There are currently no effective treatments that are deployed at scale to halt or reverse the disease, especially at the later stages. Exercise and dietary supplements are potential options to manage or slow down the decline of the disease, though studies are still underway. A likely limiting factor in their effectiveness is that sarcopenia is not routinely diagnosed, especially in the early stages when there are few warning signs to trigger patients' or clinicians' attention. When sarcopenia becomes clinically apparent, patients might already be at an advanced stage with complications such as physical frailty. To tackle this, the scientists aim to advance understanding of how sarcopenia develops in Asian populations and to explore new and pragmatic methods of diagnosis and treatment.
Professor Wang Yibin, Corresponding Principal Investigator of the MAGNET Programme and Director of the Cardiovascular & Metabolic Disorders Programme at Duke-NUS Medical School, said: "The health burden of sarcopenia is growing rapidly as our society ages, yet we are still in the early stages of understanding how it develops and how best to treat it. With MAGNET as Singapore's first nationwide research initiative dedicated to this disease, we are bringing together the country's leading minds and capabilities to deliver breakthroughs in both science and care."
To date, over 400 patients with sarcopenia from Sengkang General Hospital have been recruited for the studies (including clinical evaluation), and their relevant biological samples (e.g. blood cells and muscle tissues) have been collected for investigations.
Clinical Lead and Principal Investigator, SingHealth Duke-NUS Muscle Health Programme, Clinical Associate Professor Frederick Koh, one of the MAGNET programme theme Principal Investigators, and Consultant, Colorectal Surgery Service, Sengkang General Hospital, explained: "Sarcopenia is a complex condition with many different causes, such as ageing, advanced cancer, diabetes and heart and liver failure. It is therefore necessary to study a large cohort of patients with sarcopenia, through the collaborative efforts across all public healthcare institutions, to dissect its underlying disease processes."
Early studies have revealed new insights into how changes in the immune system and metabolism may be linked to the development of sarcopenia.
Associate Professor Samuel Chew, one of the MAGNET programme theme Principal Investigators and Senior Consultant, Department of Geriatric Medicine, Changi General Hospital, said: "From age 40, there is age-related decline in lean body mass at about 8 percent per decade, and this accelerates to about 15 percent from age 70 onwards. This may contribute to increased risks of falls, lower immunity and poor recovery after trauma and acute illnesses. This nationwide research is thus vital in aiding the screening, diagnosis and management of sarcopenia to enable earlier interventions. In caring for our community, CGH is collaborating with Duke-NUS and various healthcare partners to collectively translate these research findings from bench to bedside, in clinical settings across hospitals and in the community to benefit adults and older adults."
Professor Teh Bin Tean, one of the MAGNET programme theme Principal Investigators and Deputy Chief Executive Officer (Research) of National Cancer Centre Singapore, said: "Still, by harnessing the most advanced technological platforms to carefully unravel sarcopenia's underlying biology, we are poised to uncover new diagnostic markers and therapeutic targets
– driving earlier detection, more effective treatments and advancing precision medicine for better patient outcomes."
From left: Clinical Assoc Prof Frederick Koh, Prof Wang Yibin and (in foreground) Dr Hong Jing Han, part of the MAGNET team incorporating cutting-edge AI, genomic and molecular technologies. // Image credit: Duke-NUS Medical School
The MAGNET initiative will incorporate cutting-edge AI, genomic and molecular technologies while leveraging the largest Asian-focused clinical cohort of sarcopenia patients, alongside a unique biobank of muscle and serum samples.
MAGNET aims to achieve its objectives in four ways:
-
Mapping molecular and metabolic landscape in sarcopenia across a diverse patient population of 1,000 individuals with different disease status in Singapore.
-
Developing early diagnostic tools using biomarkers, imaging, profiling and AI-driven strategies and analysis.
-
Discovering new molecular, metabolic and inflammatory pathways in how sarcopenia develops and test therapeutic efficacies of potential targets.
-
Evaluating and translating findings into new screening methods to improve diagnosis, as well as new therapies for prevention and treatment.
This nation-wide initiative brings together a consortium of scientists and clinicians not only from Duke-NUS, Changi General Hospital, National Cancer Centre Singapore, Sengkang General Hospital and Tan Tock Seng Hospital, but also all public healthcare institutions from the three healthcare clusters
– National Healthcare Group, National University Health System and SingHealth. The initiative also involves key academic and research institutions, namely A*STAR Institute of Molecular and Cell Biology, the Life Sciences Institute Immunology Programme at National University of Singapore (NUS), as well as the Immunology Translational Research Programme at NUS Yong Loo Lin School of Medicine.
1 Chen L-K, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment, of the American Medical Directors Association. 2019;21(3):300-307.e2.
2 Pang BW, Wee SL, Lau LK, Jabbar KA, Seah WT, Ng DH, Tan QL, Chen KK, Jagadish MU, Ng TP. Prevalence and associated factors of Sarcopenia in Singaporean adults—the Yishun Study. Journal of the American Medical Directors Association. 2021 Apr 1;22(4):885-e1.
3 Ng DHL, Koh FHX, Yeong HEL, Huey TCW, Chue KM, Foo FJ, Chew STH. Nutrition Care after Hospital Discharge in Singapore: Evidence-Based Best-Practice Recommendations. Nutrients. 2023 Oct 24;15(21):4492.
4 Trejo-Avila M, Bozada-Gutiérrez K, Valenzuela-Salazar C, Herrera-Esquivel J, Moreno-Portillo M. Sarcopenia predicts worse postoperative outcomes and decreased survival rates in patients with colorectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis. 2021 Jun;36(6):1077-1096.
