Diagnosis of sarcopenia in primary health care

Abstract

With aging, there is a loss of skeletal muscle mass and function, which leads to an increased risk of falls, fractures, long-term institutional care, cardiovascular and metabolic diseases, and even mortality. Sarcopenia has been defined as a condition characterized by low muscle mass together with low muscle strength and/or low muscle performance. In 2019, the Asian Working Group for Sarcopenia (AWGS) published a consensus paper on the diagnosis and treatment of sarcopenia. The AWGS 2019 guideline, in particular, presented strategies for case-finding and assessment, which could aid in the diagnosis of possible sarcopenia in primary care settings. AWGS 2019 proposed an algorithm that recommends calf circumference measurement (cut-off <34 cm in men, <33 cm in women) or the SARC-F (strength, assistance in walking, rising from a chair, climbing stairs, falls) questionnaire (cut-off ≥4), followed by handgrip strength measurement (cut-off <28 kg in men, <18 kg in women) or the 5-time chair stand test (≥12 seconds). Finally, “possible sarcopenia” is defined by either low muscle strength (handgrip strength) or low physical performance (5-time chair stand test). This paper will address the way in which sarcopenic patients can be identified and assessed practically in primary care settings.