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Management of sarcopenia depicted as percentages of consulted healthcare professionals for interventions: (a) before attendance (n = 223); (b) directly after attendance (intention to consult) (n = 223) and (c) five months after attendance (data available in n = 60). PT physiotherapist, ET exercise therapist.
Source publication
Objectives
Sarcopenia is an emerging clinical challenge in an ageing population and is associated with serious negative health outcomes. This study aimed to assess the current state of the art regarding the knowledge about the concept of sarcopenia and practice of the diagnostic strategy and management of sarcopenia in a cohort of Dutch healthcare...
Similar publications
Objective:
To assess the association between muscle parameters (mass, strength, physical performance) and activities of daily living (ADL), quality of life (QoL), and health care costs.
Design:
Cross-sectional Maastricht Sarcopenia Study (MaSS).
Setting:
Community-dwelling, assisted-living, residential living facility.
Participants:
227 adul...
Increasing total protein intake and a spread protein intake distribution are potential strategies to attenuate sarcopenia related loss of physical function and quality of life. The aim of this cross-sectional study was to investigate whether protein intake and protein intake distribution are associated with muscle strength, physical function and qu...
Background:
With lean mass declining early in Alzheimer's disease, muscle quality beyond quantity is relevant to physical performance. We sought to identify potentially modifiable factors for the differential loss of muscle mass (pre-sarcopenia) and its performance (sarcopenia) in older adults with mild cognitive impairment (MCI) and mild-to-moder...
Aims/Introduction
Hyperglycemia is a risk factor for sarcopenia when comparing individuals with and without diabetes. However, no studies have investigated whether the findings could be extrapolated to patients with diabetes with relatively higher glycemic levels. Here, we aimed to clarify whether glycemic control was associated with sarcopenia in...
Citations
... Raised awareness among health professionals, adequate training, and availability of equipment to perform the measurements, institutional support, interprofessional collaboration, and financial reimbursement are important factors to prevent lack of diagnosis and lack of interventions for malnutrition and sarcopenia and should be enforced (51,52). Assessment of the Global Malnutrition Composite Score could support institutions to adequately screen for malnutrition, plan therapeutic interventions, and document the findings (53). ...
Objective: To investigate the prevalence of malnutrition and sarcopenia in different disciplines of inpatient rehabilitation and the course of nutritional status parameters. Design: Multi-centre cross-sectional prevalence study and longitudinal observational study. Subjects/Patients: Inpatients (> 18 years) in geriatric, pulmonary, cardiovascular, internal medicine/oncological, musculoskeletal, or neurological rehabilitation in 5 rehabilitation centres were included. Methods: Malnutrition was assessed according to the Global Leadership Initiative on Malnutrition criteria. Sarcopenia was assessed according to the European Working Group on Sarcopenia in Older People criteria. Bodyweight, hand grip strength (HGS), and functional independence measure (FIM) were assessed within 3 days of admission and after 21 days of rehabilitation and analysed using linear mixed models with time*diagnosis interaction. Results: The study included 558 patients (51.8% male, median age 73.0 years). The overall prevalence of malnutrition and sarcopenia was 35.5% (95% CI 31.5, 39.6%) and 32.7% (95% CI 28.8, 36.8%), respectively. Patients with risk of malnutrition lost on average 1.14 kg (95% CI –1.64, –0.63) during rehabilitation. Patients slightly increased their HGS and FIM, irrespective of risk or diagnosis of malnutrition or sarcopenia. However, at the end of the rehabilitation, malnourished or sarcopenic patients had still a significantly lower bodyweight, HGS, and FIM than patients without (p < 0.01). Some 37.3% of patients at risk of and 35.4% with diagnosed -malnutrition did not receive group or individual nutritional -counselling. Conclusion: Malnutrition and sarcopenia are highly prevalent during inpatient rehabilitation. Nevertheless, dietitians are often not involved in the therapy. While nutritional parameters and functional independence improve, patients with malnutrition and sarcopenia remain on a lower level after 3 weeks of rehabilitation. Long-term follow-up after rehabilitation is recommended to prevent nutritional and muscular decline and related negative health outcomes.
