Singapore Clinical Practice Guidelines for Sarcopenia: Screening, Diagnosis, Management, and Prevention

Sarcopenia refers to the age-associated progressive and generalised loss of skeletal muscle mass plus loss of muscle strength and/or reduced physical performance.Despite its importance, sarcopenia often remains unrecognised and inadequately managed in routine clinical care.A workgroup was convened by the Chapter of Geriatricians and the Society for Geriatric Medicine Singapore to develop the first-ever country-specific Clinical Practice Guidelines (CPG) for sarcopenia.The workgroup developed 20 evidence-based recommendations that aim to facilitate adoption of the Asian Working Group for Sarcopenia (AWGS) 2019 consensus into current practice in Singapore.The CPG recommends a casefinding approach in at-risk older adults using validated case-finding tools.Screen-positive individuals should be assessed for "possible sarcopenia" and underlying causes.For diagnosis, the CPG recommends using the AWGS 2019 algorithm, and, when necessary, dual-energy X-ray absorptiometry to determine low lean mass for a confirmatory diagnosis of sarcopenia.For treatment, the CPG recommends resistance exercises and a quality protein-rich diet/protein supplementation, with Vitamin D supplementation for insufficiency (<30 g/L).For prevention, the CPG recommends regular resistance-based physical activity and adequate protein intake (1.0 g/kg body weight).We encourage more research to address local evidence gaps.With increasing interest in muscle health and sarcopenia, this CPG provides evidence-based consensus recommendations for sarcopenia that will play a key role in the translation into current practice in Singapore.