire en français afin d'en évaluer sa fiabilité et sa validité. Matériel et méthode : La traduction et l’adaptation interculturelle du questionnaire ont été réalisées selon les recommandations internationales comprenant 6 étapes : traduction initiale, synthèse des traductions, traduction de retour vers la langue d’origine, comité d'experts, test de la version pré-finale et approbation du comité d'experts. Une fois la version française obtenue, les participants (n=101) ont rempli 2 fois le Kujula AKPS à un intervalle de 7 jours, et le Short Form Health Survey (SF-36) afin d'en évaluer les propriétés psychométriques (la cohérence interne, la fidélité test-retest et la validité de construit). Résultats : Le Kujula AKPS montre une fidélité test-retest élevée pour le score total (ICC 0,97). La traduction française possède une cohérence interne élevée (0,87). Le Kujula AKPS possède une corrélation forte avec une partie des sous-échelles convergentes du SF-36 (PF, RP et BP). Il y a une corrélation faible ou modérée avec les sous-échelles divergentes du SF-36 (MH, SF et VT). Il n’y a pas d’effet plancher et plafond. Conclusion : La version française du questionnaire Kujula AKPS étant facilement compréhensible, elle semble avoir une bonne adaptation interculturelle. Cette étude a démontré que le Kujula AKPSF est fiable et valide pour les patients francophones souffrant d'un syndrome rotulien. [less ▲]

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See detailEffects of a giant exercising board game intervention on ambulatory physical activity among nursing home residents: a preliminary study
Mouton, Alexandre ULg; Gillet, Nicolas; Mouton, Flore et al

Conference (2017, July 08)

Purpose: This study examined the effects of a giant (4 meters by 3 meters) exercising board game intervention on ambulatory physical activity (PA) and on a broader array of physical and psychological ... [more ▼]

Purpose: This study examined the effects of a giant (4 meters by 3 meters) exercising board game intervention on ambulatory physical activity (PA) and on a broader array of physical and psychological outcomes among nursing home residents. Materials and methods: A quasi-experimental longitudinal study was carried out in two comparable nursing homes. Ten participants (aged 82.5 ± 6.3 and comprising 6 women) meeting the inclusion criteria took part to the one-month intervention in one nursing home, whereas eleven participants (aged 89.9 ± 3.1 with 8 women) were assigned to the control group in the other nursing home. The giant exercising board game required participants to perform strength, flexibility, balance and endurance activities. The assistance provided by an exercising specialist decreased gradually during the intervention in an autonomy-oriented approach, based on the self-determination theory (SDT). The following were assessed at baseline, after the intervention and after a follow-up period of three months: PA (steps/day and energy expenditure/day with ActiGraph, GT3X+), cognitive status (MMSE), quality of life (EQ-5D), motivation for PA (BREQ-2), gait and balance (Tinetti and SPPB), functional mobility (Timed Up and Go) and the muscular isometric strength of the lower limb muscles. Results and conclusions: In the intervention group, PA increased from 2921 steps/day at baseline to 3358 steps/day after the intervention (+14.9%, p = 0.04) and 4083 steps/day (+39.8%, p = 0.03) after three months. Energy expenditure/day also increased after the intervention (+110 kcal/day, +6.3%, p = 0.01) and after three months (+219 kcal/day, +12.3%, p = 0.02). Quality of life (p < 0.05), balance and gait (p < 0.05), and strength of the ankle (p < 0.05) were also improved after three months. Such improvements were not observed in the control group. The preliminary results are promising but further investigation is required to confirm and evaluate the longterm effectiveness of PA interventions in nursing homes [less ▲]

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See detailInfluence of environmental factors on food intake among nursing home residents: a survey combined with a video approach
Buckinx, Fanny ULg; Reginster, Jean-Yves ULg; Morelle, Alison et al

in Clinical Interventions in Aging (2017), 12

Background: In addition to the well-known physiological factors, dietary behavior that affects health seems to be influenced by a wide variety of environmental factors. The aim of this study was to assess ... [more ▼]

