Tools in the Assessment of Sarcopenia

Abstract

This review provides a framework for the development of an operational definition of sarcopenia and of the potential end points that might be adopted in clinical trials among older adults. While the clinical relevance of sarcopenia is widely recognized, there is currently no universally accepted definition of the disorder. The development of interventions to alter the natural history of sarcopenia also requires consensus on the most appropriate end points for determining outcomes of clinical importance which might be utilized in intervention studies. We review current approaches to the definition of sarcopenia and the methods used for the assessment of various aspects of physical function in older people. The potential end points of muscle mass, muscle strength, muscle power, and muscle fatigue, as well as the relationships between them, are explored with reference to the availability and practicality of the available methods for measuring these end points in clinical trials. Based on current evidence, none of the four potential outcomes in question is sufficiently comprehensive to recommend as a uniform single outcome in randomized clinical trials. We propose that sarcopenia may be optimally defined (for the purposes of clinical trial inclusion criteria as well as epidemiological studies) using a combination of measures of muscle mass and physical performance. The choice of outcome measures for clinical trials in sarcopenia is more difficult; co-primary outcomes, tailored to the specific intervention in question, may be the best way forward in this difficult but clinically important area.

Sarcopenia

“…As we move on to considering treatments for sarcopenia, it is worth noting that a further application of the EWGSOP algorithm is as the inclusion criteria for intervention studies. The question of what outcome measures should be used in such studies is less clear, however (25).…”

“…Growth hormone has been shown to increase muscle mass but not clearly alter functional outcomes and is therefore of questionable benefit. This highlights the challenge of choosing outcome measure(s) for trials in sarcopenia (25). Testosterone supplementation has been found to increase both muscle mass and strength in men but has now been linked to adverse cardio-vascular events (46).…”

The mortality determinants of sarcopenia and comorbidities in hospitalized geriatric patients

“…Since then, a revolution in the concept of the definition of sarcopenia had been set [3][4][5] . Several international research groups, including the European Working Group on Sarcopenia in Older People (EWGSOP), use these three determinants to present their clinical definition for the diagnosis of sarcopenia 6,7 . Unfortunately, these groups all use their own diagnostic criteria and cut off values.…”

Relationship Between Arthritis And Muscular Strength In Older Women With Symptoms Of Sarcopenia

“…While organizations have various criteria for sarcopenia, muscular strength is often assessed using grip strength test because it is considered a valid measure to predict overall muscular strength [6,[10][11][12]. Using a hand grip dynamometer instead of the current gold standard, isokinetic dynamometry is easier to administer to large populations as it is more portable and compact than an isokinetic dynamometer [11][12][13].…”

“…Using a hand grip dynamometer instead of the current gold standard, isokinetic dynamometry is easier to administer to large populations as it is more portable and compact than an isokinetic dynamometer [11][12][13]. Additionally, grip strength is predictive of health outcomes including frailty, disability, and mortality since naturally, muscular strength declines with age [10,[13][14][15][16][17][18].…”