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Consensus among groups such as the European Society on Clinician Nutrition and Metabolism (ESPEN) and Special Interest Groups (SIG) on geriatric nutrition and on cachexia-anorexia in chronic wasting disease, have concluded using a test called DXA (dual-energy X-ray absorptiometry), in combination with measuring gait speed (walking speed) can be used to diagnose sarcopenia1.
DXA measures lean body mass in reference to a normal population. The European Working Group on Sarcopenia in Older People (EWGSOP) developed a diagnostic definition that measures muscle strength and physical performance using well-validated techniques. See attached tables developed by the EWGSOP2.
Table 1: Definition of sarcopenia for clinical and epidemiological studies3
Diagnosis is based on documentation of criterion 1 plus criterion 2 and/or 3 |
1.1. Low muscle mass 2.2 Low muscle strength 3.3 Low physical performance |
Table 2 Measurements of muscle mass, strength, and function in research and practice. Adapted from2
Variable | Research | Clinical Practice |
Muscle Mass |
Computed tomography (CT) Magnetic resonance Imaging (MRI) Dual-energy X-ray Absorptiometry (DXA) Bio-electrical impedance analysis (BIA) Total or partial body Potassium per fat-free Soft tissue |
BIA DXA Anthropmetry |
Muscle Strength |
Handgrip strength Knee flexion / extension Peak expiratory flow |
Handgrip strength |
Physical Performance |
Short Physical Performance Battery (SPPB) Usual gait speed Timed get-up-and-go test Stair climb power test |
SPPB Usual gait speed Get-up-and-go test |
References
1. Muscaritoli M, Anker S Argilés J, et al (2010) Consensus definition of sarcopenia, cachexia and pre-cachexia : Joint document elaborated by Special Interest Groups (SIG). “Cachexia-anorexia in chronic wasting diseases” and “nutrition in geriatrics”. Clinical Nutrition 29(2):154-9
2. Sarcopenia: European consensus on definition and diagnosis, Report of the European Working Group on Sarcopenia in Older People," Age and Ageing Advance Access originally published online on April 13, 2010, Age and Ageing 2010 39(4):412-423
3. Mithal A, Bonjour J-P, Boonen S, Burckhardt P, Degens H, El Hajj Fuleihan G, Josse R, Lips P, Morales Torres J, Rizzoli R, Yoshimura N, Wahl D.A., Cooper C, Dawson-Hughes B(2011) Impact of nutrition on muscle strength and performance in older adults. Osteoporosis International (in press)
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