Sarcopenia in daily practice: assessment and management

Charlotte Beaudart, Eugène McCloskey, Olivier Bruyère, Matteo Cesari, Yves Rolland, René Rizzoli, Islène Araujo de Carvalho, Jotheeswaran Amuthavalli Thiyagarajan, Ivan Bautmans, Marie-Claude Bertière, Maria Luisa Brandi, Nasser M Al-Daghri, Nansa Burlet, Etienne Cavalier, Francesca Cerreta, Antonio Cherubini, Roger Fielding, Evelien Gielen, Francesco Landi, Jean Petermans, Jean-Yves Reginster, Marjolein Visser, John Kanis, Cyrus Cooper, Charlotte Beaudart, Eugène McCloskey, Olivier Bruyère, Matteo Cesari, Yves Rolland, René Rizzoli, Islène Araujo de Carvalho, Jotheeswaran Amuthavalli Thiyagarajan, Ivan Bautmans, Marie-Claude Bertière, Maria Luisa Brandi, Nasser M Al-Daghri, Nansa Burlet, Etienne Cavalier, Francesca Cerreta, Antonio Cherubini, Roger Fielding, Evelien Gielen, Francesco Landi, Jean Petermans, Jean-Yves Reginster, Marjolein Visser, John Kanis, Cyrus Cooper

Abstract

Background: Sarcopenia is increasingly recognized as a correlate of ageing and is associated with increased likelihood of adverse outcomes including falls, fractures, frailty and mortality. Several tools have been recommended to assess muscle mass, muscle strength and physical performance in clinical trials. Whilst these tools have proven to be accurate and reliable in investigational settings, many are not easily applied to daily practice.

Methods: This paper is based on literature reviews performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group on frailty and sarcopenia. Face-to-face meetings were afterwards organized for the whole group to make amendments and discuss further recommendations.

Results: This paper proposes some user-friendly and inexpensive methods that can be used to assess sarcopenia in real-life settings. Healthcare providers, particularly in primary care, should consider an assessment of sarcopenia in individuals at increased risk; suggested tools for assessing risk include the Red Flag Method, the SARC-F questionnaire, the SMI method or different prediction equations. Management of sarcopenia should primarily be patient centered and involve the combination of both resistance and endurance based activity programmes with or without dietary interventions. Development of a number of pharmacological interventions is also in progress.

Conclusions: Assessment of sarcopenia in individuals with risk factors, symptoms and/or conditions exposing them to the risk of disability will become particularly important in the near future.

Keywords: Assessment; Daily practice; Management; Sarcopenia; Tools.

