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

E. Dent*, J. E. Morley, A. J. Cruz-Jentoft, H. Arai, S. B. Kritchevsky, J. Guralnik, J. M. Bauer, M. Pahor, B. C. Clark, M. Cesari, J. Ruiz, C. C. Sieber, M. Aubertin-Leheudre, D. L. Waters, R. Visvanathan, F. Landi, D. T. Villareal, R. Fielding, C. W. Won, O. TheouF. C. Martin, B. Dong, J. Woo, L. Flicker, L. Ferrucci, R. A. Merchant, L. Cao, T. Cederholm, S. M. L. Ribeiro, L. Rodriguez-Manas, S. D. Anker, J. Lundy, L. M. Gutierrez Robledo, I. Bautmans, I. Aprahamian, J. M. G. A. Schols, M. Izquierdo, B. Vellas

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

297 Citations (Web of Science)

Abstract

ObjectivesSarcopenia, 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).MethodsTo 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.RecommendationsWe 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.

Original languageEnglish
Pages (from-to)1148-1161
Number of pages14
JournalJournal of Nutrition Health & Aging
Volume22
Issue number10
DOIs
Publication statusPublished - Dec 2018

Keywords

  • Sarcopenia
  • diagnosis
  • sarcopenia
  • therapy
  • muscle strength
  • aged
  • 80 and over
  • practice guideline
  • SARC-F QUESTIONNAIRE
  • SKELETAL-MUSCLE MASS
  • LEAN BODY-MASS
  • OLDER-ADULTS
  • VITAMIN-D
  • PHYSICAL FUNCTION
  • DOUBLE-BLIND
  • ELDERLY-MEN
  • EWGSOP DEFINITION
  • GROWTH-HORMONE

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