Objective To explore the diagnostic value of four screening tools Simple Five-item Questionnaire (SARC-F), SARC-Calf Questionnaire, calf circumference (CC), Ishii score based on the expert consensus of Asian Working Group for Sarcopenia (AWGS) in the elderly in China with sarcopenia.

Methods Web of Science, PubMed, EMBase, CNKI, WanFang Data databases were searched by computer. Diagnostic tests on the accuracy of sarcopenia screening tools were collected from the establishment of database until April 2023. Two researchers independently screened the literature, extracted and cross-checked the data, and evaluated the quality of the included studies. Meta-analysis was performed by using Meta-disc 1.4 and Stata 17.0 software.

Results A total of 18 studies were included, involving four screening tools. Based on AWGS diagnostic criteria, the sensitivity of SARC-F, SARC-Calf, CC and Ishii score in Chinese elderly was 19%, 58%, 82% and 92%, and the specificity was 93%, 84%, 72% and 71%, respectively. The area under the curve (AUC) was 0.76, 0.77, 0.85 and 0.88, respectively. The sensitivities of SARC-F, SARC-Calf and CC in females were higher than that of males, but the specificities were lower than that of males, and Ishii score was the opposite. The sensitivities of SARC-F and Ishii score in nursing institutions and inpatients were higher, which were 39% and 95%, respectively. SARC-Calf had a higher specificity among community residents (87%). CC had higher sensitivity and specificity among community residents, which were 84% and 76%, respectively.

Conclusion SARC-F and Ishii score are more suitable for screening sarcopenia in elderly care institutions and hospitalized patients, CC is more suitable for screening sarcopenia in community residents, and SARC-F and SARC-Calf can be used as tools to exclude patients with sarcopenia. The application value of SARC-F, SARC-Calf and CC in females is higher than that in males, and the Ishii score is opposite.