References

    1. Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr. 1997;127:990S–991S.
    1. Muscaritoli M, et al. Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) ‘cachexia-anorexia in chronic wasting diseases’ and ‘nutrition in geriatrics’. Clin Nutr. 2010;29:154–159. doi: 10.1016/j.clnu.2009.12.004.
    1. Cruz-Jentoft AJ, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39:412–423. doi: 10.1093/ageing/afq034.
    1. Fielding RA, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011;12:249–256. doi: 10.1016/j.jamda.2011.01.003.
    1. Dam T-T, et al. An evidence-based comparison of operational criteria for the presence of sarcopenia. J Gerontol A Biol Sci Med Sci. 2014;69:584–590. doi: 10.1093/gerona/glu013.
    1. Morley JE, et al. Sarcopenia with limited mobility: an International Consensus. J Am Med Dir Assoc. 2011;12:403–409. doi: 10.1016/j.jamda.2011.04.014.
    1. Studenski SA, et al. The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci. 2014;69:547–558. doi: 10.1093/gerona/glu010.
    1. Baumgartner RN, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998;147:755–763. doi: 10.1093/oxfordjournals.aje.a009520.
    1. Cooper C, et al. Frailty and sarcopenia: definitions and outcome parameters. Osteoporos Int. 2012;23:1839–1848. doi: 10.1007/s00198-012-1913-1.
    1. Chen L-K, et al. Sarcopenia in Asia: Consensus Report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014;15:95–101. doi: 10.1016/j.jamda.2013.11.025.
    1. Cruz-Jentoft AJ. et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing. 2014. doi:10.1093/ageing/afu115
    1. Bischoff-Ferrari HA, et al. Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older. Osteoporos Int. 2015
    1. Beaudart C, Rizzoli R, Bruyere O, Reginster JY, Biver E. Sarcopenia: Burden and challenges for Public Health. 2014. Archives of Public Health. Arch Public Heal. 2014;72:45. doi: 10.1186/2049-3258-72-45.
    1. Rizzoli R, et al. Quality of life in sarcopenia and frailty. Calcif Tissue Int. 2013;93:101–120. doi: 10.1007/s00223-013-9758-y.
    1. Lauretani F, et al. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol. 2003;95:1851–1860. doi: 10.1152/japplphysiol.00246.2003.
    1. Visser M, Schaap LA. Consequences of sarcopenia. Clin Geriatr Med. 2011;27:387–399. doi: 10.1016/j.cger.2011.03.006.
    1. Lang T, et al. Sarcopenia: etiology, clinical consequences, intervention, and assessment. Osteoporos Int. 2010;21:543–559. doi: 10.1007/s00198-009-1059-y.
    1. Landi F, et al. Sarcopenia and frailty: From theoretical approach into clinical practice. 2016.
    1. Landi F, et al. Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study. Clin Nutr. 2012;31:652–658. doi: 10.1016/j.clnu.2012.02.007.
    1. Denison HJ, Cooper C, Sayer AA, Robinson SM. Prevention and optimal management of sarcopenia: a review of combined exercise and nutrition interventions to improve muscle outcomes in older people. Clin Interv Aging. 2015;10:859–869.
    1. Molfino A, Gioia G, Rossi Fanelli F, Muscaritoli M. Beta-hydroxy-beta-methylbutyrate supplementation in health and disease: a systematic review of randomized trials. Amino Acids. 2013;45:1273–1292. doi: 10.1007/s00726-013-1592-z.
    1. Devries MC, Phillips SM. Creatine supplementation during resistance training in older adults-a meta-analysis. Med Sci Sports Exerc. 2014;46:1194–1203. doi: 10.1249/MSS.0000000000000220.
    1. Cooper C, et al. Tools in the assessment of sarcopenia. Calcif Tissue Int. 2013;93:201–210. doi: 10.1007/s00223-013-9757-z.
    1. Mijnarends DM, et al. Validity and reliability of tools to measure muscle mass, strength, and physical performance in community-dwelling older people: a systematic review. J Am Med Dir Assoc. 2013;14:170–178. doi: 10.1016/j.jamda.2012.10.009.
