Sarcopenia in Adults with Intellectual Disability: A Scoping Review Protocol to map and describe the existing research.

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Ageing in the general population is associated with poorer health, and sarcopenia, the age-related loss of muscle mass and function, is associated with debilitating consequences of declining function, disability, adverse health outcomes and hospitalisations. The consequences of sarcopenia in older adults with intellectual disability is likely to be even more complex given their pre-existing life-long disabilities. Identifying the extent of sarcopenia in people with intellectual disability will contribute to the development of early screening and prevention strategies, as well as interventions to address this treatable condition to reduce long term complications. Consequently, the aim of this scoping review is to map and describe the existing research on sarcopenia in adults with intellectual disability. Methods A scoping review methodology following the Arksey and O’Malley framework and drawing on guidelines from the Joanna Briggs Institute will be conducted. The research question will be formulated based on the ‘’Population, Context, Concept’’ (PCC) framework and relevant literature will be retrieved through a comprehensive search strategy using the CINAHL Ultimate (EBSCO), Medline (EBSCO), EMBASE (Elsevier), PsycINFO (EBSCO), and Web of Science (Clarivate) databases. All study designs will be included without time period restrictions and an extensive grey literature search will also be conducted, in order to capture existing literature as broadly as possible. Information will be extracted using a data extraction tool and thematic analysis will be carried out to categorize the findings. The results will be presented through a descriptive and narrative form to answer the research question. Conclusions This will be the first scoping review conducted to identify and describe the extent of existing literature on the prevalence, diagnosis, associated factors and implications of sarcopenia in adults with intellectual disability. These findings will assist in informing further research and in guiding clinical practice. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://hrbopenresearch.org/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://hrbopenresearch.org/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://hrbopenresearch.org/articles/8-61/v1", "name": "Sarcopenia in Adults with Intellectual Disability: A Scoping Review..." } } ] } Home Browse Sarcopenia in Adults with Intellectual Disability: A Scoping Review... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Chen S, McMahon M, Eustace-Cook J and Burke E. Sarcopenia in Adults with Intellectual Disability: A Scoping Review Protocol to map and describe the existing research. [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2025, 8 :61 ( https://doi.org/10.12688/hrbopenres.14033.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol Sarcopenia in Adults with Intellectual Disability: A Scoping Review Protocol to map and describe the existing research. [version 1; peer review: 1 approved, 1 approved with reservations] Shiling Chen https://orcid.org/0009-0005-1387-6487 1,2 , Martin McMahon https://orcid.org/0000-0002-3340-9537 1 , Jessica Eustace-Cook https://orcid.org/0000-0002-6145-5477 1 , Eilish Burke https://orcid.org/0000-0002-3097-8048 1,2 Shiling Chen https://orcid.org/0009-0005-1387-6487 1,2 , Martin McMahon https://orcid.org/0000-0002-3340-9537 1 , Jessica Eustace-Cook https://orcid.org/0000-0002-6145-5477 1 , Eilish Burke https://orcid.org/0000-0002-3097-8048 1,2 PUBLISHED 16 May 2025 Author details Author details 1 Trinity College Dublin School of Nursing and Midwifery, Dublin, Leinster, Ireland 2 Trinity Centre for Ageing and Intellectual Disability, Dublin, Leinster, Ireland 3 Happee Hearts Movement and IDHealth, Singapore, 574421, Singapore Shiling Chen Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Martin McMahon Roles: Conceptualization, Supervision, Validation, Visualization, Writing – Review & Editing Jessica Eustace-Cook Roles: Data Curation, Investigation, Resources, Validation, Visualization Eilish Burke Roles: Conceptualization, Supervision, Validation, Visualization, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background There is a growing population of older persons with intellectual disability globally. Ageing in the general population is associated with poorer health, and sarcopenia, the age-related loss of muscle mass and function, is associated with debilitating consequences of declining function, disability, adverse health outcomes and hospitalisations. The consequences of sarcopenia in older adults with intellectual disability is likely to be even more complex given their pre-existing life-long disabilities. Identifying the extent of sarcopenia in people with intellectual disability will contribute to the development of early screening and prevention strategies, as well as interventions to address this treatable condition to reduce long term complications. Consequently, the aim of this scoping review is to map and describe the existing research on sarcopenia in adults with intellectual disability. Methods A scoping review methodology following the Arksey and O’Malley framework and drawing on guidelines from the Joanna Briggs Institute will be conducted. The research question will be formulated based on the ‘’Population, Context, Concept’’ (PCC) framework and relevant literature will be retrieved through a comprehensive search strategy using the CINAHL Ultimate (EBSCO), Medline (EBSCO), EMBASE (Elsevier), PsycINFO (EBSCO), and Web of Science (Clarivate) databases. All study designs will be included without time period restrictions and an extensive grey literature search will also be conducted, in order to capture existing literature as broadly as possible. Information will be extracted using a data extraction tool and thematic analysis will be carried out to categorize the findings. The results will be presented through a descriptive and narrative form to answer the research question. Conclusions This will be the first scoping review conducted to identify and describe the extent of existing literature on the prevalence, diagnosis, associated factors and implications of sarcopenia in adults with intellectual disability. These findings will assist in informing further research and in guiding clinical practice. READ ALL READ LESS Keywords Intellectual Disability, Sarcopenia, Ageing, Muscle Strength, Muscle Mass, Frailty, Mobility, Function Corresponding Author(s) Shiling Chen ( [email protected] ) Close Corresponding author: Shiling Chen Competing interests: No competing interests were disclosed. Grant information: Health Research Board [IDS-TILDA-2021-001]. Copyright: © 2025 Chen S et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Chen S, McMahon M, Eustace-Cook J and Burke E. Sarcopenia in Adults with Intellectual Disability: A Scoping Review Protocol to map and describe the existing research. [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2025, 8 :61 ( https://doi.org/10.12688/hrbopenres.14033.1 ) First published: 16 May 2025, 8 :61 ( https://doi.org/10.12688/hrbopenres.14033.1 ) Latest published: 16 May 2025, 8 :61 ( https://doi.org/10.12688/hrbopenres.14033.1 ) Introduction Sarcopenia is defined as an age-associated progressive and generalised loss of skeletal muscle mass and strength ( Cruz-Jentoft et al. , 2019 ). First described by Rosenberg in 1989 using the Greek words ‘sarx’ and ‘penia’ to denote ‘poverty of flesh’ ( Rosenberg, 1997 ), sarcopenia has since 2016, become recognised as a disease in the World Health Organisation (WHO)’s International Statistical Classification of Diseases and Related Health Problems (ICD) (M62.84) ( WHO, 2004 ). This reflects an important step taken to recognise sarcopenia in clinical practice. Sarcopenia is common in older adults in the general population and a systematic review conducted by Petermann-Rocha et al. (2022) estimated its prevalence to be approximately 10–27% in adults aged 60 years and older, with its prevalence rising with increasing age ( Meng et al. , 2024 ; Papadopoulou, 2020 ). There is increasing recognition that the presence of sarcopenia is associated with adverse health consequences including mobility difficulties, falls, frailty, functional decline and hospitalisation, resulting in higher healthcare costs, mortality and public health burden ( Beaudart et al. , 2017 ; Lim et al. , 2022 ). As a result, major efforts have been made by academics and clinicians to review practices for screening, diagnosis and management in the general older population, with the objective of developing intervention and treatment options that can potentially prevent and reverse sarcopenia ( Marcos-Pardo et al. , 2020 ; Marzetti et al. , 2017 ). The phenomenon of increasing longevity with its related challenges are similarly encountered in people with intellectual disability, who are living longer, leading to a rapidly increasing proportion of adults ageing with intellectual disability ( Dolan et al. , 2021 ; McCallion & McCarron, 2004 ). The increased longevity can be particularly demanding in this group as the rise in age related disabilities compound pre-existing lifelong disabilities, leading to further challenges for this already vulnerable population and their families ( Brennan et al. , 2020 ; Ryan et al. , 2014 ). Moreover, with the added phenomenon of premature ageing in people with intellectual disability ( Garcia-Dominguez et al. , 2020 ; Gensous et al. , 2020 ), it is especially important to assess for potential health issues early, as leaving these untreated could lead to worsening function and morbidity for longer periods ( Dolan et al. , 2021 ). With this in mind, researchers in the field of intellectual disability have in recent years also started exploring sarcopenia in the population of older adults with intellectual disability. Carmeli et al. (2012) reported the findings of a non-randomised, controlled and double-blinded, cross-sectional study, which set out to determine the association between sarcopenia, presarcopenia and physical ability in persons with intellectual disability. Overall, 44 adults living in a residential center in Vancouver with the average age of 59.7 +/- 7.7 years participated in this study, with sex and aged matched individuals without intellectual disability serving as the control group. The functional ability, muscle strength and muscle mass of the participants were assessed using two physical tests (sit-to-stand and stair climb) and with the Katz ADL questionnaire ( Katz & Akpon, 1976 ). The results demonstrated a higher prevalence of sarcopenia in the group with intellectual disability compared to the control group, and this was strongly related to poorer functional and physical ability (p< 0.001). Though limited by the small number of participants, this suggests not only that the prevalence of sarcopenia is higher in adults with intellectual disability compared to the general population, but also that sarcopenia is strongly associated with functional impairments. The negative impact of sarcopenia in older adults with intellectual disability was also reported by Bastiaanse et al. (2012) , as part of the HA-ID study conducted in Netherlands. In this study, the prevalence and associations of sarcopenia was examined in 884 participants above the age of 50 years. The criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) ( Cruz-Jentoft et al. , 2019 ) was used in this study to define sarcopenia. Analysis of the results showed a strong relationship between sarcopenia and mobility impairment, with participants who were wheelchair dependant being 34 times more likely to have sarcopenia (OR 34.23). This finding is especially important as the presence of mobility difficulties has been shown by several studies to be a predictor of mortality in people with intellectual disability ( Hosking et al. , 2016 ; Tyrer et al. , 2007 ). The strong association of sarcopenia with mobility impairment suggests that the presence of sarcopenia could also have implications on mortality. Furthermore, as part of the HA-ID study, a review of all-cause mortality measured over a 5-year period showed that the presence of sarcopenia in the participants is an independent risk factor for early mortality for older adults with intellectual disability ( Valentin et al. , 2023 ). Though these associations of sarcopenia are yet to be extensively studied, these findings highlight the potential importance and serious implications of sarcopenia in people with intellectual disability. In view of the considerable impact sarcopenia has on function and health outcomes in the general population, there has been urgency in recent years to develop effective screening and diagnostic tools that can be utilised for early detection and intervention ( Ackermans et al. , 2022 ; Ishii et al. , 2014 ). A number of screening tools are currently in use, including grip strength, gait speed and the SARC-F, a 5-item questionnaire that looks at strength, assistance with walking, rising from a chair, climbing stairs and falls ( Malmstrom & Morley, 2013 ). These screening tools are not only accessible but also easily integrated into routine clinical practice, allowing for early identification. Once identified, the next step involves utilising objective assessment tools to diagnose sarcopenia, which will require the clinician to assess individuals based on