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Tools in the Assessment of Sarcopenia

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Abstract

This review provides a framework for the development of an operational definition of sarcopenia and of the potential end points that might be adopted in clinical trials among older adults. While the clinical relevance of sarcopenia is widely recognized, there is currently no universally accepted definition of the disorder. The development of interventions to alter the natural history of sarcopenia also requires consensus on the most appropriate end points for determining outcomes of clinical importance which might be utilized in intervention studies. We review current approaches to the definition of sarcopenia and the methods used for the assessment of various aspects of physical function in older people. The potential end points of muscle mass, muscle strength, muscle power, and muscle fatigue, as well as the relationships between them, are explored with reference to the availability and practicality of the available methods for measuring these end points in clinical trials. Based on current evidence, none of the four potential outcomes in question is sufficiently comprehensive to recommend as a uniform single outcome in randomized clinical trials. We propose that sarcopenia may be optimally defined (for the purposes of clinical trial inclusion criteria as well as epidemiological studies) using a combination of measures of muscle mass and physical performance. The choice of outcome measures for clinical trials in sarcopenia is more difficult; co-primary outcomes, tailored to the specific intervention in question, may be the best way forward in this difficult but clinically important area.

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Acknowledgments

This review was based on a workshop supported by the European Society for the Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the International Osteoporosis Foundation (IOF). We are grateful to the NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, and NIHR Nutrition Biomedical Research Unit, University of Southampton, UK.

Disclosures

C. C. has received consultancy fees/honoraria from Servier, Eli Lilly, Merck, Amgen, Novartis, GSK, Alliance, Medtronic; W. D. is an employee and stockholder of Amgen; W. E. is an employee of GlaxoSmithKline; B. M. is an employee and shareholder of Eli Lilly and Company; Y. T. is an employee of Servier. Y. R. has spoken for and prepared an education module with Nutricia and is on the expert board of Cheisi and Lactalis. S. B. was senior clinical investigator of the Fund for Scientific Research, Flanders, Belgium, and holder of the Leuven University Chair in Gerontology and Geriatrics.

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Authors and Affiliations

  1. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK

    C. Cooper & A. A. Sayer

  2. NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, SO16 6YD, UK

    C. Cooper

  3. NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, OX3 7LD, UK

    C. Cooper

  4. Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, 02111-1524, USA

    R. Fielding & K. Reid

  5. Department of Health Sciences, VU University Medical Center, VU University Amsterdam and EMGO + Institute, Amsterdam, The Netherlands

    M. Visser

  6. Department of Human Movement Sciences, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, The Netherlands

    L. J. van Loon

  7. Gérontopôle de Toulouse, INSERM Unit 1027, Department of Geriatric Medicine, Toulouse University Hospital, Toulouse, France

    Y. Rolland

  8. Department of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239-3098, USA

    E. Orwoll

  9. Division of Gerontology and Geriatrics and Center for Musculoskeletal Research, Department of Experimental Medicine, Leuven University, Leuven, Belgium

    S. Boonen

  10. Division of Geriatric Medicine and Center for Metabolic Bone Diseases, Department of Internal Medicine, Leuven University Hospital, Leuven, Belgium

    S. Boonen

  11. Amgen Ltd, Uxbridge, UK

    W. Dere

  12. Division of Endocrinology, Mount Sinai School of Medicine, New York, NY, USA

    S. Epstein

  13. Lilly Research Laboratories, Eli Lilly & Co, Indianapolis, IN, USA

    B. Mitlak

  14. Institut de Recherches Internationales Servier, 50 rue Carnot, 92284, Suresnes Cedex, France

    Y. Tsouderos

  15. Division of Bone Diseases, Geneva University Hospitals, Geneva, Switzerland

    R. Rizzoli

  16. Bone and Cartilage Metabolism Unit, CHU Centre-Ville, Liège, Belgium

    J. Y. Reginster

  17. WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK

    J. A. Kanis

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  1. C. Cooper
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  2. R. Fielding
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  3. M. Visser
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  4. L. J. van Loon
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  5. Y. Rolland
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  6. E. Orwoll
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  7. K. Reid
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  8. S. Boonen
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  9. W. Dere
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  15. J. Y. Reginster
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  16. J. A. Kanis
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Correspondence to C. Cooper.

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S. Boonen—deceased.

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Cooper, C., Fielding, R., Visser, M. et al. Tools in the Assessment of Sarcopenia. Calcif Tissue Int 93, 201–210 (2013). https://doi.org/10.1007/s00223-013-9757-z

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