    1. Hiligsmann M, et al. A reference case for economic evaluations in osteoarthritis: An expert consensus article from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) Semin Arthritis Rheum. 2014;44:271–282. doi: 10.1016/j.semarthrit.2014.06.005.
    1. Rizzoli R, et al. The role of dietary protein and vitamin D in maintaining musculoskeletal health in postmenopausal women: a consensus statement from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) Maturitas. 2014;79:122–132. doi: 10.1016/j.maturitas.2014.07.005.
    1. Bruyère O, et al. An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: a report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) Semin Arthritis Rheum. 2014;44:253–263. doi: 10.1016/j.semarthrit.2014.05.014.
    1. Rizzoli R, et al. Management of osteoporosis of the oldest old. Osteoporos Int. 2014;25:2507–2529. doi: 10.1007/s00198-014-2755-9.
    1. Arden N, et al. Can We Identify Patients with High Risk of Osteoarthritis Progression Who Will Respond to Treatment? A Focus on Biomarkers and Frailty. Drugs Aging. 2015;32:525–535. doi: 10.1007/s40266-015-0276-7.
    1. Cooper C, et al. How to define responders in osteoarthritis. Curr Med Res Opin. 2013;29:719–729. doi: 10.1185/03007995.2013.792793.
    1. Rizzoli R, et al. Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) Curr Med Res Opin. 2013;29:305–313. doi: 10.1185/03007995.2013.766162.
    1. Kaufman J-M, et al. Treatment of osteoporosis in men. Bone. 2013;53:134–144. doi: 10.1016/j.bone.2012.11.018.
    1. Rizzoli R, et al. Guidance for the prevention of bone loss and fractures in postmenopausal women treated with aromatase inhibitors for breast cancer: an ESCEO position paper. Osteoporos Int. 2012;23:2567–2576. doi: 10.1007/s00198-011-1870-0.
    1. Reginster J-Y, et al. Recommendations for an update of the 2010 European regulatory guideline on clinical investigation of medicinal products used in the treatment of osteoarthritis and reflections about related clinically relevant outcomes: expert consensus statement. Osteoarthritis Cartilage. 2015
    1. Reginster J-Y, et al. Recommendations for the conduct of clinical trials for drugs to treat or prevent sarcopenia. Aging Clin Exp Res. 2015;28:47–58. doi: 10.1007/s40520-015-0517-y.
    1. Hunter S, White M, Thompson M. Techniques to evaluate elderly human muscle function: a physiological basis. J Gerontol Biol Sci. 1998;53:2–4.
    1. Beaudart C, et al. Estimation of sarcopenia prevalence using various assessment tools. Exp Gerontol. 2014;61C:31–37.
    1. Cavalier E, Beaudart C, Buckinx F, Bruyère O, Reginster J-Y. Critical analytical evaluation of promising markers for sarcopenia. 2015.
    1. Mitsiopoulos N, et al. Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol. 1998;85:115–122.
    1. Levine JA, et al. Measuring leg muscle and fat mass in humans: comparison of CT and dual-energy X-ray absorptiometry. J Appl Physiol. 2000;88:452–456.
    1. Visser M, Fuerst T, Lang T, Salamone L, Harris TB. Validity of fan-beam dual-energy X-ray absorptiometry for measuring fat-free mass and leg muscle mass. Health, Aging, and Body Composition Study--Dual-Energy X-ray Absorptiometry and Body Composition Working Group. J Appl Physiol. 1999;87:1513–1520.
    1. Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc. 2002;50:889–896. doi: 10.1046/j.1532-5415.2002.50216.x.
    1. Rush EC, Freitas I, Plank LD. Body size, body composition and fat distribution: comparative analysis of European, Maori, Pacific Island and Asian Indian adults. Br J Nutr. 2009;102:632–641. doi: 10.1017/S0007114508207221.
    1. Bruyère O, et al. Assessment of muscle mass, muscle strength and physical performance in clinical practice: An international survey. Eur Geriatr Med. 2016;7:243–246. doi: 10.1016/j.eurger.2015.12.009.