specific criteria; low muscle strength, low muscle quantity or quality and, low physical performance. All of these can be measured using a variety of assessment tools and scales. These include measuring the calf circumference, assessing grip strength, analysing gait speed and carrying out imaging studies such as computed tomography (CT), magnetic resonance imaging (MRI), dual energy X-ray absorptiometry (DXA) and bioelectric impedance (BIA) ( Cruz-Jentoft et al. , 2019 ). Several international work groups, including the Asian Working Group for Sarcopenia (AWGS) and the International Clinical Practice Guidelines for Sarcopenia (ICFSR) have proposed diagnostic algorithms and management pathways for sarcopenia to guide clinical practice ( Chen et al. , 2020 ; Dent et al. , 2018 ). However, these guidelines may not be suitable for adults with intellectual disability due to the different background health status, potential difficulties in utilising certain screening and diagnostic tools, the lack of validation of these assessments in this population and finally, unique challenges in implementing intervention plans in a population with intrinsic cognitive and communication difficulties. Extensive research in the general population has addressed not only the diagnosis of sarcopenia but also its prevention and treatment ( Cho et al. , 2022 ; Landi et al. , 2018 ). Key management strategies include promotion of physical activity, structured exercise programmes and targeted dietary interventions ( Beaudart et al. , 2017 ; Morley, 2016 ). These approaches have demonstrated significant potential in mitigating sarcopenia’s progression and improving overall health outcomes ( Bruyere et al. , 2022 ; Denison et al. , 2015 ). In his review, Beaudart et al. (2017) reports a clear positive effect on muscle mass and function in healthy participants aged 60 years when physical exercise programmes are instituted, with the biggest effect seen in physical performance. Studies examining physical activity and exercises carried out in adults with intellectual disability have also shown improvement in muscle endurance, flexibility and strength, which suggests that similar interventions to increase muscle strength could also prove effective in adults with intellectual disability for the prevention of sarcopenia ( Bouzas et al. , 2019 ). Additionally, dietary interventions to treat sarcopenia have been examined in several studies, with a diet sufficient in protein, vitamin D and antioxidants found to be beneficial in reducing sarcopenia in the general population ( Robinson et al. , 2018 ; Yanai, 2015 ). Given that nutrition is recognised to be an aspect commonly overlooked in adults with intellectual disability, often resulting in malnutrition or obesity, this is a potentially important area of intervention as well ( Heller et al. , 2011 ; Humphries et al. , 2009 ). Koritsas & Iacono (2016) explored the physical activity and nutrition of 51 community dwelling people with intellectual disability and found that only 37.5% of the participants had a healthy range for their body mass index (BMI), with 17.6% in the high-risk category for malnutrition. In addition, 60.3% of the participants did not meet national physical activity guidelines. These findings suggest that people with intellectual disability are at risk of developing conditions associated with poor nutrition and inactivity, which includes sarcopenia. Considering the potential profound negative impact on function and quality of life in a group already contending with lifelong disabilities, it is imperative that more is known about sarcopenia in people with intellectual disability. Their baseline health status, combined with a general lack of physical activity and poorer nutrition, significantly increases their risk of developing sarcopenia. These factors are critical considerations in both the development of the condition and the formulation of effective treatment plans. However, despite this, there is a paucity of knowledge and evidence regarding sarcopenia in people with intellectual disability amongst academics and clinicians. It is therefore of critical importance to prioritise the screening, diagnosis and treatment of sarcopenia in persons with intellectual disability, and conduct further studies to understand the condition in this vulnerable population. Being a potentially preventable and treatable condition, understanding sarcopenia better and developing evidence informed intervention plans could lead not only to overall improvement in quality of life for people with intellectual disability, but also reduced healthcare burden and cost. This scoping review therefore aims to map and describe the existing research on sarcopenia in adults with intellectual disability, in order to inform further research, policy and clinical practice. Methods Scoping reviews are defined as ‘’a type of evidence synthesis that aims to systematically identify and map the breadth of evidence available on a particular topic, field, concept, or issue, often irrespective of source (ie. Primary research, reviews, non-empirical evidence) within or across particular contexts.’’ ( Munn et al. , 2022 ). Through exploring the breadth of research for a topic or concept, scoping reviews summarise existing research and identify not only what is already known but also what the existing gaps may be. This scoping review will be conducted in accordance with the guidelines from the Joanna Briggs Institute (JBI) ( Peters et al. , 2015 ) and based on the Arksey and O’Malley framework ( Arksey & O’Malley, 2005 ). The framework of Arksey and O’Malley consists of five stages: 1) Identifying the research question 2) Identifying relevant studies 3) Study selection 4) Charting the data 5) Collating, summarizing and reporting the results Each of these stages will be presented below. Stage 1: Identifying the research question Based on the PRISMA-ScR guidelines, the ‘’Population, Context, Concept’’ (PCC) framework was used to guide and determine the research question ( Tricco et al. , 2018 ). Population: Who is the population of interest? Gender, age, ethnicity etc. Concept: What are you interested in researching? This could be an intervention or activity, or phenomena of interest. Context: Are you interested in a specific setting or location? Please refer to Table 1 below. Table 1. Identifying the Research Question with PCC Framework. PCC Criteria Description Population Adults with intellectual disability Concept Sarcopenia Context All care settings and no geographical boundary Guided by the above PCC framework, this scoping review aims to determine: What is known from the existing literature about sarcopenia in adults with intellectual disability? The objectives of this review are to: 1) Establish the