Recognizing the Burden of Sarcopenia in COPD, with Amy Attaway, MD

Sarcopenia, or skeletal muscle loss, is a major yet often overlooked complication in patients with chronic obstructive pulmonary disease (COPD). Despite being estimated to affect 20-40% of people with COPD and significantly contribute to adverse clinical outcomes, routine screening and treatment are not common.

In an interview with HCPLive based on research she’s presenting at the American Thoracic Society (ATS) International Conference 2025, Amy Attaway, MD, a pulmonologist at Cleveland Clinic, explains how part of the underdiagnosis of sarcopenia is attributable to its symptoms—such as fatigue and breathlessness—which mimic those of worsening pulmonary disease.

Highlighting the need for improved diagnostic clarity, Attaway shares a practical example from her clinical experience in which she asks patients if they get out of breath when they walk across a room. For those who said yes, she would inquire further about whether it was their breathing or their legs that made them feel like they had to stop walking to help determine whether it was attributable to their COPD or if they might have sarcopenia.

“I do molecular basic science research on sarcopenia, but I felt like there’s a really big gap clinically,” Attaway said. “When you see these patients clinically as a doctor, it kind of helps drive you to recognize the gaps, and then it goes back into what we need to focus on for research.”

Seeking to address some of these gaps, she and a group of colleagues created a subspecialty clinic for patients with COPD and suspected sarcopenia at Cleveland Clinic. One of the goals of this clinic, Attaway says, is to focus on testing patients for sarcopenia earlier and implementing evidence-based protocols from the literature into a single setting.

Looking at clinical gaps in treatment, Attaway says this process is complicated by the lack of a clear answer as to what causes sarcopenia. Specifically, she calls attention to shortcomings in nutrition counseling in these patients, citing the importance of adequate protein intake for building muscle.

“Everything we're doing is evidence-based, but never kind of put together into one clinic,” Attaway explained. “That was why that was something I thought was really important to do.”

Editors’ note: Attaway has no relevant disclosures.

Reference

Attaway A. COPD and Skeletal Muscle Mass: Discovering New Possibilities. March 8, 2023. Accessed May 20, 2025. https://consultqd.clevelandclinic.org/copd-and-skeletal-muscle-mass-discovering-new-possibilities