Did you know…

The single strongest predictor of impaired mobility, altered energy balance, and loss of vitality with age is the loss of muscle mass. It is rarely measured in routine primary care. When it is measured, it is often measured by accident, in a scan ordered for something else.

The claim, in the words of the man who introduced the term

The physician-scientist who named the progressive loss of muscle mass with aging is Irwin H. Rosenberg, then director of the USDA Human Nutrition Research Center on Aging at Tufts University. He introduced the term sarcopenia at a conference on Health and Aging in 1988, and it was published the following year in the proceedings of the American Journal of Clinical Nutrition. His 1997 paper in the Journal of Nutrition remains the founding statement of the field:

“There is probably no decline in structure and function more dramatic than the decline in lean body mass or muscle mass over the decades of life. And yet there is no more common denominator to problems of impaired mobility, altered energy balance, and even loss of vitality than the loss of muscle mass.”

— Irwin H. Rosenberg, Journal of Nutrition, 1997

Nearly forty years, one instrument, no reading

The measurement is not exotic. The same DEXA scan reimbursed in most jurisdictions for the diagnosis of osteoporosis produces, simultaneously, a lean-tissue output. That output is technically free at the point of measurement. In the routine primary care of a person in their fifties or sixties, it is not requested, not interpreted, and not communicated to the patient. Grip strength, measured routinely in occupational therapy and in geriatric assessment, is almost never measured in primary care. Bio-impedance is present in most commercial gyms and in almost no clinics.

The term sarcopenia has entered international clinical consensus. The routine physical examination has not changed.

What the reading would cost

Nothing. The scan is already ordered for osteoporosis screening. The software already produces the lean-tissue value. Communicating it to the patient adds one line to a report the system is already generating.

This entry is a companion to Right to Adequate Muscle Mass and to Strength They Measure, Mass They Miss.