prevalence of sarcopenia in adults with intellectual disability 2) Determine how sarcopenia is measured in adults with intellectual disability 3) Identify the contributing factors associated with sarcopenia in adults with intellectual disability 4) Identify the impact of sarcopenia on health outcomes in adults with intellectual disability Stage 2: Identifying relevant studies This study will retrieve relevant literature through a comprehensive search strategy using the CINAHL Ultimate, Medline, EMBASE, PsycINFO and Web of Science databases. The combinations of key concepts, common keywords and Boolean operators will be used, and the search strategy will be developed with advice from an experienced research librarian. Considering the small body of research available on this topic, grey literature search will also be carried out using various sources including the Cochrane Library, PROSPERO, Bielefeld Academic Search Engine (BASE) and Google Scholar ( Gusenbauer & Haddaway, 2020 ). The reference lists of included papers will also be scrutinized for relevant studies. The main keywords used for the search can be found in Table 2 and a sample search string can be found in Table 3 . Table 2. Keywords for the search strings. Intellectual Disability Sarcopenia “Intellectual Disabil*” OR “Intellectually disabled” OR “mentally disabled” OR “mental disabil*” OR “Intellectual Development Disorder*” OR “mental handicap*” OR “mentally handicapped” OR “mentally impaired” OR “mental impairment*” OR “intellectual impairment*” OR “mental defici*” OR “intellectual retard*” OR “mental retard*” OR “mentally retarded” OR “intellectually challenged” OR “intellectually deficient*” OR “intellectually handicapped” OR “intellectually impaired” OR “intellectually retarded” OR “mentally challenged” OR “mentally defici*” OR “cognitive disab*”) OR AB (“Intellectual Disabil*” OR “Intellectually disabled” OR “mentally disabled” OR “mental disabil*” OR “Intellectual Development Disorder*” OR “mental handicap*” OR “mentally handicapped” OR “mentally impaired” OR “mental impairment*” OR “intellectual impairment*” OR “mental defici*” OR “intellectual retard*” OR “mental retard*” OR “mentally retarded” OR “intellectually challenged” OR “intellectually deficient*” OR “intellectually handicapped” OR “intellectually impaired” OR “intellectually retarded” OR “mentally challenged” OR “mentally defici*” OR “cognitive disab*” sarcopenia* OR “muscle atroph*” OR “muscle declin*” OR “muscular degener*” OR “muscular declin*” OR “muscular degener*” OR “muscular atrophy*” Table 3. Sample Search String in EMBASE. Concept Index Terms Search Terms Intellectual Disability 'mentally disabled person'/exp OR 'mental deficiency'/exp OR 'intellectual impairment'/exp OR 'cognitive defect'/exp ‘Intellectual Disabil*’:ab,ti OR ‘Intellectually disabled’:ab,ti OR ‘mentally disabled’:ab,ti OR ‘mental disabil*’:ab,ti OR ‘Intellectual Development Disorder*’:ab,ti OR ‘mental handicap*’:ab,ti OR ‘mentally handicapped’:ab,ti OR ‘mentally impaired’:ab,ti OR ‘mental impairment*’:ab,ti OR ‘intellectual impairment*’:ab,ti OR ‘developmental disabil*’:ab,ti OR ‘mental defici*’:ab,ti OR ‘intellectual retard*’:ab,ti OR ‘mental retard*’:ab,ti OR ‘mentally retarded’:ab,ti OR ‘intellectually challenged’:ab,ti OR ‘intellectually deficient*’:ab,ti OR ‘intellectually handicapped’:ab,ti OR ‘intellectually impaired’:ab,ti OR ‘intellectually retarded’:ab,ti OR ‘mentally challenged’:ab,ti OR ‘mentally defici*’:ab,ti OR ‘cognitive disab*’:ab,ti AND Sarcopenia 'sarcopenia'/exp Ti / ab sarcopenia* OR “muscle atroph*” OR “muscle declin*” OR “muscular degener*” OR “muscular declin*” OR “muscular degener*” OR “muscular atrophy*” Stage 3: Study selection The PRISMA framework ( Moher et al. , 2009 ) will be used to guide the selection of the literature and this stage will be guided by the inclusion and exclusion criteria for the scoping review. Employing the help of screening and data extraction software such as Covidence ( Babineau, 2014 ), duplicate studies retrieved from different databases will firstly be excluded. Thereafter, the titles and abstracts of remaining studies will be screened based on the eligibility criteria. All peer reviewed and non-peer reviewed articles will be included and retrieved. All analyses that refer exclusively to children and people without intellectual disability will be excluded. As the aim of the study is to examine what is known in existing literature about sarcopenia in adults with intellectual disability, there will be no restriction on study design and objectives. Studies that have not examined sarcopenia as a primary outcome or objective will also be included. See Table 3 for the inclusion and exclusion criteria. Table 3. Inclusion and Exclusion Criteria. Inclusion Criteria Exclusion Criteria Studies that focus on adults with intellectual disability Studies focusing on children or people without intellectual disability Studies that examine sarcopenia as a primary or secondary outcomes All study designs Peer reviewed, non-peer reviewed, grey literature will all be included No time period restrictions Any care settings or countries Stage 4: Charting the data An extraction and data charting form will be used to collate the information necessary to answer the research question and will be guided by the JBI template ( Pollock et al. , 2022 ). These will include: Study data such as authors, year of publication, country of origin, study design, sample size and objectives Prevalence and incidence of sarcopenia Tools utilised to screen and assess for sarcopenia Interventions trialed and implemented in sarcopenia Factors associated with sarcopenia Impact and outcomes of sarcopenia Please refer to Table 4 for a template of the data extraction table. Table 4. Data Extraction Table. Evidence Source Details and Characteristics Citation details (e.g. author(s), date, title, journal, volume, issue, pages) Country Context Aims/Purpose Methodology Population and Sample (e.g. age, gender, number) Details/Results extracted from source of evidence Prevalence of Sarcopenia Measurements and Assessments for Sarcopenia Associated Factors and Determinants Health Outcomes Related to Sarcopenia Stage 5: Collating, summarising and reporting the results In order to identify the main themes within the literature, a thematic analysis using The Braun and Clarke framework ( Braun & Clarke, 2006 ) will be carried out. This is a six-step process of building familiarity with the literature, coding, categorising and synthesising the main concepts, and finally naming the main themes. The collated data will be presented graphically or diagrammatically in a manner that is appropriate for the objectives of this scoping review. A narrative and descriptive summary will explain how the