Baek Ji Yeon, Jung Hee-Won, Kim Kyoung Min, Kim Miji, Park Clara Yongjoo, Lee Kwang-Pyo, Lee Sang Yoon, Jang Il-Young, Jeon Ok Hee, Lim Jae-Young
Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Division of Endocrinology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
Ann Geriatr Med Res. 2023 Mar;27(1):9-21. doi: 10.4235/agmr.23.0009. Epub 2023 Mar 24.
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.
尽管韩国引入了诊断代码并接受了将肌肉减少症作为一种新的健康技术的诊断流程,但许多从业者仍对肌肉减少症的评估不熟悉。因此,韩国肌肉减少症工作组(KWGS)制定了韩国老年成年人肌肉减少症诊断的临床实践指南。对40名专家小组成员进行了一个包含19个问题的两阶段德尔菲访谈,其中22人参加了2022年6月至8月的第一轮访谈。德尔菲访谈的第二轮包括第一轮中未达成一致的其余11个问题。肌肉减少症的筛查过程包括在不同研究和临床环境中使用的各种问卷和检查。通过结合病例发现和评估步骤,简化了肌肉减少症的诊断过程。由于简短体能测试具有多方面性质,因此受到特别强调。无论肌肉量如何,肌肉力量低且体能表现差在临床上被认为是相关的,并被重新定义为“功能性肌肉减少症”。综合老年评估对于诊断肌肉减少症很重要。KWGS的临床指南旨在通过允许在统一过程中使用各种筛查工具并减少关于使用哪些工具进行诊断的困惑,促进肌肉减少症的早期检测。本建议根据衰弱的概念,将肌肉减少症的概念定义扩展为一种复杂的病理生理状态,旨在激发在临床环境中对肌肉减少症诊断和管理的进一步研究。