    1. Landi F, et al. Midarm muscle circumference, physical performance and mortality: results from the aging and longevity study in the Sirente geographic area (ilSIRENTE study) Clin Nutr. 2010;29:441–447. doi: 10.1016/j.clnu.2009.12.006.
    1. Landi F, et al. Calf circumference, frailty and physical performance among older adults living in the community. Clin Nutr. 2014;33:539–544. doi: 10.1016/j.clnu.2013.07.013.
    1. Rolland Y, et al. Sarcopenia, calf circumference, and physical function of elderly women: a cross-sectional study. J Am Geriatr Soc. 2003;51:1120–1124. doi: 10.1046/j.1532-5415.2003.51362.x.
    1. Heymsfield SB, McManus C, Smith J, Stevens V, Nixon DW. Anthropometric measurement of muscle mass: revised equations for calculating bone-free arm muscle area. Am J Clin Nutr. 1982;36:680–690.
    1. Kulkarni B, et al. Development and validation of anthropometric prediction equations for estimation of lean body mass and appendicular lean soft tissue in Indian men and women. J Appl Physiol. 2013;115:1156–1162. doi: 10.1152/japplphysiol.00777.2013.
    1. Yu S, et al. An anthropometric prediction equation for appendicular skeletal muscle mass in combination with a measure of muscle function to screen for sarcopenia in primary and aged care. J Am Med Dir Assoc. 2015;16:25–30. doi: 10.1016/j.jamda.2014.06.018.
    1. Villani AM, et al. Appendicular skeletal muscle in hospitalised hip-fracture patients: development and cross-validation of anthropometric prediction equations against dual-energy X-ray absorptiometry. Age Ageing. 2014;43:857–862. doi: 10.1093/ageing/afu106.
    1. Reiss J, et al. Case finding for sarcopenia in geriatric inpatients: performance of bioimpedance analysis in comparison to dual X-ray absorptiometry. BMC Geriatr. 2016;16:52. doi: 10.1186/s12877-016-0228-z.
    1. Kim M, Kim H. Accuracy of segmental multi-frequency bioelectrical impedance analysis for assessing whole-body and appendicular fat mass and lean soft tissue mass in frail women aged 75 years and older. Eur J Clin Nutr. 2013;67:395–400. doi: 10.1038/ejcn.2013.9.
    1. Kim M, Shinkai S, Murayama H, Mori S. Comparison of segmental multifrequency bioelectrical impedance analysis with dual-energy X-ray absorptiometry for the assessment of body composition in a community-dwelling older population. Geriatr Gerontol Int. 2015;15:1013–1022. doi: 10.1111/ggi.12384.
    1. Buckinx F, et al. Concordance between muscle mass assessed by bioelectrical impedance analysis and by dual energy X-ray absorptiometry: a cross-sectional study. BMC Musculoskelet Disord. 2015;16:60. doi: 10.1186/s12891-015-0510-9.
    1. Stevens PJ, et al. Is grip strength a good marker of physical performance among community-dwelling older people? J Nutr Heal Aging. 2012;16:769–774. doi: 10.1007/s12603-012-0388-2.
    1. Bohannon RW, Magasi SR, Bubela DJ, Wang Y-C, Gershon RC. Grip and knee extension muscle strength reflect a common construct among adults. Muscle Nerve. 2012;46:555–558. doi: 10.1002/mus.23350.
    1. Roberts HC, et al. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 2011;40:423–429. doi: 10.1093/ageing/afr051.
    1. Bean JF, et al. The relationship between leg power and physical performance in mobility-limited older people. J Am Geriatr Soc. 2002;50:461–467. doi: 10.1046/j.1532-5415.2002.50111.x.
    1. Dodds RM, et al. Grip strength across the life course: normative data from twelve British studies. PLoS One. 2014;9:e113637. doi: 10.1371/journal.pone.0113637.
    1. Anjum SN, Choudary P, Dimri R, Ankarath S. Comparative evaluation of grip and pinch strength in an Asian and European population. Hand Ther. 2012;17:11–14. doi: 10.1258/ht.2011.011023.
    1. Brown M, Sinacore DR, Binder EF, Kohrt WM. Physical and performance measures for the identification of mild to moderate frailty. J Gerontol A Biol Sci Med Sci. 2000;55:M350–M355. doi: 10.1093/gerona/55.6.M350.
