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International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnosis and Management

journal contribution
posted on 22.01.2019, 05:46 authored by Elsa DentElsa Dent, John Morley, Alfonso Cruz-Jentoft, Hidenori Arai, Stephen Kritchevsky, Marco Pahor, Brian Clark, Matteo Cesari, J. Ruiz, Cornel C. Sieber, Mylène Aubertin-Leheudre, Debra WatersDebra Waters, Renuka VisvanathanRenuka Visvanathan, Francesco Landi, Dennis T. Villareal, Roger Fielding, Changwon Won, Olga Theou, Finbarr Martin, Birong Dong, Jean Woo, Leon Flicker, Luigi Ferrucci, Reshma Merchant, Li Cao, Tommy Cederholm, Silvana Ribeiro, Leocadio Rodriguez-Mañas, Stefan Anker, Janice Lundy, Luis Gutiérrez-Robledo, Ivan Bautmans, Ivan Aprahamian, Jos Schols, Mikel Izquierdo, Bruno Vellas

Objectives

Sarcopenia, defined as an age-associated loss of skeletal muscle function and muscle mass, occurs in approximately 6 - 22 % of older adults. This paper presents evidence-based clinical practice guidelines for screening, diagnosis and management of sarcopenia from the task force of the International Conference on Sarcopenia and Frailty Research (ICSFR).

Methods

To develop the guidelines, we drew upon the best available evidence from two systematic reviews paired with consensus statements by international working groups on sarcopenia. Eight topics were selected for the recommendations: (i) defining sarcopenia; (ii) screening and diagnosis; (iii) physical activity prescription; (iv) protein supplementation; (v) vitamin D supplementation; (vi) anabolic hormone prescription; (vii) medications under development; and (viii) research. The ICSFR task force evaluated the evidence behind each topic including the quality of evidence, the benefitharm balance of treatment, patient preferences/values, and cost-effectiveness. Recommendations were graded as either strong or conditional (weak) as per the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Consensus was achieved via one face-to-face workshop and a modified Delphi process.

Recommendations

We make a conditional recommendation for the use of an internationally accepted measurement tool for the diagnosis of sarcopenia including the EWGSOP and FNIH definitions, and advocate for rapid screening using gait speed or the SARC-F. To treat sarcopenia, we strongly recommend the prescription of resistance-based physical activity, and conditionally recommend protein supplementation/a protein-rich diet. No recommendation is given for Vitamin D supplementation or for anabolic hormone prescription. There is a lack of robust evidence to assess the strength of other treatment options.

Journal of Nutrition, Health & Aging. December 2018, 22 (10), pp 1148–1161

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2018

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