The BASES Expert Statement on Physical Activity and Limiting Sedentary Behaviour for Effective Management of Sarcopenia in Community-dwelling Older Adults

Abstract

Introduction: This expert statement is intended to support practitioners and researchers in the effective management of sarcopenia in community-dwelling older adults.

The Expert Statement will start by introducing the concept and definition of sarcopenia, followed by an overview of consensus measurements techniques (core outcomes) for diagnosing and monitoring sarcopenia. Evidence will be presented demonstrating that sarcopenia is significantly adversely associated with adverse health outcomes, such as a 19-39% risk of becoming dependent in activities of daily living over a 2-year period, an increased mortality risk and reduced quality of life (e.g. Tanimoto et al. 2013).

Background and Evidence: Evidence that physical activity and sedentary behaviour are associated with sarcopenia and are key targets for effective management in older adults will be provided. A scoping review regarding the effectiveness of physical activity and sedentary behaviour interventions for improving core sarcopenia outcomes (e.g. muscle mass, hand grip strength, balance) will be undertaken and presented as follows:

Effectiveness of physical activity and sedentary behaviour interventions on sarcopenia outcomes: an overall evidence summary will be provided for these interventions being effective in the management of sarcopenia.

Mode of physical activity: the most effective mode(s) of physical activity (e.g. aerobic, resistance, flexibility, chair-based, team sports) for effective management of sarcopenia will be provided.

Dose of physical activity: the optimal frequency, intensity and duration of physical activity for effective management will be summarised (e.g. Onambélé-Pearson et al., 2010). This will include the concept of sedentary behaviour fragmentation (i.e. regularly breaking up prolonged periods of sedentary time) alongside increased physical activity (e.g. Grant et al., 2020).

The primary candidate mechanisms underpinning the beneficial responses to increasing physical activity and reducing sedentary time will be discussed. This will include changes in muscle mass, muscle fibre type and neuro-musculature adaptations.

In addition, safety considerations will be highlighted e.g. use of different exercise equipment, latency effects of exercise on falls risk, and risk of falls and injury during physical activity.

Conclusions and Recommendations: A summary of the reviewed evidence will be given with recommendations for practitioners in relation to mode and dose of physical activity and sedentary time reductions and how best to monitor effectiveness of interventions in the management of sarcopenia in older adults. We will also highlight areas for future research to further elucidate the benefits of increased physical activity and decreased sedentary time for the management of sarcopenia in community-dwelling older adults.