Background: In addition to the well-known physiological factors, dietary behavior that affects health seems to be influenced by a wide variety of environmental factors. The aim of this study was to assess, by means of an original video approach, the influence of the environment on food intake in nursing homes. Methods: The perception of the environment during meals in nursing homes was evaluated by residents and by two groups of volunteers who either work in the field of geriatrics, or who do not work in the field of geriatrics. First, a random sample of residents answered a self-administered questionnaire related to different indicators (ie, noise, space, comfort, light, odors, perceived satisfaction of meals, taste of meals, presentation of meals, service and setting). Second, two separate panels, one including the people who work in the field of geriatrics (ie, experts) and one including the people who have no particular interest in geriatrics (ie, nonexperts), were asked to answer a questionnaire on their perception of the environment after having watched a video of the lunch in each nursing home. Then, the food intake of the residents was measured by a precise food-weighing method. Results: A total of 88 residents from nine different nursing homes, 18 experts and 45 nonexperts answered the questionnaires. This study highlighted that, on the one hand, after adjustment on confounding variables, the perception of the quantity of food served by the residents is the only single factor associated with food consumption (P=0.003). On the other hand, experts and nonexperts did not perceive any environmental factor that seems to be significantly associated with residents’ food intake. Conclusion: Our results highlighted that, in a nursing home setting, environmental factors have limited influence on the food intake of the residents, with the exception of their own perception of the quantity served. The relevance of this factor deserves further investigation. [less ▲]

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See detailPrevalence of sarcopenia accoring to 10 different operational definitions of the frailty.
Buckinx, Fanny ULg; Reginster, Jean-Yves ULg; Beaudart, Charlotte ULg et al

in Osteoporosis International (2017, March), 28 Suppl 1

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See detailSarcopenia in nursing home residents: the senior cohort.
Buckinx, Fanny ULg; Reginster, Jean-Yves ULg; Beaudart, Charlotte ULg et al

in Osteoporosis International (2017, March), 28 Suppl 1

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See detailThe Future Prevalence of Sarcopenia in Europe: A Claim for Public Health Action.
Ethgen, Olivier ULg; Beaudart, Charlotte ULg; Buckinx, Fanny ULg et al

in Calcified Tissue International (2017), 100(3), 229-234

Sarcopenia is a major public health issue. To convince health policy makers of the emergency to invest in the sarcopenia field, it is of critical importance to produce reliable figures of the expected ... [more ▼]

Sarcopenia is a major public health issue. To convince health policy makers of the emergency to invest in the sarcopenia field, it is of critical importance to produce reliable figures of the expected burden of sarcopenia in the coming years. Age- and gender-specific population projections were retrieved until 2045 from the Eurostat online database (28 European countries). Age- and gender-specific prevalences of sarcopenia were interpolated from a study that compared prevalence estimates according to the different diagnostic cutoffs of the EWGSOP proposed definition. The reported prevalence estimates were interpolated between 65 and 100 years. Interpolated age- and gender-specific estimates of sarcopenia prevalence were then applied to population projections until 2045. Using the definition providing the lowest prevalence estimates, the number of individuals with sarcopenia would rise in Europe from 10,869,527 in 2016 to 18,735,173 in 2045 (a 72.4% increase). This corresponds to an overall prevalence of sarcopenia in the elderly rising from 11.1% in 2016 to 12.9% in 2045. With the definition providing the highest prevalence estimates, the number of individuals with sarcopenia would rise from 19,740,527 in 2016 to 32,338,990 in 2045 (a 63.8% increase), corresponding to overall prevalence rates in the elderly of 20.2% and 22.3% for 2016 and 2045, respectively. We showed that the number of sarcopenic patients will dramatically increase in the next 30 years, making consequences of muscle wasting a major public health issue. [less ▲]

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See detailRelationship between ambulatory physical activity assessed by activity trackers and physical frailty among nursing home residents.
Buckinx, Fanny ULg; Mouton, Alexandre ULg; Reginster, Jean-Yves ULg et al

in Gait & Posture (2017), 54

BACKGROUNDS: The aim of this study was to assess the relationship between the level of ambulatory physical activity, measured by physical activity tracker, and the clinical components of physical frailty ... [more ▼]