... height-adjusted appendicular skeletal muscle mass (also known as Skeletal Muscle mass Index; SMI) measured through techniques like Dual-energy X-ray Absorptiometry (DXA) [7] or Bioelectrical Impedance Analysis (BIA) [8,9], muscle strength is assessed through handgrip strength [10], and physical performance is quantitatively evaluated using tests such as the Short Physical Performance Battery (SPPB) [11,12], usual gait speed, 6-minute walk test, or Timed Up and Go (TUG) test [2,13]. However, a survey conducted in Australia and New Zealand revealed that in reality, the accessibility to such evaluation methods is often limited due to the restricted availability of expensive equipment [14,15]. Another drawback can be people who cannot properly perform the tasks required for assessment because of immobilization, life-threatening illnesses or consciousness problems from sedative medications do not even get a chance to be diagnosed [16][17][18]. ...
Sarcopenia is a rapidly rising health concern in the fast-aging countries, but its demanding diagnostic process is a hurdle for making timely responses and devising active strategies. To address this, our study developed and evaluated a novel sarcopenia diagnosis system using Stimulated Muscle Contraction Signals (SMCS), aiming to facilitate rapid and accessible diagnosis in community settings. We recruited 199 adults from Wonju Severance Christian Hospital between July 2022 and October 2023. SMCS data were collected using surface electromyography sensors with the wearable device exoPill. Their skeletal muscle mass index, handgrip strength, and gait speed were also measured as the reference. Binary classification models were trained to classify each criterion for diagnosing sarcopenia based on the AWGS cutoffs. The binary classification models achieved high discriminative abilities with an AUC score near 0.9 in each criterion. When combining these criteria evaluations, the proposed sarcopenia diagnosis system performance achieved an accuracy of 89.4% in males and 92.4% in females, sensitivities of 81.3% and 87.5%, and specificities of 91.0% and 93.8%, respectively. This system significantly enhances sarcopenia diagnostics by providing a quick, reliable, and non-invasive method, suitable for broad community use. The promising result indicates that SMCS contains extensive information about the neuromuscular system, which could be crucial for understanding and managing muscle health more effectively. The potential of SMCS in remote patient care and personal health management is significant, opening new avenues for non-invasive health monitoring and proactive management of sarcopenia and potentially other neuromuscular disorders.
... A questionnaire was developed and adapted for Israeli PTs, incorporating newly formulated questions alongside translated items from four existing English-language questionnaires previously used in studies on sarcopenia and malnutrition [17,19,20,26]. The newly formulated questions were based on recommendations from international working groups [2,3] and recent studies on malnutrition and sarcopenia syndrome [1,[27][28][29]. ...
... This highlights a significant knowledge gap among the surveyed PTs. These results are notably lower compared to those reported in previous studies, where 76.8-96% of PTs correctly identified the definition of sarcopenia [17,19]. These discrepancies may stem from differences in study populations and assessment tools, and the absence of a universally standardized definition of sarcopenia [32]. ...
... This disparity may reflect the delegation of malnutrition care to dietitians, as only 9.2% of PTs felt responsible for managing malnutrition. These findings align with Reijnierse et al. (2017), who found that 59.9% of PTs collaborated in sarcopenia management, mainly with dietitians (87%); and with Reinders et al. (2022), who highlighted limited collaboration in malnutrition care due to unclear role definitions [16,19]. ...
