Sarcopenia

New page (2026): had no dedicated coverage — written from a 2024 AJGP roundtable article and established knowledge; flagged for verification. See also osteoporosis and general-medicine for the broader frailty context.

A disease of progressive, accelerated loss of muscle mass, strength and function — distinct from but overlapping with frailty (sarcopenia is considered a physical component of, and precursor to, frailty). Affects an estimated 1 in 5 Australians aged ≥60; global prevalence 10–27% in that age group. Muscle mass/strength decline from age 30, accelerating after 50 (~20% mass and ~40% strength loss from peak by later life); physical function decline accelerates after 65.

• Primary (age-related) or secondary (identifiable causal factors — physical inactivity, malnutrition, systemic disease). Higher prevalence in dementia (~26%), diabetes (~31%) and respiratory disease (~13%).
• Consequences: functional decline, falls, fractures, hospitalisation, increased mortality, and considerable healthcare cost.

Screening and diagnosis

The Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) endorses the revised EWGSOP2 definition and case-finding approach:

1. Case-find with the 5-item SARC-F questionnaire (strength, assistance walking, rising from a chair, climbing stairs, falls) or on clinical suspicion.
2. Grip strength or chair-stand test — assesses probable (pre-)sarcopenia.
3. Confirm low muscle mass with DXA or bioelectrical impedance (BIA).
4. Grade severity with physical performance measures — gait speed, the Short Physical Performance Battery (SPPB), or Timed Up and Go (TUG).

Management

• Resistance-based exercise is the cornerstone intervention.
• Protein-rich diet or protein supplementation if intake is inadequate.
• Emerging evidence for creatine, HMB (beta-hydroxy-beta-methylbutyrate), vitamin D and multi-nutrient supplements in those with deficiency or established sarcopenia.

Practical notes for general practice

Sarcopenia remains under-recognised — formally classified as a disease since 2016 (2019 in Australia), but rarely screened for or diagnosed in routine practice. Consider opportunistic screening (SARC-F, grip strength/chair-stand) in at-risk patients — especially those with the comorbidities above, in existing health assessments (45–49-year and 75+ health assessments, GP Management Plans), or presenting with falls/functional decline. A “life-course approach” — building and preserving muscle mass from mid-life onward — is now emphasised as prevention, not just an older-age treatment target.