Criteria

European Working Group on Sarcopenia in Older People 2 (EWGSOP2)[1]

The revised definition by EWGSOP2 states that probable sarcopenia is identified if there is low muscle strength, as measured by hand grip strength. The threshold used by EWGSOP2 for low hand grip strength is <27 kg for men and <16 kg for women, based on normative data from 12 British studies.[1][35] A diagnosis of sarcopenia can be confirmed with documentation of low muscle quantity or quality (as measured by imaging; criteria vary). If low physical performance is also present then sarcopenia is considered severe.[1] A single cutoff gait speed of ≤0.8 m/second indicates severe sarcopenia.[1]

Asian Working Group for Sarcopenia (AWGS)[6]

The AWGS 2019 consensus update defines sarcopenia as age-related loss of muscle mass, plus low muscle strength, and/or low physical performance. It defines low muscle strength, as measured by hand grip strength, as <28 kg for men and <18 kg for women. Its criteria for low physical performance are:[6]

  • A 6-meter walk with a gait speed of <1.0 m/second, or

  • A Short Physical Performance Battery score of ≤9, or

  • A 5-time chair stand test taking ≥12 seconds.

AWGS uses the following cutoffs for height-adjusted muscle mass:[6]

  • Dual-energy x-ray absorptiometry (DXA) <7.0 kg/m² in men and <5.4 kg/m² in women

  • Bioimpedance <7.0 kg/m² in men and <5.7 kg/m² in women.

It proposes using calf circumference (<34 cm in men, <33 cm in women), SARC-F score (≥4), or SARC-CalF score (≥11), to identify earlier people at risk for sarcopenia. The AWGS 2019 consensus update also defines possible sarcopenia by either low muscle strength or low physical performance only.[6]

Sarcopenia Definition and Outcomes Consortium (SDOC)[3]

SDOC identifies grip strength, either absolute or scaled to measures of body size, as an important discriminator of health status, and that weakness (low grip strength) and slowness (low usual gait speed) should be included in the definition of sarcopenia.[3] Lean mass measured by DXA was not associated with incident adverse health-related outcomes in community-dwelling older adults with or without adjustment for body size; it was therefore excluded as a diagnostic criterion for sarcopenia by the consortium. 

International Clinical Practice Guidelines for Sarcopenia (ICFSR)[2]

The ICFSR defines sarcopenia as an age-associated loss of skeletal muscle function and muscle mass.[2] It recommends using gait speed and hand grip strength to determine low levels of muscle strength and physical performance when diagnosing sarcopenia. Cutoff values should be tailored to the population being considered.[2]

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