Sarcopenia

Sarcopenia typically presents in people older than 65 years with signs and symptoms of low muscle strength and low physical performance, such as falls, feeling weak, walking slowly, difficulty rising from a chair, and loss of weight and muscle mass.

The five-item SARC-F patient questionnaire and assessing gait speed are recommended for screening people for suspected sarcopenia. A SARC-F score ≥4 and/or a low usual gait speed indicate low muscle function. Use hand grip or the sit-stand test to assess muscle strength.

Use imaging, such as computed tomography (CT), magnetic resonance imaging (MRI), or dual x-ray absorptiometry (DXA) to assess muscle quality/quantity. Bioimpedance analysis is another diagnostic option, but is less accurate.

In people with confirmed sarcopenia, initiate an exercise or rehabilitation programme that focuses on resistance training and balance exercises, combined with dietary intervention to increase protein intake and improve overall calorie intake and quality.

Sarcopenia is a progressive and generalised skeletal muscle disorder that is associated with increased likelihood of adverse outcomes including falls, fractures, physical disability, and mortality.[1]Cruz-Jentoft AJ, Bahat G, Bauer J, et al; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31. https://academic.oup.com/ageing/article/48/1/16/5126243 http://www.ncbi.nlm.nih.gov/pubmed/30312372?tool=bestpractice.com It may be defined as an age-associated loss of skeletal muscle function and muscle mass, which is common in older adults (>65 years).[2]Dent E, Morley JE, Cruz-Jentoft AJ, et al. International clinical practice guidelines for sarcopenia (ICFSR): screening, diagnosis and management. J Nutr Health Aging. 2018;22(10):1148-61. http://www.ncbi.nlm.nih.gov/pubmed/30498820?tool=bestpractice.com

The term 'sarcopenia' is derived from the Greek words 'sarx' for flesh and 'penia' for loss. Weakness (defined by low grip strength) and a slower than usual gait speed are considered defining characteristics of the condition.[3]Bhasin S, Travison TG, Manini TM, et al. Sarcopenia definition: the position statements of the Sarcopenia Definition and Outcomes Consortium. J Am Geriatr Soc. 2020 Jul;68(7):1410-8. http://www.ncbi.nlm.nih.gov/pubmed/32150289?tool=bestpractice.com Severe sarcopenia is when physical ability (as measured by a standardised test) is also low.[2]Dent E, Morley JE, Cruz-Jentoft AJ, et al. International clinical practice guidelines for sarcopenia (ICFSR): screening, diagnosis and management. J Nutr Health Aging. 2018;22(10):1148-61. http://www.ncbi.nlm.nih.gov/pubmed/30498820?tool=bestpractice.com This topic covers ageing-related sarcopenia.