    1. Callahan D, Phillips E, Carabello R, Frontera WR, Fielding RA. Assessment of lower extremity muscle power in functionally-limited elders. Aging Clin Exp Res. 2007;19:194–199. doi: 10.1007/BF03324689.
    1. Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999;70:113–119. doi: 10.1080/02701367.1999.10608028.
    1. Karpman C, Lebrasseur NK, Depew ZS, Novotny PJ, Benzo RP. Measuring gait speed in the out-patient clinic: methodology and feasibility. Respir Care. 2014;59:531–537. doi: 10.4187/respcare.02688.
    1. National Institute on Aging, Laboratory of Epidemiology, Demography, and Biometry. .
    1. Bean JF, Kiely DK, LaRose S, Alian J, Frontera WR. Is Stair Climb Power a Clinically Relevant Measure of Leg Power Impairments in At-Risk Older Adults? Arch Phys Med Rehabil. 2007;88:604–609. doi: 10.1016/j.apmr.2007.02.004.
    1. Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev. 1996;54:S59–S65. doi: 10.1111/j.1753-4887.1996.tb03793.x.
    1. Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc. 2013;14:531–532. doi: 10.1016/j.jamda.2013.05.018.
    1. Woo J, Leung J, Morley JE. Validating the SARC-F: a suitable community screening tool for sarcopenia? J Am Med Dir Assoc. 2014;15:630–634. doi: 10.1016/j.jamda.2014.04.021.
    1. Goodman MJ, et al. Development of a practical screening tool to predict low muscle mass using NHANES 1999–2004. J Cachexia Sarcopenia Muscle. 2013;4:187–197. doi: 10.1007/s13539-013-0107-9.
    1. Visvanathan R, et al. Appendicular skeletal muscle mass: development and validation of anthropometric prediction equations. 2012.
    1. Ishii S, et al. Development of a simple screening test for sarcopenia in older adults. Geriatr Gerontol Int. 2014;14(Suppl 1):93–101. doi: 10.1111/ggi.12197.
    1. Sayer AA, et al. Type 2 Diabetes, Muscle Strength, and Impaired Physical Function: The tip of the iceberg? Diabetes Care. 2005;28:2541–2542. doi: 10.2337/diacare.28.10.2541.
    1. Reginster J-Y, Beaudart C, Buckinx F, Bruyère O. Osteoporosis and sarcopenia: two diseases or one? Curr Opin Clin Nutr Metab Care. 2015
    1. Kalyani RR, Corriere M, Ferrucci L. Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol. 2014;2:819–829. doi: 10.1016/S2213-8587(14)70034-8.
    1. Peterson MD, Sen A, Gordon PM. Influence of resistance exercise on lean body mass in aging adults: a meta-analysis. Med Sci Sport Exerc. 2011;43:249–258. doi: 10.1249/MSS.0b013e3181eb6265.
    1. Sahni S, Mangano KM, Hannan MT, Kiel DP, McLean RR. Higher Protein Intake Is Associated with Higher Lean Mass and Quadriceps Muscle Strength in Adult Men and Women. J Nutr. 2015;145:1569–1575. doi: 10.3945/jn.114.204925.
    1. Genaro Pde S, Pinheiro Mde M, Szejnfeld VL, Martini LA. Dietary protein intake in elderly women: association with muscle and bone mass. Nutr Clin Pract. 2015;30:283–9.
    1. Bauer J, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14:542–559. doi: 10.1016/j.jamda.2013.05.021.
    1. Deer RR, Volpi E. Protein intake and muscle function in older adults. Curr Opin Clin Nutr Metab Care. 2015;18:248–253. doi: 10.1097/MCO.0000000000000162.
    1. Gryson C, et al. Four-month course of soluble milk proteins interacts with exercise to improve muscle strength and delay fatigue in elderly participants. J Am Med Dir Assoc. 2014;15:958.e1–9. doi: 10.1016/j.jamda.2014.09.011.
    1. Finger D, et al. Effects of protein supplementation in older adults undergoing resistance training: a systematic review and meta-analysis. Sports Med. 2015;45:245–255. doi: 10.1007/s40279-014-0269-4.
    1. Beaudart C. et al. The effects of vitamin D on skeletal muscle strength, muscle mass and muscle power: a systematic review and meta-analysis of randomized controlled trials. J Clin Endocrinol Metab jc20141742 (2014). doi:10.1210/jc.2014-1742

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