BACKGROUNDS: The aim of this study was to assess the relationship between the level of ambulatory physical activity, measured by physical activity tracker, and the clinical components of physical frailty, among nursing home residents. METHODS: We proceeded in 3 steps: (1) Validation of the physical activity tracker (i.e. the Pebble): 24 volunteer adults walked on a treadmill. The number of steps recorded by the Pebble worn by the subjects was compared with the number of steps counted by the investigators, by means of the Intra-class correlation coefficients (ICC). (2) Measurement of ambulatory physical activity, using the Pebble trackers, over a 7-day period. (3) Relationship between the results obtained with the Pebble trackers (step 2) and subjects' clinical characteristics, linked to physical frailty. RESULTS: ICC data, showed that the reliability of the Pebble was better when it was worn at the foot level (ICC ranged from 0.60 to 0.93 depending on the tested speed). Gait speed is also an important determinant of the reliability, which is better for low gait speed. On average, the 27 nursing home residents included in the second step of this study walked 1678.4+/-1621 (median=1300) steps per day. Most physical components of frailty measured in this study were significantly different between subjects who walked less than 1300 steps per day and those who were more active. CONCLUSION: This study showed that nursing home residents have a poor ambulatory physical activity, assessed using a physical activity tracker, which is associated with poorer physical performances and higher disability. [less ▲]

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See detailSelf-Administration of Medicines and Dietary Supplements Among Female Amateur Runners: A Cross-Sectional Analysis.
Locquet, Médéa ULg; Beaudart, Charlotte ULg; Larbuisson, Robert ULg et al

in Advances in Therapy (2017), 33(12), 2257-2268

INTRODUCTION: Self-administration of medicines or dietary supplements without any physician's advice is a widespread behavior and appears to be more frequently practiced by women. Moreover, reasons to ... [more ▼]

INTRODUCTION: Self-administration of medicines or dietary supplements without any physician's advice is a widespread behavior and appears to be more frequently practiced by women. Moreover, reasons to self-administer products are often pains and injuries especially among athletes who might also use remedies to improve physical performance. The objective of this study was thus to assess the prevalence of self-administration of medicines and dietary supplements as well as its determinants among female amateur runners. METHODS: Our sample was comprised of women who took part in amateur running events. Data regarding self-administration of substances, exclusively aiming at being physically prepared for the running event (i.e., intake the week before), were collected through an anonymous self-administered questionnaire including four specific themes (i.e., general information, self-administered medicines and dietary supplements, context of self-administration of substances and knowledge of the anti-doping regulations). RESULTS: A total of 136 women, with a median age of 39 years (interquartile range: 27-47), volunteered. Among them, 34.6% reported self-administration of medicines during the period immediately preceding the running event, with the aim to be physically prepared. More than one third (33.8%) also declared self-administration of dietary supplements. Furthermore, we observed that about 8.1% of the sample had consumed a potentially doping substance. After adjustments for confounding variables, the probability of self-administration of products (medicines or supplements) increased significantly with the intensity of the activity and the membership in a sports club. CONCLUSIONS: Our study showed that self-administration of products among female runners seems to be a widespread behavior, where the intensity of the sports practice and the network of runners seem to influence the decision to resort to this behavior. [less ▲]

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See detailRelevance of vitamin D in the pathogenesis and therapy of frailty.
Bruyère, Olivier ULg; Cavalier, Etienne ULg; Buckinx, Fanny ULg et al

in Current Opinion in Clinical Nutrition & Metabolic Care (2017), 20(1), 26-29

PURPOSE OF REVIEW: This article reviews recently published evidence regarding the role of vitamin D in the physiopathology of physical frailty in elderly populations and its role in the management of this ... [more ▼]

