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      English translation and validation of the SarQoL ®, a quality of life questionnaire specific for sarcopenia

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          the first quality of life questionnaire specific to sarcopenia, the SarQoL ®, has recently been developed and validated in French. To extend the availability and utilisation of this questionnaire, its translation and validation in other languages is necessary.


          the purpose of this study was therefore to translate the SarQoL ® into English and validate the psychometric properties of this new version.




          Hertfordshire, UK.


          in total, 404 participants of the Hertfordshire Cohort Study, UK.


          the translation part was articulated in five stages: (i) two initial translations from French to English; (ii) synthesis of the two translations; (iii) backward translations; (iv) expert committee to compare the backward translations with the original questionnaire and (v) pre-test. To validate the English SarQoL ®, we assessed its validity (discriminative power, construct validity), reliability (internal consistency, test–retest reliability) and floor/ceiling effects.


          the SarQoL ® questionnaire was translated without any major difficulties. Results indicated a good discriminative power (lower score of quality of life for sarcopenic subjects, P = 0.01), high internal consistency (Cronbach’s alpha of 0.88), consistent construct validity (high correlations found with domains related to mobility, usual activities, vitality, physical function and low correlations with domains related to anxiety, self-care, mental health and social problems) and excellent test– retest reliability (intraclass coefficient correlation of 0.95, 95%CI 0.92–0.97). Moreover, no floor/ceiling has been found.


          a valid SarQoL ® English questionnaire is now available and can be used with confidence to better assess the disease burden associated with sarcopenia. It could also be used as a treatment outcome indicator in research.

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          Most cited references 24

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          Sarcopenia: European consensus on definition and diagnosis

          The European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria for age-related sarcopenia. EWGSOP included representatives from four participant organisations, i.e. the European Geriatric Medicine Society, the European Society for Clinical Nutrition and Metabolism, the International Association of Gerontology and Geriatrics—European Region and the International Association of Nutrition and Aging. These organisations endorsed the findings in the final document. The group met and addressed the following questions, using the medical literature to build evidence-based answers: (i) What is sarcopenia? (ii) What parameters define sarcopenia? (iii) What variables reflect these parameters, and what measurement tools and cut-off points can be used? (iv) How does sarcopenia relate to cachexia, frailty and sarcopenic obesity? For the diagnosis of sarcopenia, EWGSOP recommends using the presence of both low muscle mass + low muscle function (strength or performance). EWGSOP variously applies these characteristics to further define conceptual stages as ‘presarcopenia’, ‘sarcopenia’ and ‘severe sarcopenia’. EWGSOP reviewed a wide range of tools that can be used to measure the specific variables of muscle mass, muscle strength and physical performance. Our paper summarises currently available data defining sarcopenia cut-off points by age and gender; suggests an algorithm for sarcopenia case finding in older individuals based on measurements of gait speed, grip strength and muscle mass; and presents a list of suggested primary and secondary outcome domains for research. Once an operational definition of sarcopenia is adopted and included in the mainstream of comprehensive geriatric assessment, the next steps are to define the natural course of sarcopenia and to develop and define effective treatment.
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            Quality criteria were proposed for measurement properties of health status questionnaires.

            Recently, an increasing number of systematic reviews have been published in which the measurement properties of health status questionnaires are compared. For a meaningful comparison, quality criteria for measurement properties are needed. Our aim was to develop quality criteria for design, methods, and outcomes of studies on the development and evaluation of health status questionnaires. Quality criteria for content validity, internal consistency, criterion validity, construct validity, reproducibility, longitudinal validity, responsiveness, floor and ceiling effects, and interpretability were derived from existing guidelines and consensus within our research group. For each measurement property a criterion was defined for a positive, negative, or indeterminate rating, depending on the design, methods, and outcomes of the validation study. Our criteria make a substantial contribution toward defining explicit quality criteria for measurement properties of health status questionnaires. Our criteria can be used in systematic reviews of health status questionnaires, to detect shortcomings and gaps in knowledge of measurement properties, and to design validation studies. The future challenge will be to refine and complete the criteria and to reach broad consensus, especially on quality criteria for good measurement properties.
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              EQ-5D: a measure of health status from the EuroQol Group.

              Established in 1987, the EuroQol Group initially comprised a network of international, multilingual and multidisciplinary researchers from seven centres in Finland, the Netherlands, Norway, Sweden and the UK. Nowadays, the Group comprises researchers from Canada, Denmark, Germany, Greece, Japan, New Zealand, Slovenia, Spain, the USA and Zimbabwe. The process of shared development and local experimentation resulted in EQ-5D, a generic measure of health status that provides a simple descriptive profile and a single index value that can be used in the clinical and economic evaluation of health care and in population health surveys. Currently, EQ-5D is being widely used in different countries by clinical researchers in a variety of clinical areas. EQ-5D is also being used by eight out of the first 10 of the top 50 pharmaceutical companies listed in the annual report of Pharma Business (November/December 1999). Furthermore, EQ-5D is one of the handful of measures recommended for use in cost-effectiveness analyses by the Washington Panel on Cost Effectiveness in Health and Medicine. EQ-5D has now been translated into most major languages with the EuroQol Group closely monitoring the process.

                Author and article information

                Age Ageing
                Age Ageing
                Age and ageing
                7 April 2017
                01 March 2017
                01 September 2017
                : 46
                : 2
                : 271-276
                [1 ]Public Health, Epidemiology and Health Economics, University of Liège, Avenue de l’Hopital 3, Liège 4000, Belgium
                [2 ]MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hants, United Kingdom of Great Britain and Northern Ireland
                [3 ]Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
                [4 ]MRC Lifecourse Epidemiology Unit – University of Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland
                [5 ]Department of Sport and Rehabilitation Sciences, University of Liège, Liège, Belgium
                [6 ]Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva 14, Switzerland
                [7 ]Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
                [8 ]Southampton General Hospital, MRC Resource Centre, Tremona Road, Southampton SO16 6YD, United Kingdom of Great Britain and Northern Ireland
                [9 ]Epidemiology and Public Health, University of Liege, CHU Sart Tilman, Liege 4000, Belgium
                [10 ]MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital Tremona Road, Southampton SO16 6YD, United Kingdom of Great Britain and Northern Ireland
                Author notes
                Address correspondence to: C. Beaudart. Tel: +3243664933; Fax: +3243662812. c.beaudart@

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@


                Geriatric medicine

                older people, sarcopenia, quality of life, translation, validation


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