Clinical Interventions in Aging (Feb 2024)
Obstacles to the Early Diagnosis and Management of Sarcopenia: Current Perspectives
Abstract
Hoyli Ooi,1 Carly Welch1,2 1Department of Ageing and Health, Guy’s and St Thomas’ NHS Foundation Trust, St Thomas’ Hospital, London, UK; 2Department of Twin Research and Genetic Epidemiology, School of Life Course and Population Sciences, St Thomas’ Campus, King’s College London, London, UKCorrespondence: Carly Welch, Department of Twin Research & Genetic Epidemiology King’s College London, St Thomas’ Campus 3rd & 4th Floor South Wing Block D Westminster Bridge Road, London, SE1 7EH, UK, Tel +44 (0) 20 7188 6765, Email [email protected]: Research in sarcopenia has grown exponentially over the last 15 years in geriatrics and gerontology, as well as other specialties, including oncology and hepatology. There is now strong evidence for the role of resistance exercise to prevent declines in muscle strength and function, especially when combined with nutritional optimization with protein supplementation. However, there remains a disparity between research evidence and clinical practice. There are multiple factors for this, which relate to the current diagnostic criteria for sarcopenia, practical and logistical aspects of diagnosis of sarcopenia, clinician knowledge of both diagnosis and management, and the availability of pathways for interventions. Sarcopenia is currently defined based on the identification of muscle strength, in combination with muscle size or quality, below cut-off thresholds at a single timepoint. This defines sarcopenia as a binary process of either present or not present, thus early diagnosis can be challenging. In this article, we summarize current obstacles to early diagnosis and management of sarcopenia in clinical practice, and make recommendations to how these might be overcome. This includes our recommendation of incorporation of handgrip strength measurement into standard care, to enable dynamic assessment and identification of early declines in handgrip strength, so that interventions can be implemented to prevent disability.Keywords: EWGSOP2, dynamic change, handgrip strength, implementation, exercise