Background/objectives: Malnutrition and sarcopenia are interrelated health concerns among the elderly. Each condition is associated with increased mortality, morbidity, rehospitalization rates, longer hospital stays, higher healthcare costs, and reduced quality of life. Their combination leads to the development of “Malnutrition–Sarcopenia Syndrome” (MSS), characterized by reductions in body weight, muscle mass, strength, and physical function. Despite being preventable and reversible through nutritional and physical interventions, the clinical competence of physical therapists (PTs) in managing MSS remains underexplored. This study aims to assess the clinical competency of PTs in MSS management. Methods: An anonymous cross-sectional survey was conducted from January to August 2024 among 337 certified PTs in Israel, using the “Qualtrics” platform. The survey assessed prior familiarity with MSS concepts, MSS knowledge levels, screening and treatment skills, attitudes and beliefs toward MSS management, and interprofessional collaboration practices. Results: While 52% of PTs were familiar with MSS, familiarity with diagnostic guidelines was low (EWGSOP2: 3.6%; GLIM: 0.6%). The MSS knowledge score was moderate, but screening and treatment skills were low. Attitudes toward MSS management were moderately positive, but self-belief in diagnosing and treating MSS was low. Interprofessional collaboration was limited, particularly in malnutrition care. PTs familiar with MSS had higher knowledge, better skills, more positive attitudes and beliefs, and greater interprofessional collaboration. Conclusions: Significant gaps exist in the clinical competency of Israeli PTs in MSS management. Integrating MSS content into physical therapy curricula and providing continuing professional development are necessary to enhance competencies. Equipping PTs with essential tools, clarifying roles, and promoting interprofessional collaboration can optimize MSS management and improve patient outcomes.
... In total, 2925 HCP participants were included. Two studies used similar methods in evaluating the impact of a professional training event termed "the Sarcopenia Roadshow" with follow-up surveys conducted months later to investigate change in practice and assess knowledge attrition [26,27]. The other studies were crosssectional, most using online surveys, analysed quantitatively, to compare knowledge and attitudes between specialities [28], and across healthcare settings or cadres [29]. ...
... -Geriatric Medicine Interviewee [25] 2007)." [26] 6 papers, 7 references System factors as "barriers" ...
... Clearly, financial aspects such as the acquisition of even a relatively cheap bioelectrical impedance analysis (BIA) device, creates huge barriers for implementation." [26] 5 papers, 9 themes ...
Rationale and objective
Perceptions of sarcopenia have rarely been explored, yet understanding these will be key for successful translation of sarcopenia research findings into meaningful benefits for patients and the public. This scoping review aimed to explore how sarcopenia is perceived amongst patients, health and care professionals (HCP), and the public in different countries.
Methods
Seven electronic databases were searched from inception up to December 2023 with no geographical or language limitations. Studies were included if they were peer-reviewed research of any design where the focus related to perceptions of sarcopenia. Studies using alternative descriptors only, such as “skeletal muscle weakness/loss” were excluded. Study characteristics were charted, and thematic synthesis conducted.
Results
Following independent screening of 11,533 records, 20 articles were included in this review representing 19 countries. Five studies focused on patient perceptions, 11 investigated HCP, and four the public. Three key themes were identified: (1) Low awareness of sarcopenia—among all groups, its nature as a disease was contested. (2) The “know-do” gap in healthcare—even where knowledge among HCP existed, this had not translated into clinical practice, in part, due to perceptions of sarcopenia and its management. (3) Experiencing weakness—living with sarcopenia had physical and psychological sequalae.
Key conclusions
These findings reveal perceptions that may be contributing to the slow adoption of sarcopenia prevention, screening, diagnosis, and management. Addressing these areas has the potential to aid translation of sarcopenia research findings into improved clinical care and benefits for patients and the public.
... 10,16,17 To promote early clinical detection and treatment of patients having or at risk for sarcopenia, the European Working Group on Sarcopenia in Older People (EWGSOP2) presented consensus definitions for sarcopenia, characterizing probable sarcopenia by low muscle strength, confirmed sarcopenia by the presence of low muscle mass, and severe sarcopenia as the combination of low muscle strength, mass, and physical performance parameters. 2 However, patients with sarcopenia often go undetected in busy clinical practices. 18 First, sarcopenia diagnosis requires measuring muscle mass, strength, and performance, 1,2,18 necessitating access to specialized equipment to measure muscle mass, such as magnetic resonance imaging (MRI), computed tomography (CT), or whole-body dual-energy x-ray absorptiometry (DXA), or dynamometry to measure grip strength. In addition, some tests such as gait speed require available space and time for assessment. ...
