Korean Working Group on Sarcopenia Guideline: Expert Consensus on Sarcopenia Screening and Diagnosis by the Korean Society of Sarcopenia, the Korean Society for Bone and Mineral Research, and the Korean Geriatrics Society

Abstract

Despite the introduction of a diagnostic code and acceptance of a diagnostic process for sarcopenia as a new health technology in Korea, many practitioners remain unfamiliar with the evaluation of sarcopenia. Thus, the Korean Working Group on Sarcopenia (KWGS) developed clinical practice guidelines for the diagnosis of sarcopenia in older Korean adults. A two-phase Delphi interview comprising 19 questions was conducted with 40 expert panelists, 22 of whom participated in the first round between June and August 2022. The second round of the Delphi interview included the remaining 11 questions that were not agreed upon in the first round. The screening process for sarcopenia includes various questionnaires and examinations used in different research and clinical settings. The diagnostic process for sarcopenia was simplified by combining the steps of case finding and assessment. The Short Physical Performance Battery test was given particular emphasis owing to its multifaceted nature. Regardless of muscle mass, having low muscle strength with low physical performance is considered clinically relevant and newly defined as "functional sarcopenia." Comprehensive geriatric assessment is important for diagnosing sarcopenia. The KWGS's clinical guideline aims to facilitate the early detection of sarcopenia by allowing various screening tools to be used in a unified process and reducing confusion about which tools to use for diagnosis. This recommendation expands the conceptual definition of sarcopenia as a complex pathophysiological state in line with the concept of frailty and aims to stimulate further research on the diagnosis and management of sarcopenia in clinical settings.

Keywords: Delphi method; Geriatric assessment; Practice guideline; Sarcopenia.

Fig. 1.

Sarcopenia is a complex system consisting of numerous pathophysiologies in both biological and clinical aspects. ADL, activities of daily living; IADL, instrumental activities of daily living.

Fig. 2.

Specific questions and the level of agreement in the first Delphi round. SARC-F, strength, assistance with walking, rising from a chair, climbing stairs, and falls; DEXA, dual-energy X-ray absorptiometry; BIA, bioimpedance analysis; AWGS, Asian Working Group for Sarcopenia.

Fig. 3.

Multiple-choice questions of the first Delphi round. 6MWT, 6-minute walk test; SPPB, short physical performance battery.

Fig. 4.

Specific questions and the level of agreement in the second Delphi round. SARC-F, strength, assistance with walking, rising from a chair, climbing stairs, and falls; DEXA, dual-energy X-ray absorptiometry; BIA, bioimpedance analysis; AWGS, Asian Working Group for Sarcopenia.

Fig. 5.

Algorithm for sarcopenia evaluation. SARC-F, strength, assistance with walking, rising from a chair, climbing stairs, and falls; SPPB, short physical performance battery; ASM, appendicular skeletal muscle mass; BIA, bioimpedance analysis; DEXA, dual-energy X-ray absorptiometry.

Fig. 6.

Decreased sarcopenia burden after CGA-based intervention. ADL, activities of daily living; IADL, instrumental activities of daily living; CGA, comprehensive geriatric assessments.