Singapore Clinical Practice Guidelines for Sarcopenia: Screening, Diagnosis, Management, and Prevention

Abstract

Sarcopenia refers to the age-associated progressive and generalised loss of skeletal muscle mass plus loss of muscle strength and/or reduced physical performance. Despite its importance, sarcopenia often remains unrecognised and inadequately managed in routine clinical care. A workgroup was convened by the Chapter of Geriatricians and the Society for Geriatric Medicine Singapore to develop the first-ever country-specific CPG for sarcopenia. The workgroup developed 20 evidence-based recommendations that aim to facilitate adoption of the Asian Working Group for Sarcopenia (AWGS) 2019 consensus into current practice in Singapore. The CPG recommends a case-finding approach in atrisk older adults using validated case-finding tools. Screen-positive individuals should be assessed for “possible sarcopenia” and underlying causes. For diagnosis, the CPG recommends using the AWGS 2019 algorithm, and when necessary, dual-energy X-ray absorptiometry to determine low lean mass for a confirmatory diagnosis of sarcopenia. For treatment, the CPG recommends resistance exercises and a quality protein-rich diet/protein supplementation, with Vitamin D supplementation for insufficiency (<30 micrograms/L). For prevention, the CPG recommends regular resistance-based physical activity and adequate protein intake (≥1.0g/kg bodyweight). We encourage more research to address local evidence gaps. It is hoped that this first country-specific CPG for sarcopenia will play a big role in facilitating the adoption of the AWGS 2019 consensus into current practice in Singapore.