Incident sarcopenia in hospitalized older people: A systematic review

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Abstract

Hospitalization has been associated with the development of sarcopenia. This study aimed to examine the new incidences of hospital sarcopenia, associated risk factors and health outcomes, as defined by internationally recognized diagnostic criteria in hospitalized older people. Pre-defined search terms were run through five databases. Six studies that assessed sarcopenia on two separate time points during hospitalization on older inpatients were included. Prevalence of sarcopenia varied from 14.1% to 55% depending on diagnostic criteria and cut-off points used. New sarcopenia occurred between 12% to 38.7% patients following hospitalization. Risk factors were older age, longer duration of bed rest, lower baseline body mass index, cognitive impairment and activities of daily living disability. None of the studies reported health outcomes associated with newly developed sarcopenia in hospital.

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Sarcopenia: revised European consensus on definition and diagnosis

Alfonso Cruz-Jentoft, Gulistan Bahat, Jürgen Bauer … (2018)

Abstract Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.

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Sarcopenia: European consensus on definition and diagnosis

Alfonso Cruz-Jentoft, Jean-Pierre Baeyens, Jürgen M Bauer … (2011)

The European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria for age-related sarcopenia. EWGSOP included representatives from four participant organisations, i.e. the European Geriatric Medicine Society, the European Society for Clinical Nutrition and Metabolism, the International Association of Gerontology and Geriatrics—European Region and the International Association of Nutrition and Aging. These organisations endorsed the findings in the final document. The group met and addressed the following questions, using the medical literature to build evidence-based answers: (i) What is sarcopenia? (ii) What parameters define sarcopenia? (iii) What variables reflect these parameters, and what measurement tools and cut-off points can be used? (iv) How does sarcopenia relate to cachexia, frailty and sarcopenic obesity? For the diagnosis of sarcopenia, EWGSOP recommends using the presence of both low muscle mass + low muscle function (strength or performance). EWGSOP variously applies these characteristics to further define conceptual stages as ‘presarcopenia’, ‘sarcopenia’ and ‘severe sarcopenia’. EWGSOP reviewed a wide range of tools that can be used to measure the specific variables of muscle mass, muscle strength and physical performance. Our paper summarises currently available data defining sarcopenia cut-off points by age and gender; suggests an algorithm for sarcopenia case finding in older individuals based on measurements of gait speed, grip strength and muscle mass; and presents a list of suggested primary and secondary outcome domains for research. Once an operational definition of sarcopenia is adopted and included in the mainstream of comprehensive geriatric assessment, the next steps are to define the natural course of sarcopenia and to develop and define effective treatment.

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Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment

Liang-Kung Chen, Jean Woo, Prasert Assantachai … (2020)

Clinical and research interest in sarcopenia has burgeoned internationally, Asia included. The Asian Working Group for Sarcopenia (AWGS) 2014 consensus defined sarcopenia as "age-related loss of muscle mass, plus low muscle strength, and/or low physical performance" and specified cutoffs for each diagnostic component; research in Asia consequently flourished, prompting this update. AWGS 2019 retains the previous definition of sarcopenia but revises the diagnostic algorithm, protocols, and some criteria: low muscle strength is defined as handgrip strength <28 kg for men and <18 kg for women; criteria for low physical performance are 6-m walk <1.0 m/s, Short Physical Performance Battery score ≤9, or 5-time chair stand test ≥12 seconds. AWGS 2019 retains the original cutoffs for height-adjusted muscle mass: dual-energy X-ray absorptiometry, <7.0 kg/m2 in men and <5.4 kg/m2 in women; and bioimpedance, <7.0 kg/m2 in men and <5.7 kg/m2 in women. In addition, the AWGS 2019 update proposes separate algorithms for community vs hospital settings, which both begin by screening either calf circumference (<34 cm in men, <33 cm in women), SARC-F (≥4), or SARC-CalF (≥11), to facilitate earlier identification of people at risk for sarcopenia. Although skeletal muscle strength and mass are both still considered fundamental to a definitive clinical diagnosis, AWGS 2019 also introduces "possible sarcopenia," defined by either low muscle strength or low physical performance only, specifically for use in primary health care or community-based health promotion, to enable earlier lifestyle interventions. Although defining sarcopenia by body mass index-adjusted muscle mass instead of height-adjusted muscle mass may predict adverse outcomes better, more evidence is needed before changing current recommendations. Lifestyle interventions, especially exercise and nutritional supplementation, prevail as mainstays of treatment. Further research is needed to investigate potential long-term benefits of lifestyle interventions, nutritional supplements, or pharmacotherapy for sarcopenia in Asians.

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Author and article information

Contributors

Safiyyah Nurnajah Wan:

ORCID: https://orcid.org/0000-0001-9384-8876

Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: ValidationRole: Writing – original draftRole: Writing – review & editing

Chiann Ni Thiam: Role: Formal analysisRole: InvestigationRole: Project administrationRole: ResourcesRole: SoftwareRole: ValidationRole: Writing – review & editing

Qi Xuan Ang: Role: Formal analysisRole: InvestigationRole: SoftwareRole: ValidationRole: Writing – review & editing

Julia Engkasan: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – review & editing

Terence Ong:

ORCID: https://orcid.org/0000-0001-7473-446X

Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing

Charlotte Beaudart: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS One

Journal ID (publisher-id): plos

Title: PLOS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 2 August 2023

Publication date Collection: 2023

Volume: 18

Issue: 8

Electronic Location Identifier: e0289379

Affiliations

[1 ] Department of Medicine, Faculty of Medicine, Universiti Malaya, Wilayah Persekutuan Kuala Lumpur, Malaysia

[2 ] Department of Medicine, Hospital Sultanah Bahiyah, Alor Setar, Kedah Darul Aman, Malaysia

[3 ] Department of Rehabilitation Medicine, Universiti Malaya, Wilayah Persekutuan Kuala Lumpur, Malaysia

University of Liege: Universite de Liege, BELGIUM

Author notes

Competing Interests: The authors have declared that no competing interests exist.

* E-mail: terence.ong@ 123456ummc.edu.my

Author information

Safiyyah Nurnajah Wan https://orcid.org/0000-0001-9384-8876

Terence Ong https://orcid.org/0000-0001-7473-446X

Article

Publisher ID: PONE-D-23-04332

DOI: 10.1371/journal.pone.0289379

PMC ID: 10395895

PubMed ID: 37531398

SO-VID: 23cae358-2235-4291-8b65-0483b3261885

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 19 February 2023

Date accepted : 18 July 2023

Page count

Figures: 1, Tables: 2, Pages: 14

Funding

Funded by: funder-id http://dx.doi.org/10.13039/501100004386, Universiti Malaya;

Award ID: GPF007-2020

Award Recipient :

ORCID: https://orcid.org/0000-0001-7473-446X

Terence Ong

This study was supported by the Universiti Malaya Faculty of Medicine Research Programme Grant (GPF007-2020); awarded to TO and JPE. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."

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Data Availability All relevant data are within the Supporting information files (S3 Minimal dataset).

Incident sarcopenia in hospitalized older people: A systematic review

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Most cited references 55

Sarcopenia: revised European consensus on definition and diagnosis

Sarcopenia: European consensus on definition and diagnosis

Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment

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