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.

Sarcopenia as the Mobility Phenotype of Aging: Clinical Implications

“…The KWGS and AWGS 2019 guidelines recommend various methods for identifying sarcopenia. [7,10] Screening tools according to the KWGS guidelines are listed in Table 1. These methods include assessing calf circumference, hand grip strength, chair stand test, gait speed, and time up-and-go tests.…”

“…[7,[53][54][55] Additionally, questionnaires such as strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) and ring tests using the thumb and index finger to measure calf circumference are suggested. [10,56] Notably, SARC-F has limitations as a screening tool due to its low sensitivity and high specificity. [57] Consequently, case identification in clinical practices may heavily rely on clinical suspicion, considering factors such as significant weight loss, general weakness, or history of falls, regardless of age.…”

“…Clinical risk factors may include treatment affecting sex hormones, chronic use of glucocorticoids, chronic inflammatory conditions, and underlying malignancy. [10] Geriatric risks include mood, cog-nitive disorders, polypharmacy, chronic constipation, swallowing difficulties, falls, history of hospitalization, and other geriatric syndromes. [10]…”

“…[9] In 2023, the Korean Working Group on Sarcopenia (KWGS) published clinical practice guidelines for screening and diagnosing sarcopenia in older Korean adults. [10,11] Since the prevalence of sarcopenia in the population increases with age, and its pathophysiology is associated with various age-related mechanisms or outcomes, it is regarded as both an aging-related condition and a geriatric syndrome. [12] Additionally, sarcopenia can be considered as a mobility phenotype of the human aging spectrum owing to its focus on muscle mass and function.…”

New Clinical Practice Guidelines for Sarcopenia Screening and Diagnosis in Korean Older Adults: A Step Forward

“…In Korea, the Korean Working Group on Sarcopenia (KWGS) has established new clinical practice guidelines for sarcopenia screening and diagnosis. 4) As Korea is one of the fastest-aging countries worldwide, preventing and treating sarcopenia in older adults to prevent further frailty and disabilities has become an overarching healthcare issue. 5) Although international guidelines for sarcopenia have been previously established, several issues support country-specific guidelines for this condition.…”