Abstract: Research in sarcopenia has grown exponentially over the last 15 years in geriatrics and gerontology, as well as other specialties, including oncology and hepatology. There is now strong evidence for the role of resistance exercise to prevent declines in muscle strength and function, especially when combined with nutritional optimization with protein supplementation. However, there remains a disparity between research evidence and clinical practice. There are multiple factors for this, which relate to the current diagnostic criteria for sarcopenia, practical and logistical aspects of diagnosis of sarcopenia, clinician knowledge of both diagnosis and management, and the availability of pathways for interventions. Sarcopenia is currently defined based on the identification of muscle strength, in combination with muscle size or quality, below cut-off thresholds at a single timepoint. This defines sarcopenia as a binary process of either present or not present, thus early diagnosis can be challenging. In this article, we summarize current obstacles to early diagnosis and management of sarcopenia in clinical practice, and make recommendations to how these might be overcome. This includes our recommendation of incorporation of handgrip strength measurement into standard care, to enable dynamic assessment and identification of early declines in handgrip strength, so that interventions can be implemented to prevent disability.

Keywords: EWGSOP2, dynamic change, handgrip strength, implementation, exercise


中文翻译：

---

肌肉减少症早期诊断和治疗的障碍：当前观点

摘要：过去 15 年，老年病学和老年学以及肿瘤学和肝病学等其他专业领域对肌肉减少症的研究呈指数级增长。现在有强有力的证据表明抗阻运动可以预防肌肉力量和功能下降，特别是与营养优化和蛋白质补充相结合时。然而，研究证据和临床实践之间仍然存在差距。造成这种情况的因素有很多，包括当前肌肉减少症的诊断标准、肌肉减少症诊断的实践和后勤方面、临床医生的诊断和治疗知识以及干预途径的可用性。目前，肌肉减少症的定义是根据肌肉力量的识别，结合肌肉大小或质量，在单个时间点低于截止阈值。这将肌肉减少症定义为存在或不存在的二元过程，因此早期诊断可能具有挑战性。在本文中，我们总结了目前临床实践中肌肉减少症早期诊断和治疗的障碍，并就如何克服这些障碍提出了建议。这包括我们建议将握力测量纳入标准护理中，以便能够动态评估和识别握力的早期下降，以便采取干预措施来预防残疾。

关键词： EWGSOP2、动态变化、握力、实施、练习