{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T03:09:18Z","timestamp":1782961758599,"version":"3.54.5"},"reference-count":51,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Sarcopenia and physical frailty are interconnected geriatric syndromes that frequently coexist in older adults, sharing common pathophysiological pathways. However, their early detection in community settings is limited by resource constraints and by the lack of simplified, scalable diagnostic tools. This cross-sectional study aimed to estimate the prevalence and overlap of sarcopenia and frailty in a real-world public health screening programme and to evaluate the diagnostic performance of a pragmatic two-step algorithm. In September 2025, a total of 256 consecutive community-dwelling adults aged \u226565 years underwent standardized assessment using the SARC-F questionnaire, handgrip strength dynamometry, and selective bioelectrical impedance analysis (BIA). Sarcopenia was defined according to 2019 EWGSOP2 criteria, and frailty according to the Fried phenotype. Confirmed sarcopenia was identified in 37 participants (14.5%, 95% CI 10.7\u201319.1%) and frailty in 31 (12.1%, 95% CI 8.6\u201316.7%), with substantial overlap (77.4% of frail individuals also had sarcopenia; Cohen\u2019s \u03ba = 0.62). The two-step algorithm (Step 1: SARC-F \u2265 4; Step 2: handgrip strength and BIA only in screen-positive participants) demonstrated excellent accuracy for confirmed sarcopenia (AUC 0.913, 95% CI 0.871\u20130.955), with sensitivity 91.9%, specificity 81.3%, and a 53.9% reduction in BIA use. Factors independently associated with confirmed sarcopenia included older age, BMI &lt; 22 kg\/m2, physical inactivity, and higher SARC-F score. A simple, function-centered two-step approach enables efficient and scalable identification of sarcopenia and frailty in community settings, supporting early preventive strategies to preserve physical function.<\/jats:p>","DOI":"10.3390\/life16010106","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T09:13:01Z","timestamp":1768209181000},"page":"106","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Pragmatic Two-Step Screening Algorithm for Sarcopenia and Frailty in Community-Dwelling Older Adults: A Cross-Sectional Population-Based Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-6151","authenticated-orcid":false,"given":"Silvana Mirella","family":"Aliberti","sequence":"first","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, SA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1562-2446","authenticated-orcid":false,"given":"Antonio","family":"Menini","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples \u201cFederico II\u201d, 80131 Naples, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Sacco","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples \u201cFederico II\u201d, 80131 Naples, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Romano","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples \u201cFederico II\u201d, 80131 Naples, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Di Martino","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples \u201cFederico II\u201d, 80131 Naples, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria","family":"Acampora","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples \u201cFederico II\u201d, 80131 Naples, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Izzo","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples \u201cFederico II\u201d, 80131 Naples, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Sorrentino","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples \u201cFederico II\u201d, 80131 Naples, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1092-6168","authenticated-orcid":false,"given":"Daria","family":"Nurzynska","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, SA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franca","family":"Di Meglio","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples \u201cFederico II\u201d, 80131 Naples, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1475-5036","authenticated-orcid":false,"given":"Clotilde","family":"Castaldo","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples \u201cFederico II\u201d, 80131 Naples, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102111","DOI":"10.1016\/j.arr.2023.102111","article-title":"Frailty and sarcopenia: A bibliometric analysis of their association and potential targets for intervention","volume":"92","author":"Ye","year":"2023","journal-title":"Ageing Res. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Buchman, A.S., Leurgans, S.E., Wang, T., Schnaider-Beeri, M., Agarwal, P., Dawe, R.J., Delbono, O., and Bennett, D.A. (2021). Motor function is the primary driver of the associations of sarcopenia and physical frailty with adverse health outcomes in community-dwelling older adults. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0245680"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"455","DOI":"10.7861\/clinmedicine.16-5-455","article-title":"Sarcopenia and frailty: New challenges for clinical practice","volume":"16","author":"Dodds","year":"2016","journal-title":"Clin. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: Evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.cger.2010.08.009","article-title":"The frailty syndrome: Definition and natural history","volume":"27","author":"Xue","year":"2011","journal-title":"Clin. Geriatr. Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Checa-L\u00f3pez, M., Oviedo-Briones, M., Pardo-G\u00f3mez, A., Gonzales-Tur\u00edn, J., Guevara-Guevara, T., Carnicero, J.A., Alamo-Ascencio, S., Landi, F., Cesari, M., and Grodzicki, T. (2019). FRAILTOOLS study protocol: A comprehensive validation of frailty assessment tools to screen and diagnose frailty in different clinical and social settings and to provide instruments for integrated care in older adults. BMC Geriatr., 19.","DOI":"10.1186\/s12877-019-1042-1"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1007\/s12603-021-1652-0","article-title":"Development and Validation of a Multidimensional Frailty Scale for Clinical Geriatric Assessment","volume":"25","author":"Shin","year":"2021","journal-title":"J. Nutr. Health Aging"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.jbspin.2018.08.001","article-title":"Sarcopenia","volume":"86","author":"Tournadre","year":"2019","journal-title":"Jt. Bone Spine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1002\/jcsm.12783","article-title":"Global prevalence of sarcopenia and severe sarcopenia: A systematic review and meta-analysis","volume":"13","author":"Balntzi","year":"2022","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s12603-023-1888-y","article-title":"Comparing Prevalence of Sarcopenia Using Twelve Sarcopenia Definitions in a Large Multinational European Population of Community-Dwelling Older Adults","volume":"27","author":"Stuck","year":"2023","journal-title":"J. Nutr. Health Aging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"110801","DOI":"10.1016\/j.exger.2019.110801","article-title":"Prevalence of sarcopenia as a comorbid disease: A systematic review and meta-analysis","volume":"131","author":"Pacifico","year":"2020","journal-title":"Exp. Gerontol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4633","DOI":"10.1016\/j.clnu.2021.06.009","article-title":"Global prevalence of sarcopenic obesity in older adults: A systematic review and meta-analysis","volume":"40","author":"Gao","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.clnesp.2022.01.027","article-title":"Screening, diagnosis and monitoring of sarcopenia: When to use which tool?","volume":"48","author":"Ackermans","year":"2022","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.jamda.2013.05.018","article-title":"SARC-F: A simple questionnaire to rapidly diagnose sarcopenia","volume":"14","author":"Malmstrom","year":"2013","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Yang, M., Hu, X., Xie, L., Zhang, L., Zhou, J., Lin, J., Wang, Y., Li, Y., Han, Z., and Zhang, D. (2018). Screening Sarcopenia in Community-Dwelling Older Adults: SARC-F vs SARC-F Combined with Calf Circumference (SARC-CalF). J. Am. Med. Dir. Assoc., 19.","DOI":"10.1016\/j.jamda.2017.12.016"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Coelho-J\u00fanior, H.J., Calvani, R., Picca, A., Tosato, M., Landi, F., and Marzetti, E. (2023). Engagement in Aerobic Exercise Is Associated with a Reduced Prevalence of Sarcopenia and Severe Sarcopenia in Italian Older Adults. J. Pers. Med., 13.","DOI":"10.3390\/jpm13040655"},{"key":"ref_18","unstructured":"(2025, December 03). Assessment Timed Up & Go (TUG), Available online: https:\/\/www.cdc.gov\/steadi\/media\/pdfs\/steadi-assessment-tug-508.pdf."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1753944719870084","DOI":"10.1177\/1753944719870084","article-title":"6-minute walking test: A useful tool in the management of heart failure patients","volume":"13","author":"Giannitsi","year":"2019","journal-title":"Ther. Adv. Cardiovasc. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Perna, S., Gasparri, C., Ferraris, C., Barrile, G.C., Cavioni, A., Mansueto, F., Patelli, Z., Peroni, G., Tartara, A., and Zese, M. (2022). Validation of the Italian Version of the SARC-F Questionnaire to Assess Sarcopenia in Older Adults. Nutrients, 14.","DOI":"10.3390\/nu14122533"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"990S","DOI":"10.1093\/jn\/127.5.990S","article-title":"Sarcopenia: Origins and clinical relevance","volume":"127","author":"Rosenberg","year":"1997","journal-title":"J. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1146\/annurev.pu.17.050196.000325","article-title":"Disability as a public health outcome in the aging population","volume":"17","author":"Guralnik","year":"1996","journal-title":"Annu. Rev. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1111\/j.1532-5415.2004.52014.x","article-title":"The healthcare costs of sarcopenia in the United States","volume":"52","author":"Janssen","year":"2004","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","article-title":"Frailty in elderly people","volume":"381","author":"Clegg","year":"2013","journal-title":"Lancet"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1016\/j.exger.2008.03.007","article-title":"Sarcopenia and frailty: A clinician\u2019s controversial point of view","volume":"43","author":"Bauer","year":"2008","journal-title":"Exp. Gerontol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.exger.2012.10.004","article-title":"The stress of aging","volume":"48","author":"Cesari","year":"2013","journal-title":"Exp. Gerontol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1111\/j.1532-5415.2004.52174.x","article-title":"Interventions on Frailty Working Group. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: A consensus report","volume":"52","author":"Ferrucci","year":"2004","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1111\/jgs.12773","article-title":"Identifying common characteristics of frailty across seven scales","volume":"62","author":"Theou","year":"2014","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/s12603-009-0246-z","article-title":"Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an international academy on nutrition and aging (IANA) task force","volume":"13","author":"Rolland","year":"2009","journal-title":"J. Nutr. Health Aging"},{"key":"ref_30","first-page":"226","article-title":"Work Package 5 of the Joint Action ADVANTAGE. Prevalence of frailty at population level in European ADVANTAGE Joint Action Member States: A systematic review and meta-analysis","volume":"54","author":"Galluzzo","year":"2018","journal-title":"Ann. Ist. Super. Sanita"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Wang, L., Chao, J., Zhang, N., Li, X., Li, J., Jin, S., Tan, G., Chen, T., and Wu, Y. (2025). Prevalence and factors associated with sarcopenia in community-dwelling older adults: A systematic review and meta-analysis. Gerontology, 1\u201325. advance online publication.","DOI":"10.1159\/000549808"},{"key":"ref_32","unstructured":"Gordis, L. (2009). The epidemiologic approach to disease and intervention. Epidemiology, Saunders Elsevier."