Assessment of dynapenia and undernutrition in primary care, a systematic screening study in community medicine

Clin Nutr ESPEN. 2023 Oct:57:561-568. doi: 10.1016/j.clnesp.2023.08.003. Epub 2023 Aug 5.

Abstract

Screening for sarcopenia is a growing public health issue since associated with functional alterations and an increase in morbidity and mortality.

Objective: To analyze the prevalence of decreased muscle strength (dynapenia) in patients aged 18 to 74 in community medicine, as measured in the general practitioner's office, and to assess the prevalence of undernutrition in this population.

Method: Muscle strength was measured with a Hand Grip (HG) dynamometer according to European recommended thresholds and French guidelines. Malnutrition was defined according to the GLIM criteria.

Results: Of 341 patients, 303 were evaluated (89%): mean age was 47.8 ± 17.4 years, including 51.2% women, 103 with an acute disease (AD) and 200 with a chronic disease (CD). 23.5% were below the 10th percentile threshold in the CD group and 19.4% in the AD group. For these patients, muscle age, evaluated on the median values for age, was higher by 39.3 ± 15.2 years for men and by 41.5 ± 13.6 years for women. Maximum HG values were significantly correlated with changes in International Physical Activity Questionnaire (IPAQ) score (F = 10.22; p = 0.0017) and weight changes (%) (F = 5.30; p = 0.0227) in women only, regardless of age, BMI, disease, professional status or type of work (manual or not); 19.1% suffered from malnutrition (10.9% Stage 1 and 8.3% Stage 2), with 20.0% in the CD group and 17.4% in the AD group.

Conclusion: This study highlights the feasibility of screening for sarcopenia in primary care community medicine. The prevalence of dynapenia in the studied population (nearly one in 5 patients) and the observed higher-than-expected undernutrition (17.5%) justify their screening for appropriate management care.

Clinical trial registration: NCT04451694; referred to as "observational research", "non-interventional", or « non-RIPH ».

Keywords: Dynapenia; Handgrip test; Malnutrition; Sarcopenia; Undernutrition.

MeSH terms

  • Adult
  • Aged
  • Community Medicine
  • Female
  • Hand Strength
  • Humans
  • Male
  • Malnutrition* / diagnosis
  • Malnutrition* / epidemiology
  • Middle Aged
  • Primary Health Care
  • Sarcopenia* / diagnosis
  • Sarcopenia* / epidemiology
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT04451694