results answer the research question as well as the specific objectives. Prevalence data will be presented with population characteristics and demographics. Associated factors, determinants and health outcomes will be presented in a table or chart format as indicated. Discussion The findings of this scoping review will provide an overview of what is known in existing literature about sarcopenia in adults with intellectual disability. By identifying key gaps in knowledge, this review will pinpoint areas that require further investigation among those with intellectual disability. Importantly, it will highlight the potential clinical implications of these knowledge gaps, underscoring the need for targeted research to address them. This will not only strengthen the development of more accurate screening, diagnosis, and management strategies for sarcopenia in this population but also justify the need for further studies to improve health outcomes and promote overall wellbeing. In this way, the scoping review will provide a critical rationale for advancing research efforts in this underexplored area. This will form a base from which further research can be conducted to inform the screening, diagnosis and management of sarcopenia in this population group to promote positive health and wellbeing. Data availability statement No data are associated with this article. Reporting guidelines The study will follow the PRISMA Extension for Scoping Reviews (PRISMA-ScR) reporting guidelines for scoping review protocols. Faculty Opinions recommended References Ackermans LLGC, Rabou J, Basrai M, et al. : Screening, diagnosis and monitoring of sarcopenia: when to use which tool? Clin Nutr ESPEN. 2022; 48 : 36–44. 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PubMed Abstract | Publisher Full Text | Free Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 16 May 2025 ADD YOUR COMMENT Comment Author details Author details 1 Trinity College Dublin School of Nursing and Midwifery, Dublin, Leinster, Ireland 2 Trinity Centre for Ageing and Intellectual Disability, Dublin, Leinster, Ireland 3 Happee Hearts Movement and IDHealth, Singapore, 574421, Singapore Shiling Chen Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Martin McMahon Roles: Conceptualization, Supervision, Validation, Visualization, Writing – Review & Editing Jessica Eustace-Cook Roles: Data Curation, Investigation, Resources, Validation, Visualization Eilish Burke Roles: Conceptualization, Supervision, Validation, Visualization, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information Health Research Board [IDS-TILDA-2021-001]. Article Versions (1) version 1 Published: 16 May 2025, 8:61 https://doi.org/10.12688/hrbopenres.14033.1 Copyright © 2025 Chen S et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics VIEWS $counts.viewCount downloads Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Chen S, McMahon M, Eustace-Cook J and Burke E. Sarcopenia in Adults with Intellectual Disability: A Scoping Review Protocol to map and describe the existing research. [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2025, 8 :61 ( https://doi.org/10.12688/hrbopenres.14033.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 16 May 2025 Views 0 Cite How to cite this report: Espoz-Lazo S. Reviewer Report For: Sarcopenia in Adults with Intellectual Disability: A Scoping Review Protocol to map and describe the existing research. [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2025, 8 :61 ( https://doi.org/10.21956/hrbopenres.15405.r47760 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-61/v1#referee-response-47760 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 12 Jul 2025 Sebastián Espoz-Lazo , Pontificia Universidad Catolica de Chile, Santiago, Santiago Metropolitan Region, Chile Approved with Reservations VIEWS 0 https://doi.org/10.21956/hrbopenres.15405.r47760 1. Is the rationale for, and objectives of, the study clearly described? Answer: Yes The rationale is well-structured and persuasive, supported by current evidence regarding both sarcopenia and the health profiles of individuals with intellectual disability. The introduction ... Continue reading READ ALL 1. Is the rationale for, and objectives of, the study clearly described? Answer: Yes The rationale is well-structured and persuasive, supported by current evidence regarding both sarcopenia and the health profiles of individuals with intellectual disability. The introduction clearly frames the clinical and public health significance of the issue, and the lack of consolidated literature is logically highlighted. The research question and objectives are clearly stated and aligned with the scope and design of a scoping review. The use of the PCC (Population, Concept, Context) framework further clarifies the study’s scope. 2. Is the study design appropriate for the research question? Answer: Yes The proposed methodology is well justified. A scoping review is the most appropriate approach when the aim is to explore the breadth and depth of existing evidence, particularly in under-researched areas. The use of the Arksey and O’Malley framework, supported by JBI recommendations and PRISMA-ScR guidelines, strengthens the methodological foundation. The inclusion of all study designs and grey literature is appropriate and enhances the comprehensiveness of the review. 3. Are sufficient details of the methods provided to allow replication by others? Answer: Partly While the authors provide a generally sound overview of the methodology, several areas require clarification or expansion to ensure replicability: Tables referenced are incomplete or missing content. For example: Table 1 (PCC framework) appears truncated or incorrectly formatted. Table 3 is mentioned as inclusion/exclusion criteria but only headings are shown. Table 4 (data extraction tool) is cited but lacks content or example fields. Inclusion and exclusion criteria should be fully developed within the text, beyond the mention of table headers. Search strategy would benefit from additional detail. A full search string is only provided for EMBASE. Including full strings for all databases (or an appendix with complete search strategies) would enhance transparency and reproducibility. Data charting lacks specificity. While referencing the JBI template is helpful, outlining the exact variables and how thematic analysis will be conducted (e.g., whether coding will be manual or software-assisted) would improve clarity. Screening and selection process could benefit from a more explicit workflow (e.g., how disagreements between reviewers will be resolved). Recommendation: To improve scientific rigor, the authors should revise the manuscript to (1) fully display the referenced tables, (2) expand on the inclusion/exclusion criteria, and (3) specify the exact tools and procedures to be used during data extraction and thematic analysis. 