PURPOSE OF REVIEW: This article reviews recently published evidence regarding the role of vitamin D in the physiopathology of physical frailty in elderly populations and its role in the management of this geriatric condition. RECENT FINDINGS: Some recent studies have found a low level of 25-hydroxyvitamin D, considered the best marker of vitamin D status, in frail individuals. All prospective studies consistently report that low vitamin D status is associated with an increased risk of becoming frail. Recent studies also suggest that the relationship between vitamin D status and frailty is largely mediated by the development of sarcopenia. Very few well designed randomized controlled trials are available that assess the effectiveness of vitamin D supplementation in the prevention or management of frailty. In the absence of specific guidelines, a minimal serum 25-hydroxyvitamin D level of 75 nmol/l is proposed for frail elderly patients by some scientific societies. The doses necessary to reach this target are between 800 and 2000 IU/day. SUMMARY: Several studies suggest a potential effect of vitamin D on physical frailty but large clinical trials are lacking at this time to provide solid evidence of clinical benefit. [less ▲]

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See detailPrevalence of Frailty in Nursing Home Residents According to Various Diagnostic Tools
Buckinx, Fanny ULg; Reginster, Jean-Yves ULg; GILLAIN, Sophie ULg et al

in Journal of Frailty & Aging (2017), 6(3), 122-8

Background: Although the theoretical foundations of frailty are well established in the literature, it remains an evolving concept lacking any unique definition or diagnostic criteria for use in clinical ... [more ▼]

Background: Although the theoretical foundations of frailty are well established in the literature, it remains an evolving concept lacking any unique definition or diagnostic criteria for use in clinical practice and epidemiological research. No consensus exists about the accurate prevalence rates of frailty. The various operational definitions of frailty can at least partly explain such discrepancies. Objective: To compare the prevalence of frailty, measured with different diagnostic tools, among elderly nursing home residents. Design: This is an analysis of baseline data collected among the SENIOR (Sample of Nursing home Elderly Individuals: an Observational Research) cohort. Setting: Nursing homes. Population: A total of 662 volunteer subjects from 28 nursing homes were included in this analysis. Among them, the mean age was 83.2 ± 8.99 years and 484 (72.5%) of them were women. Measurement: The percentages of frail and non-frail subjects were calculated according to 10 different definitions. Results: Prevalence of frailty varies from 1.70% (Frailty Index) to 76.3% (Groningen Frailty Indicator) depending on the tool used. Conclusions: The prevalence of frailty is highly dependent on the diagnostic tool used. It would be necessary to reach a consensus on which diagnostic tools to use if one wishes to have comparable data obtained in epidemiological studies. [less ▲]

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See detailPrediction of the Incidence of Falls and Deaths Among Elderly Nursing Home Residents: The SENIOR Study.
Buckinx, Fanny ULg; Croisier, Jean-Louis ULg; Reginster, Jean-Yves ULg et al

in Journal of the American Medical Directors Association (2017), (Online),

OBJECTIVE: The objective of this study was to evaluate, among nursing home residents, the extent to which the various operational definitions of frailty predict mortality and falls at 1 year. METHODS: We ... [more ▼]

OBJECTIVE: The objective of this study was to evaluate, among nursing home residents, the extent to which the various operational definitions of frailty predict mortality and falls at 1 year. METHODS: We studied 662 participants from the Sample of Elderly Nursing home Individuals: An Observational Research (SENIOR) cohort aged 83.2 ± 8.99 years, including 484 (72.5%) women and living in nursing homes. Among this cohort, 584 and 565 participants, respectively, were monitored over 12 months for mortality assessment and for occurrence of falls (ie, by mean of their medical records). Each patient was subjected to a clinical examination at baseline, during which many original clinical characteristics were collected. Stepwise regression analyses were carried out to predict mortality and falls. RESULTS: Among the participants included in the study, 93 (15.9%) died and 211 (37.3%) experienced a fall during the 1-year of follow-up. After adjustment, none of the definitions of frailty assessed predicted the 1-year occurrence of negative health outcomes. When comparing the clinical characteristics of deceased participants and those still alive, being a man (OR = 1.89; 95% CI: 1.19-3.01; P = .002) and being diagnosed with sarcopenia (OR = 1.7; 95% CI: 1.1-2.92; P = .03) were independent factors associated with 1-year mortality. Other independent factors that were significantly associated with the 1-year occurrence of falls were the results obtained with the Tinetti test (OR = 0.93; 95% CI: 0.87-0.98; P = .04), with the grip strength test (OR = 0.95; 95% CI: 0.90-0.98, P = .03), and with the isometric strength test of elbow extensors (OR = 0.93; 95%CI: 0.87-0.97; P = .04). CONCLUSIONS: Within the operational definitions of frailty assessed, none is sufficiently sensitive to predict the occurrence of falls and deaths at 1 year among nursing home residents. Globally, the frequency of undesirable health outcomes seems to be higher among participants with lower muscle strength and mobility. Medical strategy or adapted physical activity, with the aim of improving specific isometric muscle strength and mobility could potentially, but significantly, reduce the occurrence of falls and even deaths. [less ▲]

