From the Guidelines
The best way to assess sarcopenia clinically is by using a combination of muscle strength testing, muscle quantity/quality measurement, and physical performance evaluation, with gait speed being a key indicator of sarcopenia, as evidenced by a gait speed of <0.8 m/s indicating poor performance 1. When assessing sarcopenia, it is essential to consider multiple factors, including:
- Muscle strength testing, such as grip strength measurement using a handheld dynamometer, with cutoffs of <20 kg for women and <30 kg for men 1
- Muscle quantity assessment, such as dual-energy X-ray absorptiometry (DXA) to measure appendicular skeletal muscle mass, with cutoffs of <7.26 kg/m2 for men and <5.5 kg/m2 for women 1
- Physical performance tests, such as gait speed, with a cutoff of <0.8 m/s indicating poor performance 1, or the Short Physical Performance Battery, Timed-Up-and-Go test, or 400-meter walk test This comprehensive approach is necessary because sarcopenia affects both muscle quantity and function, with age-related muscle loss often accompanied by increased fat infiltration and decreased muscle quality, as noted in a study published in 2021 1. In clinical practice, the choice of assessment method may depend on availability and patient factors, such as the presence of ascites or edema, which can affect the accuracy of certain measurements, as discussed in a study published in 2020 1. Overall, early detection of sarcopenia allows for timely intervention with resistance training, protein supplementation, and addressing underlying medical conditions that contribute to muscle loss, highlighting the importance of regular assessment and monitoring of muscle health in older adults, as emphasized in a review published in 2023 1.
From the Research
Assessing Sarcopenia Clinically
The best way to assess sarcopenia clinically is a multifaceted approach that includes various measurements. The options provided are:
- A. Bone density assessment
- B. BMI
- C. Skinfold thickness
- D. Gait speed
Recommended Assessment Methods
According to the studies, the following methods are recommended for assessing sarcopenia:
- Gait speed measurement, with a cut-off point of <0.8m/s identifying risk for sarcopenia in community-dwelling older people 2, 3
- Muscle mass assessment using methods such as Dual Energy X-Ray Absorptiometry (DEXA) 3, 4
- Handgrip strength test to assess muscle strength 3, 4
- Physical performance tests, such as the Chair Stand Test 3
Key Findings
The studies suggest that:
- A combination of measures of muscle mass and physical performance is optimal for defining sarcopenia 5
- Gait speed is a useful screening tool for sarcopenia, but muscle strength and muscle mass should also be considered 2
- Resistance exercise and protein supplementation can improve sarcopenia 3
- Aerobic exercise training can improve muscle quality and strength in older adults 6
Clinical Diagnosis
A clinical diagnosis of sarcopenia should be made using a combination of these assessment methods, and management should consist of resistance exercise and adequate protein intake 4.