Harnish Patel is a Consultant Geriatrician and Honorary Clinical Senior Lecturer, University of Southampton.
Sarcopenia, the loss of skeletal muscle mass and function with age is now recognised as a major clinical problem for older people. Sarcopenia is common and associated with serious health consequences in terms of frailty, disability, morbidity and mortality, not forgetting the high health care costs which have run into billions of dollars in the USA.
Research in the area is expanding exponentially.The European Working Group on Sarcopenia in Older People (EWGSOP) recently published consensus guidelines on the definition and diagnosis of sarcopenia. This definition was an important development in sarcopenia research and has provided a systematic approach not only in case finding but also in understanding aetiology and developing treatments. Using the working group definitions we have, for the first time, estimated the prevalence of sarcopenia in the UK. In our paper, the prevalence of sarcopenia was estimated to affect 4.6% men and 7.9% women with an average age of 67 years – broadly comparable to international estimates.
It is time to act. Sarcopenia needs to be recognised in clinical practice as well as in research. We found the EWGSOP consensus definition of practical use in identifying the prevalence of sarcopenia among community dwelling older people in the UK. However, pragmatic approaches to the identification of sarcopenia, which do not rely on resource intensive scanning or scarce reference data are required to characterise the burden of sarcopenia in a wide range of populations. Incorporation of walking speed and grip strength into routine comprehensive geriatric assessment may well be the direction forward in identifying patients who would need further diagnostic testing i.e. with bioelectrical impedance or DXA. What of those patients who are not ambulant? Does the research and clinical community need a modified diagnostic algorithm to Identify outcomes as well as cut-offs relevant to the population being studied? There are still many unanswered questions however they do lend themselves to a promising future in sarcopenia research.