4. Are the datasets clearly presented in a usable and accessible format? Answer: Not applicable As this is a protocol, no datasets are yet available. However, the manuscript outlines the plan for organizing and presenting data using tables and thematic analysis. While this is appropriate for a protocol, the actual design of the extraction tables and analytic themes will need to be clearly demonstrated once the full review is conducted. Points that must be addressed to ensure the article is scientifically sound Correct and complete all referenced tables (Table 1, 3, and 4) in both formatting and content. Presenting even a sample row would enhance transparency. Fully detail the inclusion and exclusion criteria within the main text, not only as placeholders or table headers. Expand on the search strategy, including full search strings for each database or providing a supplementary file with that information. Clarify the method of thematic analysis — e.g., manual coding versus software use, and how themes will be validated or reviewed. Explain reviewer concordance procedures during study selection (e.g., use of Cohen's kappa, consensus meetings). Overall Recommendation This is a timely and well-founded protocol addressing a critical gap in the literature. With minor but necessary improvements to the methodological detail and internal consistency of the manuscript (particularly in the presentation of tables and criteria), this protocol will be suitable for indexing and will serve as a valuable foundation for further research in this area. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? No Competing Interests: No competing interests were disclosed. Reviewer Expertise: Physical Activity Sciences I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Espoz-Lazo S. Reviewer Report For: Sarcopenia in Adults with Intellectual Disability: A Scoping Review Protocol to map and describe the existing research. [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2025, 8 :61 ( https://doi.org/10.21956/hrbopenres.15405.r47760 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-61/v1#referee-response-47760 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 09 Aug 2025 shiling chen , Trinity College Dublin School of Nursing and Midwifery, Dublin, Ireland 09 Aug 2025 Author Response Dear Sebastien, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank ... Continue reading Dear Sebastien, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank you once again! warm regards, Shiling Dear Sebastien, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank you once again! warm regards, Shiling Competing Interests: No competing interests were disclosed. Close Report a concern Author Response 09 Aug 2025 shiling chen , Trinity College Dublin School of Nursing and Midwifery, Dublin, Ireland 09 Aug 2025 Author Response Dear Sebastian, I had a look at the tables that you mentioned, and I can see the full tables. Wondering if you could try looking at them again? ... Continue reading Dear Sebastian, I had a look at the tables that you mentioned, and I can see the full tables. Wondering if you could try looking at them again? Thank you! Dear Sebastian, I had a look at the tables that you mentioned, and I can see the full tables. Wondering if you could try looking at them again? Thank you! Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 09 Aug 2025 shiling chen , Trinity College Dublin School of Nursing and Midwifery, Dublin, Ireland 09 Aug 2025 Author Response Dear Sebastien, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank ... Continue reading Dear Sebastien, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank you once again! warm regards, Shiling Dear Sebastien, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank you once again! warm regards, Shiling Competing Interests: No competing interests were disclosed. Close Report a concern Author Response 09 Aug 2025 shiling chen , Trinity College Dublin School of Nursing and Midwifery, Dublin, Ireland 09 Aug 2025 Author Response Dear Sebastian, I had a look at the tables that you mentioned, and I can see the full tables. Wondering if you could try looking at them again? ... Continue reading Dear Sebastian, I had a look at the tables that you mentioned, and I can see the full tables. Wondering if you could try looking at them again? Thank you! Dear Sebastian, I had a look at the tables that you mentioned, and I can see the full tables. Wondering if you could try looking at them again? Thank you! Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Elbers RG. Reviewer Report For: Sarcopenia in Adults with Intellectual Disability: A Scoping Review Protocol to map and describe the existing research. [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2025, 8 :61 ( https://doi.org/10.21956/hrbopenres.15405.r47460 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-61/v1#referee-response-47460 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 14 Jun 2025 Roy G Elbers , University Medical Center Rotterdam, Rotterdam, The Netherlands Approved VIEWS 0 https://doi.org/10.21956/hrbopenres.15405.r47460 Summary of the article The authors have clearly described their scoping review protocol, which aims to identify and detail the existing literature on sarcopenia in adults with intellectual disability. Overall, the manuscript is well-written. I have a few minor ... Continue reading READ ALL Summary of the article The authors have clearly described their scoping review protocol, which aims to identify and detail the existing literature on sarcopenia in adults with intellectual disability. Overall, the manuscript is well-written. I have a few minor suggestions to improve consistency and add detail in some sections. Please see my comments below. General Consistent use of subheadings I am unsure about the guidelines for subheadings in the Abstract and Main text. The authors use 'Background, Methods, and Conclusions' in the Abstract, but 'Introduction, Methods, and Discussion' in the Main text. I suggest standardising these subheadings for consistency across the entire manuscript." Keywords The existing keywords cover intellectual disability and sarcopenia. To better represent the scope of the literature explored, the authors might consider adding keywords that describe the various domains, such as 'clinical aspects' and 'epidemiology'. Rationale and objectives of the study The introduction outlines current knowledge on sarcopenia in adults with intellectual disability and states a broad aim for the review. However, there are some inconsistencies in the study's stated aims. While the methods section details specific aims (e.g., prevalence, measurement, contributing factors, health outcomes), the bulleted list under 'Stage 4 Charting the data' surprisingly includes "Interventions trialed and implemented in sarcopenia." This interest in interventions is also implied in the introduction but is not explicitly presented as an aim in the methods. To improve clarity and ensure consistency, I would suggest aligning the aims in the methods section with the data intended for collection. If exploring interventions is an objective, it would be beneficial to clearly state it as an aim in the methods and include this in Table 4 (example data extraction). Is the study design appropriate for the research question? The authors plan to search relevant databases and grey literature. The EMBASE search strategy provided is comprehensive. Considering a forward citation search on the key papers mentioned in the introduction or among included studies could enhance the review's comprehensiveness. Are sufficient details of the methods provided to allow replication? Stage 3: study selection The description of the study selection process could be clearer. It would strengthen the review if the selection of studies will be performed by two independent reviewers, which is not explicitly stated in the current protocol. I recommend clearly detailing the study selection process. Stage 5: Collating, summarising and reporting the results I am not an expert in thematic analysis, but the proposed method by Braun and Clarke seems appropriate. Data availability statement It may be interesting to include future plans for data availability once collected, even though no data is available yet. Is the rationale for, and objectives of, the study clearly described? Partly Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: Systematic review methodology. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Elbers RG. Reviewer Report For: Sarcopenia in Adults with Intellectual Disability: A Scoping Review Protocol to map and describe the existing research. [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2025, 8 :61 ( https://doi.org/10.21956/hrbopenres.15405.r47460 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-61/v1#referee-response-47460 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 09 Aug 2025 shiling chen , Trinity College Dublin School of Nursing and Midwifery, Dublin, Ireland 09 Aug 2025 Author Response Dear Roy, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank ... Continue reading Dear Roy, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank you once again! warm regards, Shiling Dear Roy, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank you once again! warm regards, Shiling Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 09 Aug 2025 shiling chen , Trinity College Dublin School of Nursing and Midwifery, Dublin, Ireland 09 Aug 2025 Author Response Dear Roy, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank ... Continue reading Dear Roy, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank you once again! warm regards, Shiling Dear Roy, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank you once again! warm regards, Shiling Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 16 May 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 Version 1 16 May 25 read read Roy G Elbers , University Medical Center Rotterdam, Rotterdam, The Netherlands Sebastián Espoz-Lazo , Pontificia Universidad Catolica de Chile, Santiago, Chile Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Espoz-Lazo S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 12 Jul 2025 | for Version 1 Sebastián Espoz-Lazo , Pontificia Universidad Catolica de Chile, Santiago, Santiago Metropolitan Region, Chile 0 Views copyright © 2025 Espoz-Lazo S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (2) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions 1. Is the rationale for, and objectives of, the study clearly described? Answer: Yes The rationale is well-structured and persuasive, supported by current evidence regarding both sarcopenia and the health profiles of individuals with intellectual disability. The introduction clearly frames the clinical and public health significance of the issue, and the lack of consolidated literature is logically highlighted. The research question and objectives are clearly stated and aligned with the scope and design of a scoping review. The use of the PCC (Population, Concept, Context) framework further clarifies the study’s scope. 2. Is the study design appropriate for the research question? Answer: Yes The proposed methodology is well justified. A scoping review is the most appropriate approach when the aim is to explore the breadth and depth of existing evidence, particularly in under-researched areas. The use of the Arksey and O’Malley framework, supported by JBI recommendations and PRISMA-ScR guidelines, strengthens the methodological foundation. The inclusion of all study designs and grey literature is appropriate and enhances the comprehensiveness of the review. 3. Are sufficient details of the methods provided to allow replication by others? Answer: Partly While the authors provide a generally sound overview of the methodology, several areas require clarification or expansion to ensure replicability: Tables referenced are incomplete or missing content. For example: Table 1 (PCC framework) appears truncated or incorrectly formatted. Table 3 is mentioned as inclusion/exclusion criteria but only headings are shown. Table 4 (data extraction tool) is cited but lacks content or example fields. Inclusion and exclusion criteria should be fully developed within the text, beyond the mention of table headers. Search strategy would benefit from additional detail. A full search string is only provided for EMBASE. Including full strings for all databases (or an appendix with complete search strategies) would enhance transparency and reproducibility. Data charting lacks specificity. While referencing the JBI template is helpful, outlining the exact variables and how thematic analysis will be conducted (e.g., whether coding will be manual or software-assisted) would improve clarity. Screening and selection process could benefit from a more explicit workflow (e.g., how disagreements between reviewers will be resolved). Recommendation: To improve scientific rigor, the authors should revise the manuscript to (1) fully display the referenced tables, (2) expand on the inclusion/exclusion criteria, and (3) specify the exact tools and procedures to be used during data extraction and thematic analysis. 