International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnosis and Management

肌萎缩 医学 药方 分级(工程) 物理疗法 内科学 护理部 工程类 土木工程
作者
Elsa Dent,John E. Morley,Alfonso J. Cruz-Jentoft,Hidenori Arai,Stephen B. Kritchevsky,Jack M. Guralnik,Jürgen Bauer,Marco Pahor,Brian C. Clark,Matteo Cesari,Jorge G. Ruiz,Cornel Sieber,Mylène Aubertin‐Leheudre,Debra L. Waters,Renuka Visvanathan,Francesco Landi,Dennis T. Villareal,Roger A. Fielding,Chang Won Won,Olga Theou,Finbarr C. Martin,Birong Dong,Jean Woo,Leon Flicker,Luigi Ferrucci,Reshma Aziz Merchant,Li Cao,Tommy Cederholm,Sandra Maria Lima Ribeiro,L. Rodríguez-Mañas,Stefan D. Anker,Janice Lundy,Luis Miguel Gutiérrez Robledo,Ivan Bautmans,Ivan Aprahamian,Jos M. G. A. Schols,Mikel Izquierdo,Bruno Vellas
出处
期刊:Journal of Nutrition Health & Aging [Springer Nature]
卷期号:22 (10): 1148-1161 被引量:522
标识
DOI:10.1007/s12603-018-1139-9
摘要

Sarcopenia, defined as an age-associated loss of skeletal muscle function and muscle mass, occurs in approximately 6 - 22 % of older adults. This paper presents evidence-based clinical practice guidelines for screening, diagnosis and management of sarcopenia from the task force of the International Conference on Sarcopenia and Frailty Research (ICSFR).To develop the guidelines, we drew upon the best available evidence from two systematic reviews paired with consensus statements by international working groups on sarcopenia. Eight topics were selected for the recommendations: (i) defining sarcopenia; (ii) screening and diagnosis; (iii) physical activity prescription; (iv) protein supplementation; (v) vitamin D supplementation; (vi) anabolic hormone prescription; (vii) medications under development; and (viii) research. The ICSFR task force evaluated the evidence behind each topic including the quality of evidence, the benefit-harm balance of treatment, patient preferences/values, and cost-effectiveness. Recommendations were graded as either strong or conditional (weak) as per the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Consensus was achieved via one face-to-face workshop and a modified Delphi process.We make a conditional recommendation for the use of an internationally accepted measurement tool for the diagnosis of sarcopenia including the EWGSOP and FNIH definitions, and advocate for rapid screening using gait speed or the SARC-F. To treat sarcopenia, we strongly recommend the prescription of resistance-based physical activity, and conditionally recommend protein supplementation/a protein-rich diet. No recommendation is given for Vitamin D supplementation or for anabolic hormone prescription. There is a lack of robust evidence to assess the strength of other treatment options.
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