Silvia Crosignani, MD, Fellowship in Geriatrics and Gerontology, University of Milan, Milan, Italy, Email:
J Frailty Aging. 2021;10(3):226-232. doi: 10.14283/jfa.2020.63.
Detection of sarcopenia in primary care is a first and essential step in community-dwelling older adults before implementing preventive interventions against the onset of disabling conditions. In fact, leaving this condition undiagnosed and untreated can impact on the individual's quality of life and function, as well as on healthcare costs. This article summarizes the many instruments today available for promoting an earlier and prompter detection of sarcopenia in primary care, combining insights about its clinical management. Primary care physicians may indeed play a crucial role in the identification of individuals exposed to the risk of sarcopenia or already presenting this condition. To confirm the suspected diagnosis, several possible techniques may be advocated, but it is important that strategies are specifically calibrated to the needs, priorities and resources of the setting where the evaluation is conducted. To tackle sarcopenia, nutritional counselling and physical activity programs are today the two main interventions to be proposed. Multicomponent and personalized exercise programs can (and should) be prescribed by primary care physicians, taking advantage of validated programs ad hoc designed for this purpose (e.g., the Vivifrail protocol). It is possible that, in the next future, new pharmacological treatments may become available for tackling the skeletal muscle decline. These will probably find application in those individuals non-responding to lifestyle interventions.
在初级保健中检测肌肉减少症是社区居住的老年人实施预防干预以防止出现致残状况的第一步，也是至关重要的一步。事实上，如果不诊断和治疗这种疾病，可能会影响个人的生活质量和功能，以及医疗保健成本。本文总结了目前可用于在初级保健中更早、更及时地检测肌肉减少症的多种工具，并结合了其临床管理方面的见解。初级保健医生在识别有肌肉减少症风险或已经存在这种疾病的个体方面确实可以发挥关键作用。为了确认疑似诊断，可以提倡使用几种可能的技术，但重要的是，策略应根据评估所进行的环境的需求、优先级和资源进行具体调整。为了解决肌肉减少症问题，营养咨询和身体活动计划是目前要提出的两种主要干预措施。初级保健医生可以（并且应该）开出多成分和个性化的运动计划，利用专门为此目的设计的经过验证的计划（例如，Vivifrail 协议）。在未来，可能会有新的药物治疗方法可用于解决骨骼肌衰退问题。这些方法可能会应用于对生活方式干预无反应的个体。