4. Are the datasets clearly presented in a usable and accessible format? Answer: Not applicable As this is a protocol, no datasets are yet available. However, the manuscript outlines the plan for organizing and presenting data using tables and thematic analysis. While this is appropriate for a protocol, the actual design of the extraction tables and analytic themes will need to be clearly demonstrated once the full review is conducted. Points that must be addressed to ensure the article is scientifically sound Correct and complete all referenced tables (Table 1, 3, and 4) in both formatting and content. Presenting even a sample row would enhance transparency. Fully detail the inclusion and exclusion criteria within the main text, not only as placeholders or table headers. Expand on the search strategy, including full search strings for each database or providing a supplementary file with that information. Clarify the method of thematic analysis — e.g., manual coding versus software use, and how themes will be validated or reviewed. Explain reviewer concordance procedures during study selection (e.g., use of Cohen's kappa, consensus meetings). Overall Recommendation This is a timely and well-founded protocol addressing a critical gap in the literature. With minor but necessary improvements to the methodological detail and internal consistency of the manuscript (particularly in the presentation of tables and criteria), this protocol will be suitable for indexing and will serve as a valuable foundation for further research in this area. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? No Competing Interests No competing interests were disclosed. Reviewer Expertise Physical Activity Sciences I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (2) Author Response 09 Aug 2025 shiling chen, Trinity College Dublin School of Nursing and Midwifery, Dublin, Ireland Dear Sebastien, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank you once again! warm regards, Shiling View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Author Response 09 Aug 2025 shiling chen, Trinity College Dublin School of Nursing and Midwifery, Dublin, Ireland Dear Sebastian, I had a look at the tables that you mentioned, and I can see the full tables. Wondering if you could try looking at them again? Thank you! View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Espoz-Lazo S. Peer Review Report For: Sarcopenia in Adults with Intellectual Disability: A Scoping Review Protocol to map and describe the existing research. [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2025, 8 :61 ( https://doi.org/10.21956/hrbopenres.15405.r47760) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-61/v1#referee-response-47760 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Elbers R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 14 Jun 2025 | for Version 1 Roy G Elbers , University Medical Center Rotterdam, Rotterdam, The Netherlands 0 Views copyright © 2025 Elbers R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Summary of the article The authors have clearly described their scoping review protocol, which aims to identify and detail the existing literature on sarcopenia in adults with intellectual disability. Overall, the manuscript is well-written. I have a few minor suggestions to improve consistency and add detail in some sections. Please see my comments below. General Consistent use of subheadings I am unsure about the guidelines for subheadings in the Abstract and Main text. The authors use 'Background, Methods, and Conclusions' in the Abstract, but 'Introduction, Methods, and Discussion' in the Main text. I suggest standardising these subheadings for consistency across the entire manuscript." Keywords The existing keywords cover intellectual disability and sarcopenia. To better represent the scope of the literature explored, the authors might consider adding keywords that describe the various domains, such as 'clinical aspects' and 'epidemiology'. Rationale and objectives of the study The introduction outlines current knowledge on sarcopenia in adults with intellectual disability and states a broad aim for the review. However, there are some inconsistencies in the study's stated aims. While the methods section details specific aims (e.g., prevalence, measurement, contributing factors, health outcomes), the bulleted list under 'Stage 4 Charting the data' surprisingly includes "Interventions trialed and implemented in sarcopenia." This interest in interventions is also implied in the introduction but is not explicitly presented as an aim in the methods. To improve clarity and ensure consistency, I would suggest aligning the aims in the methods section with the data intended for collection. If exploring interventions is an objective, it would be beneficial to clearly state it as an aim in the methods and include this in Table 4 (example data extraction). Is the study design appropriate for the research question? The authors plan to search relevant databases and grey literature. The EMBASE search strategy provided is comprehensive. Considering a forward citation search on the key papers mentioned in the introduction or among included studies could enhance the review's comprehensiveness. Are sufficient details of the methods provided to allow replication? Stage 3: study selection The description of the study selection process could be clearer. It would strengthen the review if the selection of studies will be performed by two independent reviewers, which is not explicitly stated in the current protocol. I recommend clearly detailing the study selection process. Stage 5: Collating, summarising and reporting the results I am not an expert in thematic analysis, but the proposed method by Braun and Clarke seems appropriate. Data availability statement It may be interesting to include future plans for data availability once collected, even though no data is available yet. Is the rationale for, and objectives of, the study clearly described? Partly Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise Systematic review methodology. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 09 Aug 2025 shiling chen, Trinity College Dublin School of Nursing and Midwifery, Dublin, Ireland Dear Roy, Thank you so much for taking the time to read the article and for your suggestions. I will review the article and make the necessary adjustments. Thank you once again! warm regards, Shiling View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Elbers RG. Peer Review Report For: Sarcopenia in Adults with Intellectual Disability: A Scoping Review Protocol to map and describe the existing research. [version 1; peer review: 1 approved, 1 approved with reservations] . HRB Open Res 2025, 8 :61 ( https://doi.org/10.21956/hrbopenres.15405.r47460) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-61/v1#referee-response-47460 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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