Use of patient-reported outcome measures and patient-reported experience measures within interventional studies aiming at the management of sarcopenia: results from a systematic literature review.

Objective: Sarcopenia, age-related muscle decline, affects the mobility and independence of elderly individuals. Its prevalence varies across populations, with severe consequences such as increased risk of falls, fractures, depression, and even mortality, ultimately reducing overall quality of life. Current interventions involve a multifaceted approach, including nutrition, exercise, and pharmacology. The global increase in life expectancy emphasizes the growing importance of sarcopenia as a public health challenge. Patient-reported outcome measures (PROMs) and Patient-reported experience measures (PREMs) provide crucial insights for evaluating intervention effectiveness. The aim of this review is to identify all sarcopeniadesigned interventional studies that used a PROMS/PREMS as the primary or secondary outcome, identify the different PROMS/PREMS used within those studies and summarize the effects of sarcopenia-designed interventions on PROMS/PREMS of sarcopenic participants.
Methods: A systematic search of databases (Medline, EMBASE, Review- Cochrane Central of Register of Controlled Trials and PsychINFO (Via Ovid)) was conducted in September 2023. The review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement, and the protocol was registered on the Open Science Framework (https://osf.io/zxgwm/). Risk of bias was measured using the Cochrane 2.0 risk of bias tool.
Results: The systematic review identified 17 RCTs as sarcopeniadesigned interventional studies that used a PROM as primary or secondary outcome. PROMs were exclusively used in these studies (i.e., no PREMS were reported) and covered the assessment of various aspects, including quality of life (15/17, 88.2%) depressive symptoms (3/17, 17.6%) sleep quality/disturbance (2/17, 11.8%) and loneliness/social isolation, daytime sleepiness, insomnia impact (all reported in 1/17, 5.9%). Except of SarQoL, which is a specific healthrelated quality of life questionnaire for sarcopenia, all other PROMs identified were generic. Interventions included medication (11.8%), nutritional supplementation (35.3%), exercise Programs (23.5%) and a combination of exercise and nutritional supplements (29.41%). None of the included RCT contained any high risk of bias. The effect
of sarcopenia-designated interventions on PROMs showed considerable heterogeneity.
Conclusion: heterogeneity in outcome measures underscores the need for standardization in sarcopenia research by developing a Core Outcome Set (COS). COS in sarcopenia studies would ensure consistent and comparable findings, ultimately enhancing the reliability and effectiveness of interventions.