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See detailHow clinical practitioners assess frailty in their daily practice: an international survey
Bruyère, Olivier ULg; Buckinx, Fanny ULg; Beaudart, Charlotte ULg et al

in Aging Clinical and Experimental Research (2017), (On line),

NTRODUCTION: Various operational definitions have been proposed to assess the frailty condition among older individuals. Our objective was to assess how practitioners measure the geriatric syndrome of ... [more ▼]

NTRODUCTION: Various operational definitions have been proposed to assess the frailty condition among older individuals. Our objective was to assess how practitioners measure the geriatric syndrome of frailty in their daily routine. METHODS: An online survey was sent to national geriatric societies affiliated to the European Union Geriatric Medicine Society (EUGMS) and to members of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). RESULTS: A total of 388 clinicians from 44 countries answered to the survey. Most of them were medical doctors (93%), and their primary field of practice was geriatrics (83%). Two hundred and five clinicians (52.8%) always assessed frailty in their daily practice, 38.1% reported to "sometimes" measure it, and 9.1% never assess it. A substantial proportion of clinicians (64.9%) diagnose frailty using more than one instrument. The most widely used tool was the gait speed test, adopted by 43.8% of the clinicians, followed by clinical frailty scale (34.3%), the SPPB test (30.2%), the frailty phenotype (26.8%) and the frailty index (16.8%). CONCLUSION: A variety of tools is used to assess frailty of older patients in clinical practice highlighting the need for standardisation and guidelines. [less ▲]

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See detailPrevalence of sarcopenia in a population of nursing home residents according to their frailty status: results of the SENIOR cohort
Buckinx, Fanny ULg; Reginster, Jean-Yves ULg; BRUNOIS, Théo ULg et al

in Journal of Musculoskeletal & Neuronal Interactions (2017), 17(3), 209-17

Objective: To investigate the relationship between frailty and sarcopenia, by evaluating the prevalence of sarcopenia among frail, pre-frail and robust elderly nursing home residents in Belgium. Methods ... [more ▼]

Objective: To investigate the relationship between frailty and sarcopenia, by evaluating the prevalence of sarcopenia among frail, pre-frail and robust elderly nursing home residents in Belgium. Methods: This is an analysis of baseline data collected from the SENIOR (Sample of Elderly Nursing home Individuals: an Observational Research) cohort. All subjects received a sarcopenia evaluation, based on the definition proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). The frailty evaluation was primarily based on FRIED’s definition but also on 9 other operational definitions. Results: A total of 662 subjects (73.1% of women) were included in this analysis (mean age: 83.2±8.99 years). The prevalence of sarcopenia was 38.1% whereas the prevalence of frail and pre-frail persons was respectively 24.7% and 61.4%. Among frail, pre-frail and robust subjects, respectively 47%, 38.9% and 16.3% were diagnosed sarcopenic. The prevalence of sarcopenia according to ten different operational definitions of frailty ranged between 32.8 % (i.e. Frail scale Status and Frailty Index) and 47% (i.e. Fried definition). Conclusion: This research highlights that over a third of nursing home residents are sarcopenic and the percentage is almost 50% among frail subjects; those latter constitute about 1 in 4 of the population of nursing home residents studied here. [less ▲]

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See detailA scoping review of the public health impact of vitamin D - fortified dairy products for fracture prevention.
Hiligsmann, M; Neuprez, Audrey ULg; Buckinx, Fanny ULg et al

in Archives of Osteoporosis (2017), 12

Purpose : Dairy products are rich in nutrients that positively influence bone health and hence fracture risk, and have therefore been recommended and used for fracture prevention. To help decision makers ... [more ▼]