... The muscle mass measurement exams are not easily incorporated into routine office clinical practice, where primary providers have time-limited clinical encounters, and sometimes limited knowledge of sarcopenia and of its assessment through objective measures (e.g., grip strength). 18 Sarcopenia did not have an ICD code until 2016. 19 The previous research 20 combines natural language processing (NLP) techniques based on key words and phrases with expert review of text terms from clinical notes supporting sarcopenia (as well as cachexia and frailty, which can be related to sarcopenia) along with ICD codes, to identify patients with sarcopenia in the EHR. ...
... 21 The testing includes grip strength, 3,22 repeat chair stand test, 22 gait speed, 23 muscle strength, 24 Short Physical Performance Battery (SPPB), 4,5 and appendicular skeletal muscle mass adjusted for height in meters-squared (ASM/m 2 ) as measured by dual-energy X-ray absorptiometry (DXA). 1 Each test has a criteria threshold to identify sarcopenia. Patients were classified using definitions and thresholds for sarcopenia from the EWGSOP2 guidelines, 18 applied as in the previous publication 21 (See also Supplemental methods). For the current analysis, if a patient met one or more of the criteria test thresholds for sarcopenia, the patient was categorized as having sarcopenia, otherwise, the patient was categorized as a control. ...
Background: Patients with sarcopenia often go undetected in busy clinical practices since the muscle measurements are not easily incorporated into routine clinical practice. The current research fills the gap by utilizing unstructured clinical notes combined with structured data from electronic health records (EHR), to increase sarcopenia detection. Methods: We developed and evaluated four approaches to first extract clinical note features, then integrate with structured data for sarcopenia detection models. Case studies were used to demonstrate the interpretation of the results and show the important association between predictors and outcomes. Results: Out of 1304 participants, 1055 were controls, 249 met at least one criterion for Sarcopenia. The best performing model which incorporated both data-driven and knowledge-driven approaches to integrate clinical note features demonstrated a higher mean area under the curve (AUC = 73.93%, (95% CI, 73.83-74.02)) compared to the baseline model (AUC 71.59%, (95%CI, 71.56-71.61)). The case study shows that the important clinical note predictors may contribute to detection of sarcopenia such as “cane”, “walker”, “unsteady”, etc. Conclusions: Incorporating clinical note features in sarcopenia detection models can identify a greater number of patients at risk for sarcopenia, potentially leading to targeted muscle testing assessments and corresponding treatments to address sarcopenia.
... Por lo anterior, es necesario que los profesionales de la salud tengan una adecuada comprensión del rol que cumple la FM en el estado de salud, así como sus implicaciones en el tratamiento y el pronóstico de diferentes condiciones. Sin embargo, el Sarcopenia Road Show mostró un bajo conocimiento sobre FM; por ejemplo, sólo el 2% de los profesionales sanitarios reconocían los puntos de corte para determinar baja FP 13,14 . Además, se ha demostrado que las principales barreras para la evaluación rutinaria de la FM son la falta de conciencia, la disponibilidad de equipos de medición y las limitaciones de tiempo 13,14 . ...
... Sin embargo, el Sarcopenia Road Show mostró un bajo conocimiento sobre FM; por ejemplo, sólo el 2% de los profesionales sanitarios reconocían los puntos de corte para determinar baja FP 13,14 . Además, se ha demostrado que las principales barreras para la evaluación rutinaria de la FM son la falta de conciencia, la disponibilidad de equipos de medición y las limitaciones de tiempo 13,14 . El presente estudio evaluó el conocimiento sobre FM como factor de riesgo de múltiples eventos adversos para la salud, su medición y la educación recibida sobre este tema entre proveedores de salud médicos y no médicos en Colombia. ...
... Este tipo de estudios se han realizado en países de alto ingresos y han mostrado resultados similares. El Sarcopenia Roadshow, un programa de educación continua realizado en los Países Bajos, Australia y Nueva Zelanda, fue diseñado para fortalecer las estrategias de diagnóstico y manejo de la sarcopenia 13,14 . En Australia y Nueva Zelanda se reportó que un alto porcentaje de los participantes encuestados tenían conceptos sobre el diagnostico con FM, 81,4%. ...
