Sarcopenia is a medical condition that is frequent and important. According to The European Working Group on Sarcopenia in Older People (EWGSOP), “sarcopenia is a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and death” . Iannuzzi-Sucich, et al found that the prevalence of sarcopenia over the age of 64 was 22.6% in women and 26.8% in men. A subgroup analysis of women and men 80 years or older revealed prevalence rates of 31.0% and 52.9%, respectively .
Sarcopenia can cause morbidity and mortality. According to Sarcopenia: Revised European Consensus on Definition and Diagnosis published in 2018:
Unfortunately, sarcopenia is too often undiagnosed. The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) recommends the following methods for identifying sarcopenia in clinical practice: 1. the SARC-F questionnaire for case finding; 2. grip strength and the chair stand test for skeletal muscle strength; 3. dual-energy x-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA) for measuring skeletal muscle mass. SARC-F is questionnaire that asks about strength, walking, rising from a chair, climbing stairs, and falls. Grip strength requires a calibrated handheld dynamometer. The chair stand test measures the time required to rise five times from a seated position.
For measuring muscle mass, DXA is generally preferred by clinicians because of greater accuracy, but x-ray equipment and a physician order are required. BIA is the easiest and least expensive method for estimating muscle mass and can be performed serially at home to monitor the course of sarcopenia. BIA estimates the volume of fat and lean body mass by measuring the electrical resistance of the body using an imperceptibly low electrical current. The test equipment itself is widely available, inexpensive and easy to use. However, it is contraindicated in pregnancy, and in people with cardiac pacemakers and other internal and external medical devices.
According to the EWGSOP2:
- Elderly people
- People with a fever
- Body builders or highly trained athletes
- Persons undergoing dialysis
- Persons with osteoporosis who have very low bone density
- Persons with edema
- Children in growth stage
The accuracy of skeletal muscle measurement by Omron equipment has been evaluated in clinical studies. Pietiläinen KH, Kaye S, Karmi A, Suojanen L, et al. compared bioelectrical impedance analysis (BIA) using the Omron BF-500 with dual-energy X-ray absorptiometry (DXA) and MRI in estimating body fat, skeletal muscle and visceral fat during a 12-month weight loss intervention. BIA, as compared to DXA, accurately assessed loss of fat (7·0 (SE 1·5) v. 7·0 (SE 1·4)kg, P¼0·94) and muscle (1·0 (SE 0·2) v. 1·4 (SE 0·3)kg, P¼0·18), though skeletal muscle was underestimated by 1–2 kg using BIA at each time point.
The authors warn that the:
The authors summarized that “BIA is at its best when assessing the amount or changes in fat mass. It is a useful method for measuring skeletal muscle, but limited in its ability to measure visceral fat” .
BIA is widely used for assessing body composition including muscle mass. However, it is contraindicated in people with cardiac pacemakers and other external and internal medical devices, with several medical conditions, with abnormal hydration, with weight extremes, and in pregnancy. Furthermore, the validity of BIA depends upon using the correct measurement technique and an accurate analysis equation considering sex, age and ethnicity. Thus, it would be prudent for an individual to discuss BIA with a medical care provider prior to its use to ensure that BIA is safe and appropriate for that person. Also, results should be reviewed by their medical care provider, and if necessary confirmed with DXA, which is considered more accurate though less convenient and more expensive.
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Disclaimer: Since healthcare is complicated and personal, you should discuss these topics with your healthcare provider before applying this information to your own health. This website does not intend to diagnose or treat any disease or medical condition. Its only purpose is to assist people to monitor their health at home under the supervision of their healthcare provider.