How to Diagnose Sarcopenia in Korean Older Adults?

Abstract

In 2017, Korea became an aged society, with the percentage of the population aged ≥65 years accounting for 14% of the total Korean population. The increasing number of older adults and the current health status of Korean older adults had led to increased medical expenditure and social problems. Sarcopenia, defined as the progressive decrease in skeletal muscle mass and strength, develops as a consequence of aging. Sarcopenia is also associated with a risk of adverse health outcomes such as frailty, physical disability, poor quality of life, and death. Thus, sarcopenia is a serious clinical problem among older adults. The International Classification of Diseases, Tenth Revision, Clinical Modification code for sarcopenia, M62.84, became available on October 1, 2016, in the United States. The diagnosis and treatment of sarcopenia urgently requires the establishment of an operational definition for sarcopenia in Korean older adults. In this article, I suggest a screening strategy and diagnostic criteria for sarcopenia in this population.

Keywords: Diagnosis; Sarcopenia; Screen; Skeletal muscle.

Fig. 1

Sarcopenia progression to frailty and disability. Sarcopenia is a major cause of frailty and one of the major components of frailty. It ultimately leads to disability, dependence, and death. *Geriatric syndrome: Incontinence, Falls, Pressure ulcer, Delirium, Functional decline

Fig. 2

Prevalence of sarcopenia as defined by various skeletal muscle indices in Korean older adults using data from the Korean National Health and Nutrition Examination Survey. Class I and class II sarcopenia were defined as muscle indices within −1.0 to −2.0 standard deviations (SDs) and below −2.0 SD of the sex-specific mean of young people (20 to 29 years). The cutoff points for sarcopenia (2 SD of the young reference) were 6.06 kg/m², 27.43%, and 0.784 in men and 4.07 kg/m², 21.48%, and 0.517 in women, respectively. ASM, appendicular skeletal muscle mass; BMI, body mass index; ht, height; wt, weight. Adapted from Kim et al.

Fig. 3

Age trends of total muscle mass and appendicular skeletal muscle mass in Korean men and women. Trends of total muscle mass and appendicular skeletal muscle mass (ASM) according to age groups in Korean men and women using data from the 2008–2010 Korean National Health and Nutrition Examination Survey. Adapted from Kim et al.

Fig. 4

Age trends of skeletal muscle mass indices in Korean men and women. The age trends of height-adjusted appendicular skeletal muscle mass (ASM) and body mass index (BMI)-adjusted ASM were similar to those of age-related change in ASM in Korean men. However, the age trend of muscle mass indices was quite different among the three indices in women. The peak of the height-adjusted ASM in women was around the sixties. Adapted from Kim et al.