The Singapore Family Physician

Back to issue Vol 47 No. 6 - Update: Malnutrition, Muscle Loss and Sarcopenia

Assessments and Multimodal Targeted Interventions for Muscle Health in Older Persons

Samuel TH Chew
The Singapore Family Physician Vol 47 No 6 - Update: Malnutrition, Muscle Loss and Sarcopenia
19 - 28
1 May 2021
The populations in Singapore and worldwide are ageing rapidly and poses many challenges to patients, medical professionals and the healthcare system. Recent population-based research in community-dwelling older adults in Singapore suggest that after the age of 80, impaired physical ability and cognition are two major contributors to loss of independent living. Hence, there is an urgent need to raise awareness of the importance of muscle health in older adults as one of the modifiable factors to reduce and prevent disability in later life. Good muscle health is essential to facilitate independent living for as long as possible. The SARC-F questionnaire is an ideal screening tool in the community setting for sarcopenia in older adults. For screening of low muscle mass, calf-circumference can be used in the community as a surrogate measure. Bio-electrical Impedance Analysis (BIA) and Dual-Energy X-ray Absorptiometry (DEXA) can be used to assess appendicular skeletal muscle mass index (ASMI) in the community and hospital setting respectively. Low ASMI with low muscle strength leads to the diagnosis of sarcopenia. Severe sarcopenia is diagnosed when all three of low muscle mass, low muscle strength and low physical performance are present. Muscle health is intimately linked with nutritional health and physical activity. Risk of malnutrition in older adults can be rapidly screened using Malnutrition Universal Screening Tool (MUST) in both inpatient and outpatient settings. For best outcomes, a combined multidisciplinary approach using targeted progressive resistance exercise training (RET) and provision of adequate protein, energy and replacement of any underlying Vitamin D deficiency is required. Efforts are urgently required to raise awareness and knowledge on the importance of muscle health, and its impact on function and clinical outcomes in older people.