Screening

Screening of the general population is not recommended. Screen adults ages 65 years and older for sarcopenia annually or after a major health event (such as a fall).[2] Detecting sarcopenia early on may help reduce the burden of morbidity and mortality caused.[2] The International Conference on Sarcopenia and Frailty Research (ICSFR) suggests using gait speed or the 5-item SARC-F questionnaire to identify people with suspected sarcopenia, while the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) recommends the SARC-F questionnaire or clinical judgment (e.g., when a patient age >65 years reports falling, feeling weak, walking slowly, difficulty rising from a chair, and/or weight/muscle loss).[1][2]

In community practices, the SARC-F questionnaire is the most used and recommended tool for screening for sarcopenia.[1][54] It has a low-to-moderate sensitivity and a high specificity to predict low muscle strength.[1] Refer patients screened as positive (a total score ≥4 indicates that the patient is at risk of sarcopenia) for further evaluation using muscle strength, quality/quantity, and functional performance to confirm the presence of sarcopenia and its severity. Grip strength is considered a test for diagnosing sarcopenia, but it is not recommended as a screening tool.[2]

Screening for sarcopenia should be opportunistic at a routine appointment or may be applied following a visit to the primary care physician or after admission into the hospital (e.g., following a fall or any type of illness). Due to its slow and quiet development and low rates of identification in the community, sarcopenia is mainly noticed when patients contact a healthcare professional for other reasons. Certain conditions should also trigger an assessment for sarcopenia; for instance, due to the close connection between osteoporosis and sarcopenia, all older people who have had a minimal trauma fracture should be assessed for sarcopenia.[55]

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