Table 6 Suggested population-based strategies to promote muscle health in Singapore [136]

Screening and outreach

• Identify early muscle loss by detecting deterioration in usual physical function or strength, during screening events or visits to polyclinics or general practice clinics.

• Improve HCP awareness of muscle loss identification by mere observation of general body muscle bulk in older individuals over time.

Referral and follow-up

• Encourage older persons to focus on resistance exercises in order to build muscle strength and mass, e.g., in fitness corners, resistance exercise parks and senior-friendly gyms.

• Active referral of older persons to available community resources, e.g., day rehabilitation centres, as appropriate.

• Consider referral to a dietician, if the older adult is malnourished and might require more complex interventions.

Health teaching and coaching

• Emphasize the importance of optimal calories (30 kcal/kg body weight/day) and protein (≥1.2 g/kg body weight/day) in older adults.

• Promote more active uptake of resistance exercise by advocating for gradual progression with sufficient intensity.

Consultation and collaboration

• Collaborate with organizations to include basic nutritional literacy and simple resistance exercise training as part of the nursing skills requirement for foreign domestic workers, particularly those tasked with caring for older adults.

Advocacy and policy development

• Make government subsidies available via the Senior Mobility Fund to support rehabilitation programs at home (e.g., telerehabilitation equipment, weights and resistance bands).

• Currently, eligible patients can already access subsidy for ONS under the Senior Mobility Fund.

Social marketing

• Link exercise and nutrition for muscle health with campaigns related to bone health – i.e., ‘to prevent fractures and falls, take calcium for bone and protein for muscle.’