},{"key":"ref_33","first-page":"15","article-title":"Cachexia versus sarcopenia","volume":"14","author":"Rolland","year":"2011","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1007\/s12603-012-0391-7","article-title":"The integration of frailty into clinical practice: Preliminary results from the g\u00e9rontop\u00f4le","volume":"16","author":"Subra","year":"2012","journal-title":"J. Nutr. Health Aging"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3093","DOI":"10.2174\/138161282019140523115611","article-title":"Editorial: The multidomain mobility lab in older persons: From bench to bedside","volume":"20","author":"Maggio","year":"2014","journal-title":"Curr. Pharm. Des."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1093\/gerona\/glu011","article-title":"Grip strength cutpoints for the identification of clinically relevant weakness","volume":"69","author":"Alley","year":"2014","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1093\/gerona\/glu010","article-title":"The FNIH sarcopenia project: Rationale, study description, conference recommendations, and final estimates","volume":"69","author":"Studenski","year":"2014","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1093\/gerona\/glu012","article-title":"Criteria for clinically relevant weakness and low lean mass and their longitudinal association with incident mobility impairment and mortality: The foundation for the national institutes of health (FNIH) sarcopenia project","volume":"69","author":"McLean","year":"2014","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1093\/gerona\/glu023","article-title":"Cutpoints for low appendicular lean mass that identify older adults with clinically significant weakness","volume":"69","author":"Cawthon","year":"2014","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1046\/j.1532-5415.2003.51104.x","article-title":"Physical performance measures in the clinical setting","volume":"51","author":"Studenski","year":"2003","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1001\/jama.281.6.558","article-title":"Midlife hand grip strength as a predictor of old age disability","volume":"281","author":"Rantanen","year":"1999","journal-title":"JAMA"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1152\/japplphysiol.00246.2003","article-title":"Age-associated changes in skeletal muscles and their effect on mobility: An operational diagnosis of sarcopenia","volume":"95","author":"Lauretani","year":"2003","journal-title":"J. Appl. Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Aliberti, S.M., Sacco, A.M., Belviso, I., Romano, V., Di Martino, A., Russo, E., Collet, S., Ciancaleoni Bartoli, I., Tuzi, M., and Capunzo, M. (2024). Potential Impact of Physical Activity on Measures of Well-Being and Quality of Life in People with Rare Diseases: A Nationwide Cross-Sectional Study in Italy. Healthcare, 12.","DOI":"10.3390\/healthcare12181822"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Aliberti, S.M., Funk, R.H.W., Schiavo, L., Giudice, A., Ciaglia, E., Puca, A.A., Gonnella, J., and Capunzo, M. (2022). Clinical Status, Nutritional Behavior, and Lifestyle, and Determinants of Community Well-Being of Patients from the Perspective of Physicians: A Cross-Sectional Study of Young Older Adults, Nonagenarians, and Centenarians in Salerno and Province, Italy. Nutrients, 14.","DOI":"10.3390\/nu14173665"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1126\/science.288.5463.100","article-title":"How animals move: An integrative view","volume":"288","author":"Dickinson","year":"2000","journal-title":"Science"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/gerona\/glr042","article-title":"Usefulness of preclinical models for assessing the efficacy of late-life interventions for sarcopenia","volume":"67","author":"Carter","year":"2012","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1001\/jama.2014.3033","article-title":"A diagnosis of dismobility-giving mobility clinical visibility: A mobility working group recommendation","volume":"311","author":"Cummings","year":"2014","journal-title":"JAMA"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Picca, A., Calvani, R., Cesari, M., Landi, F., Bernabei, R., Coelho-J\u00fanior, H.J., and Marzetti, E. (2020). Biomarkers of Physical Frailty and Sarcopenia: Coming up to the Place?. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21165635"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e13080","DOI":"10.1111\/acel.13080","article-title":"Measuring biological aging in humans: A quest","volume":"19","author":"Ferrucci","year":"2020","journal-title":"Aging Cell"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1042\/CS20230319","article-title":"Hallmarks of ageing in human skeletal muscle and implications for understanding the pathophysiology of sarcopenia in women and men","volume":"137","author":"Granic","year":"2023","journal-title":"Clin. Sci."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Aliberti, S.M., and Capunzo, M. (2025). The Power of Environment: A Comprehensive Review of the Exposome\u2019s Role in Healthy Aging, Longevity, and Preventive Medicine\u2014Lessons from Blue Zones and Cilento. Nutrients, 17.","DOI":"10.3390\/nu17040722"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/1\/106\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T09:31:32Z","timestamp":1768210292000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/1\/106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":51,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["life16010106"],"URL":"https:\/\/doi.org\/10.3390\/life16010106","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]}}}