European Working Group on Sarcopenia in Older People 2 (EWGSOP2)[1]Cruz-Jentoft AJ, Bahat G, Bauer J, et al; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31.
https://academic.oup.com/ageing/article/48/1/16/5126243
http://www.ncbi.nlm.nih.gov/pubmed/30312372?tool=bestpractice.com
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]Cruz-Jentoft AJ, Bahat G, Bauer J, et al; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31.
https://academic.oup.com/ageing/article/48/1/16/5126243
http://www.ncbi.nlm.nih.gov/pubmed/30312372?tool=bestpractice.com
[35]Dodds RM, Syddall HE, Cooper R, et al. Grip strength across the life course: normative data from twelve British studies. PLoS One. 2014 Dec 4;9(12):e113637.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0113637
http://www.ncbi.nlm.nih.gov/pubmed/25474696?tool=bestpractice.com
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]Cruz-Jentoft AJ, Bahat G, Bauer J, et al; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31.
https://academic.oup.com/ageing/article/48/1/16/5126243
http://www.ncbi.nlm.nih.gov/pubmed/30312372?tool=bestpractice.com
A single cutoff gait speed of ≤0.8 m/second indicates severe sarcopenia.[1]Cruz-Jentoft AJ, Bahat G, Bauer J, et al; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31.
https://academic.oup.com/ageing/article/48/1/16/5126243
http://www.ncbi.nlm.nih.gov/pubmed/30312372?tool=bestpractice.com
Asian Working Group for Sarcopenia (AWGS)[6]Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020 Mar;21(3):300-7.
http://www.ncbi.nlm.nih.gov/pubmed/32033882?tool=bestpractice.com
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]Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020 Mar;21(3):300-7.
http://www.ncbi.nlm.nih.gov/pubmed/32033882?tool=bestpractice.com
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]Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020 Mar;21(3):300-7.
http://www.ncbi.nlm.nih.gov/pubmed/32033882?tool=bestpractice.com
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]Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020 Mar;21(3):300-7.
http://www.ncbi.nlm.nih.gov/pubmed/32033882?tool=bestpractice.com
Sarcopenia Definition and Outcomes Consortium (SDOC)[3]Bhasin S, Travison TG, Manini TM, et al. Sarcopenia definition: the position statements of the Sarcopenia Definition and Outcomes Consortium. J Am Geriatr Soc. 2020 Jul;68(7):1410-8.
http://www.ncbi.nlm.nih.gov/pubmed/32150289?tool=bestpractice.com
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]Bhasin S, Travison TG, Manini TM, et al. Sarcopenia definition: the position statements of the Sarcopenia Definition and Outcomes Consortium. J Am Geriatr Soc. 2020 Jul;68(7):1410-8.
http://www.ncbi.nlm.nih.gov/pubmed/32150289?tool=bestpractice.com
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]Dent E, Morley JE, Cruz-Jentoft AJ, et al. International clinical practice guidelines for sarcopenia (ICFSR): screening, diagnosis and management. J Nutr Health Aging. 2018;22(10):1148-61.
http://www.ncbi.nlm.nih.gov/pubmed/30498820?tool=bestpractice.com
The ICFSR defines sarcopenia as an age-associated loss of skeletal muscle function and muscle mass.[2]Dent E, Morley JE, Cruz-Jentoft AJ, et al. International clinical practice guidelines for sarcopenia (ICFSR): screening, diagnosis and management. J Nutr Health Aging. 2018;22(10):1148-61.
http://www.ncbi.nlm.nih.gov/pubmed/30498820?tool=bestpractice.com
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]Dent E, Morley JE, Cruz-Jentoft AJ, et al. International clinical practice guidelines for sarcopenia (ICFSR): screening, diagnosis and management. J Nutr Health Aging. 2018;22(10):1148-61.
http://www.ncbi.nlm.nih.gov/pubmed/30498820?tool=bestpractice.com