Suggestions for assessment of muscle mass in primary care setting

Abstract

Sarcopenia is one of the prevalent geriatric syndromes that adversely affects the functionality in the older adults. The diagnosis of sarcopenia requires documentation of decreased muscle mass and decreased muscle strength or physical function. The implication of user-friendly and inexpensive methods that could be used to assess sarcopenia in real-life settings is suggested in a recent debate paper. For muscle mass assessment, bioelectric impedance analysis (BIA), and dual-energy X-ray absorptiometry (DXA) were described as having the same ease for muscle mass assessment in terms of applicability. However, BIA is easier to perform, has greater availability, inexpensive, and does not require specialist trained staff. The authors proposed the use of DXA as primary tool to assess muscle mass in the primary care setting. However, BIA is recommended as a first-line method both in research and clinical practice by EWGSOP. Regarding its much easier applicability, we conclude that BIA is a more practical method for muscle mass assessment in the primary care setting than the DXA. Thus, we suggest that BIA could be the method of choice for muscle mass assessment in the primary care setting.

Keywords:

• Sarcopenia
• primary care setting
• assessment of muscle mass

Sarcopenia is one of the prevalent geriatric syndromes that adversely affect the functionality and quality of life in the older adults. The diagnosis of sarcopenia requires documentation of decreased muscle mass and decreased muscle strength or physical function [1]. The management of sarcopenia requires its recognition in everyday clinical practice. Accordingly, the implication of user-friendly and inexpensive methods that could be used to assess sarcopenia in real-life settings is suggested in a very recent debate paper [2]. For muscle mass assessment, bioelectric impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA) were described as having the same ease for muscle mass assessment in terms of applicability [2]. However, BIA is easier to perform, has greater availability, performed with a mobile equipment, inexpensive, and does not require specialist trained staff [1]. Hence, we note that BIA is easier to perform in everyday practice.

One more thing is that, the authors proposed the use of DXA as a primary tool to assess muscle mass in the primary care setting. Furthermore, in case DXA is not available, they suggested the use of anthropometric measurements. BIA was not mentioned in this setting. However, BIA is recommended as a first-line method both in research and clinical practice by the European Working Group on Sarcopenia in Older People (EWGSOP) [1,3]. Regarding its much easier applicability, we conclude that BIA is a more practical method for muscle mass assessment in the primary care setting than the DXA. Regarding its better performance in predicting muscle mass than the rough anthropometric measurements, it should also be preferred over the anthropometric measurements. Thus, we suggest that BIA could be the method of choice for muscle mass assessment in the primary care setting.