Psychometric Properties of the SarQoL Questionnaire: A Systematic Review and Meta-Analysis

Background: 
The Sarcopenia and Quality of Life (SarQoL) questionnaire is recognized as the only disease-specific patient-reported outcome measure (PROM) for assessing sarcopenia-related HRQoL. This systematic review and meta-analysis aimed to provide a quantitative summary of all evidence reported on the reliability, validity, responsiveness and floor/ceiling effects of SarQoL in older adults. 
Methods: Following PRISMA-COSMIN guidelines, a systematic search for studies evaluating the psychometric properties of SarQoL (i.e., reliability, validity, responsiveness and floor and ceiling effects) in older people was conducted on MEDLINE (via OVID), PsycINFO, Scopus and EMBASE. Studies published between 2013 and November 2024 using a consensual definition of sarcopenia were included. Study selection and data extraction were made by two independent reviewers. A random-effects model meta-analysis was applied. PROSPERO registration: CRD42024546880. 
Results: From 411 studies identified by the search strategy, 25 fulfilled the inclusion criteria, including 4585 community-dwelling individuals, of which 1311 were diagnosed as sarcopenic. SarQoL demonstrated high reliability (pooled Cronbach's alpha values consistently exceeding 0.80) and excellent test–retest reliability (pooled ICC = 0.98). Construct validity was confirmed with strong convergent correlations (pooled r > 0.54) with related dimensions of generic SF-36 and EQ-5D and weaker divergent correlations (pooled r < 0.47). Responsiveness, evaluated in two studies using different methodologies, supported the ability of SarQoL to detect meaningful changes in HRQoL. The certainty of evidence was rated as high for reliability, validity and responsiveness. 
Conclusion: This meta-analysis consolidates a decade of evidence and confirms the strong psychometric properties of SarQoL, with a high level of evidence.