Introduction: Low muscle strength is a risk factor for various health conditions such as cardiometabolic diseases, neurodegenerative syndromes and mortality. Objective: Evaluate the knowledge of muscle strength in health professionals in Colombia. Materials and Methods: An analytical cross-sectional study was conducted in health professionals attending two continuing medical education events. Three components were evaluated through a questionnaire: identification of muscle strength as a risk factor for health conditions, measurement of muscle strength and education in muscle strength. Results: 501 participants (52.49% women) were evaluated. Of these, 53.89% (n=270) were general practitioners, 18.16% (n=91) specialists and 6.18% (n=31) nurses. The association between low muscle strength and cardiometabolic diseases was identified by 56.67% (n=153) of general practitioners and 41.94% (n=13) of nurses. The indication for measuring muscle strength in older adults was recognized by 86.81% (n=79) of specialist physicians and 41.94% (n=13) of nurses. 32.93% (n=165) of the participants were aware of some method for measurement. Physiotherapists were the group that mostly reported measuring muscle strength by 83.33% (n=20). Only 29.03% (n=9) of the nurses had received academic information on muscle strength. Discussion and Conclusions: This study demonstrates the lack of knowledge on low muscle strength, its association with health conditions and measurement methods, and the lack of information about published literature on the subject. Educational interventions are needed to incorporate muscular strength evaluation into the clinical practice.
... Given the limited time available per patient visit, primary care clinicians must assess the likelihood of ALSMM in patients before considering referral for further diagnosis and treatment. In addition, a lack of awareness of ALSMM as a distinct disease among clinicians heightens the risk of overlooked diagnoses [9]. Effectively addressing this challenge necessitates a comprehensive understanding of the characteristics of critical potential predictive indicators associated with early detection and prevention [10]. ...
... Since muscle power declines earlier and more rapidly than muscle strength and mass, it should be considered an important complementary measure in daily clinical practice, as it could potentially detect earlier functional impairment and health-related adverse outcomes than current sarcopenia measures. Considering that most health care professionals do not diagnose sarcopenia, mainly due to lack of equipment and time constraints [43][44][45], measuring muscle power using an affordable instrument could potentially reduce the incidence of adverse health-related consequences, inform about prognosis, and reduce health care cost. Moreover, engaging mobile applications enhance evaluation by providing positive experiences and boosting motivation. ...
Objectives: To analyze the associations between the different operational definitions of sarcopenia published in the last decade and reduced muscle power with a set of adverse health-related outcomes, such as comorbidities, depression, polypharmacy, self-perceived health, educational attainment, socioeconomic status, falls, and hospitalizations in Spanish community-dwelling older adults. Methods: A total of 686 community-dwelling older adults (median age: 72; women: 59.2%; physically active: 84%) were included in this cross-sectional analysis (ClinicalTrials.gov: NCT05148351). Sarcopenia was assessed using the FNIH, EWGSOP2, AWGS, and SDOC algorithms. Reduced muscle power was defined as the lowest sex-specific tertile and measured during the rising phase of the sit-to-stand test using a validated mobile application. Unadjusted and adjusted logistic regressions by potential confounders were performed to identify the association between sarcopenia and reduced muscle power with health-related outcomes. Results: Sarcopenia prevalence was 3.4%, 3.8%, 12.4%, and 21.3% according to the SDOC, FNIH, EWGSOP2, and AWGS, respectively. Among these definitions, moderate and large associations with health-related outcomes were observed for EWGSOP2 and SDOC, respectively, but few associations were found for FNIH and AWGS criteria. Reduced muscle power was associated more frequently and moderately with health-related outcomes compared to sarcopenia definitions. These associations remained constant after adjusting for confounders. Conclusions: The prevalence and impact of sarcopenia varied depending on the definitions used. Among the sarcopenia definitions, the SDOC exhibited the strongest associations, while reduced muscle power was the variable most frequently associated with health-related outcomes compared to any of the four sarcopenia definitions in well-functioning and physically active community-dwelling older adults.
