Singapore multidisciplinary consensus recommendations on muscle health in older adults: assessment and multimodal targeted intervention across the continuum of care

Table 3 Recommended tools for assessment of muscle health with cut-off values for the Singapore population

Parameter	Recommended tool	Recommended cut-off value for low muscle parameters	Reference
Physical activity related to muscle	SARC-F questionnaire	Score of ≥4 out of 10, indicative of sarcopenia	Malmstrom et al., 2016 [53]; AWGS 2019 [26]
Muscle strength	Handgrip strength	Men: < 28 kg Women: < 18 kg	AWGS 2019 [26]
Muscle strength	5-times CST test (surrogate measure)	≥10s for 5 rises	Makizako et al., 2017 [54]
Muscle mass	BIA (ASMI)	Men: < 7.0 kg/m² Women: < 5.7 kg/m²	AWGS 2019 [26]
	DXA (ASMI)	Men: < 7.0 kg/m² Women: < 5.4 kg/m²	AWGS 2019 [26]
	Calf circumference (surrogate measure)	Men: < 34 cm Women: < 33 cm	AWGS 2019 [26]
Physical performance	Usual gait speed	< 1.0 m/s	AWGS 2019 [26]
Physical performance	5-times CST test^a (surrogate measure)	≥12 s as a proxy for low gait speed (< 1.0 m/s)	AWGS 2019 [26]

^aThe use of a standardized protocol, such as the one from the American Academy or Orthotists & Prosthetists is recommended. Abbreviations: ASMI Appendicular skeletal mass index (ASM adjusted for height), AWGS Asian Working Group for Sarcopenia, BIA Bioimpedance analysis, DXA Dual-energy X-ray absorptiometry, CST Chair Stand Test

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