Purpose : Dairy products are rich in nutrients that positively influence bone health and hence fracture risk, and have therefore been recommended and used for fracture prevention. To help decision makers to efficiently allocate scare resources, it is further important to assess the public health and economic impact of any health intervention. In recent years, several studies have been conducted to estimate the public health and/or economic impact of dairy products but no overview is currently available. This article aims therefore to summarize evidence and review articles that estimated the public health and/or economic impact of vitamin D-fortified dairy products for fracture prevention. Methods: A literature review was conducted using PubMed to identify original studies that assessed the public health and/or economic impact of dairy products (or of calcium/vitamin D supplementation) for fracture prevention up to January 15, 2017. Results: Seven articles were identified. Different stratégies were used by the authors to model the economic/public health impact of dairy products. The four studies assessing the public health impact of dairy products revealed a substantial benefit in terms of fracture prevented, life years, disability-adjusted life years and/or quality-adjusted life years gained. Studies assessing the cost-effectiveness revealed that the use of dairy products is generally cost-effective in the general population aged above 70 years, and from the age of 60 years in populations at high risk of fractures. Conclusion: This systematic review suggests that the use of dairy products could substantially reduce the burden of osteoporotic fractures and seem to be an economically beneficial strategy [less ▲]

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See detailEffects of a giant exercising board game intervention on ambulatory physical activity among nursing home residents: a preliminary study
Mouton, Alexandre ULg; Gillet, Nicolas; Mouton, Flore et al

in Osteoporosis International (2017), 28(S1), 318

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See detailValidation of the SarQoL, a specific health-related quality of life questionnaire for Sarcopenia
Beaudart, Charlotte ULg; Biver, Emmanuel; Reginster, Jean-Yves et al

in Journal of cachexia, sarcopenia and muscle (2017), 8(2), 238-44

Background A specific self-administrated health-related quality of life questionnaire for sarcopenia, the Sarcopenia and Quality Of Life (SarQoL®), has been recently developed. This questionnaire is ... [more ▼]

Background A specific self-administrated health-related quality of life questionnaire for sarcopenia, the Sarcopenia and Quality Of Life (SarQoL®), has been recently developed. This questionnaire is composed of 55 items translated into 22 questions and organized into seven domains of quality of life. The objective of the present work is to evaluate the psychometric properties (discriminative power, validity, reliability, floor and ceiling effects) of the SarQoL® questionnaire. Methods Sarcopenic subjects were recruited in an outpatient clinic in Liège, Belgium and were diagnosed according to the algorithm developed by the European Working Group on Sarcopenia in Older People. We compared the score of the SarQoL® between sarcopenic and non-sarcopenic subjects using a logistic regression after adjustment for potential confounding variables. Internal consistency reliability was determined using Cronbach’s alpha coefficient; construct validity was assessed using convergent and divergent validities. Test–retest reliability was verified after a two-week interval using the intra-class correlation coefficient (ICC). At last, floor and ceiling effects were also tested. Results A total of 296 subjects with a median age of 73.3 (68.9–78.6) years were recruited for this study. Among them, 43 were diagnosed sarcopenic. After adjustment for potential confounding factors, the total score and the scores of the different dimensions of the SarQoL® questionnaire were significantly lower for sarcopenic than for non-sarcopenic subjects (54.7 (45.9– 66.3) for sarcopenic vs. 67.8 (57.3 – 79.0) for non sarcopenic, OR 0.93 (95%CI 0.90–0.96)). Regarding internal consistency, the Cronbach’s alpha coefficient was 0.87. The SarQoL® questionnaire data showed good correlation with some domains of the Short-Form 36 (SF-36) and the EuroQoL 5-dimension (EQ-5D) questionnaires and with the mobility test. An excellent agreement between the test and the retest was found with an ICC of 0.91 (95% CI 0.82–0.95). At last, neither floor nor ceiling effects were detected. Conclusions The SarQoL® questionnaire is valid, consistent, and reliable and can therefore be recommended for clinical and research purposes. However, its sensitivity to change needs to be assessed in future longitudinal studies. [less ▲]

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