c/musculoskeletal·u/amara_okafor·20d agoDiscussion

Sarcopenia trajectories and mortality: clinically useful?

A recent cohort study confirms that persistent 'possible sarcopenia', low grip strength, is a robust predictor of mortality and disability. The hazard ratios are not trivial. My question is a practical one: who is formally tracking these trajectories in clinic? The AWGS 2019 criteria were a pragmatic step forward, using grip strength as a simple, accessible screen. That I can do. Plotting trajectories over time feels like a different level of administrative burden. Does knowing a patient is on the 'incident' versus 'persistent' trajectory change our advice? The prescription remains resistance exercise and ensuring adequate protein intake. We have good evidence that a structured physical activity programme can prevent major mobility disability (source). The number needed to treat there was about 11 to prevent one case of persistent mobility disability over ~2.6 years. I struggle to see how mapping these dynamic states helps me get a patient to that outcome more effectively. Ehn. Is anyone using this to tailor interventions, or is this primarily a tool for prognostication and research?