... A study in the Netherlands reported limited knowledge of sarcopenia but a relatively good willingness to participate in treatment and prevention among communitydwelling adults (Van Ancum et al., 2020). Studies also reported a limited KAP among healthcare providers (Lu et al., 2023;Reijnierse et al., 2017;Silva et al., 2020). ...
... Of note, healthcare providers are a primary source of health-related knowledge for many patients (Alduraywish et al., 2020;Swoboda et al., 2018). The KAP of healthcare providers was not examined in the present study, but previous studies indicated that the KAP toward sarcopenia of healthcare providers in other countries was relatively poor (Lu et al., 2023;Reijnierse et al., 2017;Silva et al., 2020). A review of six papers showed that healthcare providers have a low awareness of sarcopenia, which could be detrimental to the prompt diagnosis and management of sarcopenia (Yao et al., 2022). ...
Objective
To explore the knowledge, attitudes, and practice (KAP) towards sarcopenia among older adults in Zhejiang province, China.
Methods
This cross-sectional study was conducted between April 2023 and January 2024 among older community residents who participated in a physical examination in Shaoxing People’s Hospital Physical Examination Center, Shaoxing Yuecheng District Fushan Street Community Health Service Center, Shaoxing Yuecheng District Beihai Street Community Health Service Center, Shaoxing City, and Outpatient Department of Yongkang First People’s Hospital. Their demographic characteristics and KAP towards sarcopenia were collected by a self-designed questionnaire. Structural equation modeling (SEM) was used to explore the relationship among KAP dimensions.
Results
A total of 1092 valid questionnaires were included. The median knowledge, attitude, and practice scores were 0 (0, 0) (possible range: 0–22), 31 (30, 31) (possible range: 8–40), and 17 (15, 21) (possible range: 6–30), respectively. The SEM showed that knowledge directly positively influenced attitude (β = 0.121, P < 0.001) and practice (β = 0.171, P < 0.001). Attitude directly positively influenced practice (β = 0.116, P < 0.001); therefore, the knowledge showed an indirect influence on practice via attitude.
Conclusion
Older adults in two cities in Zhejiang province, China, showed insufficient knowledge but moderate attitude and practice towards sarcopenia. It is imperative to design interventions to improve knowledge about sarcopenia and improve self-management and patient outcomes.
... Sarcopenia is associated with significant morbidity and mortality [3][4][5][6] and is multifactorial [2,[7][8][9]. The European Working Group on Sarcopenia in Older People (EWGSOP) [2,7] definition is widely applied for diagnosis in Western countries; however, this assessment requires access to specialised equipment (handgrip dynamometers, body composition scanners) and trained clinical personnel [10]. These barriers can hinder early identification, thereby delaying the initiation of prevention strategies or access to treatment. ...
Community screening for sarcopenia is complex, with barriers including access to specialized equipment and trained staff to conduct body composition, strength and function assessment. In the current study, self-reported dietary protein intake and physical activity (PA) in adults ≥65 years was assessed relative to sarcopenia risk, as determined by body composition, strength and physical function assessments, consistent with the European Working Group on Sarcopenia in Older People (EWGSOP) definition. Of those screened (n = 632), 92 participants (77% female) were assessed as being at high risk of developing sarcopenia on the basis of dietary protein intake ≤1 g∙kg⁻¹∙day⁻¹ [0.9 (0.7–0.9) g∙kg⁻¹∙day⁻¹] and moderate intensity physical activity <150 min.week⁻¹. A further 31 participants (65% female) were defined as being at low risk, with both protein intake [1.2 (1.1–1.5) g∙kg⁻¹∙day⁻¹] and PA greater than the cut-off values. High-risk participants had reduced % lean mass [53.5 (7.8)% versus 54.8 (6.1)%, p < 0.001] and impaired strength and physical function. Notably, high-risk females exhibited greater deficits in lean mass and strength, with minimal differences between groups for males. In community-dwelling older adults, self-reported low protein intake and low weekly PA is associated with heightened risk for sarcopenia, particularly in older women. Future research should determine whether early intervention in older adults with low protein intake and PA attenuates functional decline.
