An evidence-based comparison of operational criteria for the presence of sarcopenia
Open accessAbstract
BACKGROUND: Several consensus groups have previously published operational criteria for sarcopenia, incorporating lean mass with strength and/or physical performance. The purpose of this manuscript is to describe the prevalence, agreement, and discrepancies between the Foundation for the National Institutes of Health (FNIH) criteria with other operational definitions for sarcopenia. METHODS: The FNIH Sarcopenia Project used data from nine studies including: Age, Gene and Environment Susceptibility-Reykjavik Study; Boston Puerto Rican Health Study; a series of six clinical trials from the University of Connecticut; Framingham Heart Study; Health, Aging, and Body Composition Study; Invecchiare in Chianti; Osteoporotic Fractures in Men Study; Rancho Bernardo Study; and Study of Osteoporotic Fractures. Participants included in these analyses were aged 65 and older and had measures of body mass index, appendicular lean mass, grip strength, and gait speed. RESULTS: The prevalence of sarcopenia and agreement proportions was higher in women than men. The lowest prevalence was observed with the FNIH criteria (1.3% men and 2.3% women) compared with the International Working Group and the European Working Group for Sarcopenia in Older Persons (5.1% and 5.3% in men and 11.8% and 13.3% in women, respectively). The positive percent agreements between the FNIH criteria and other criteria were low, ranging from 7% to 32% in men and 5% to 19% in women. However, the negative percent agreement were high (all >95%). CONCLUSIONS: The FNIH criteria result in a more conservative operational definition of sarcopenia, and the prevalence was lower compared with other proposed criteria. Agreement for diagnosing sarcopenia was low, but agreement for ruling out sarcopenia was very high. Consensus on the operational criteria for the diagnosis of sarcopenia is much needed to characterize populations for study and to identify adults for treatment.
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Larger muscle areas are associated with higher muscle strength, but LBM is not the only determinant.
“Despite the fact that larger muscle areas are associated with higher muscle strength, LBM is not the only determinant [42,43].”
From Resistance Training Prevents Muscle Loss Induced by Caloric Restriction in Obese Elderly Individuals: A Systematic Review and Meta-Analysis (2018) · cites this paper as [43]
The Results and Discussion report that adults with higher appendicular lean mass could nevertheless have weaker grip strength, supporting the point that lean mass is not the only determinant of strength. The paper does not establish the claimed association between larger muscle areas and higher strength; it measures lean mass rather than muscle area. (LLM, conf=0.84)
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- Authors
- Dam, T.-T., Peters, K. W., Fragala, M., Cawthon, P. M., Harris, T. B., McLean, R., Shardell, M., Alley, D. E., Kenny, A., Ferrucci, L., Guralnik, J., Kiel, D. P., Kritchevsky, S., Vassileva, M. T., & Studenski, S.
- Affiliations
- Columbia University Irving Medical Center (US)
- California Pacific Medical Center (US)
- University of Central Florida (US)
- National Institutes of Health (US)
- Beth Israel Deaconess Medical Center (US)
- University of Maryland, Baltimore (US)
- Wake Forest University Health Sciences (US)
- Foundation for the National Institutes of Health (US)
- University of Pittsburgh (US)
- Corresponding author
- Dam, T.-T.
- ORCID
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-04-14
- Volume
- 69
- Issue
- 5
- Pages
- 584-590
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- PMC
- PMC3991139
- OpenAlex
- W2162998896
- Cited by
- 363
- References
- 39
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 21 · 2023: 22 · 2022: 25 · 2021: 27 · 2020: 38 · 2019: 35 · 2018: 44 · 2017: 41 · 2016: 37 · 2015: 43 · 2014: 20
- FWCI
- 31.25
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- The Journals of Gerontology Series A (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Journal of International Crisis and Risk Communication Research (submittedVersion)
- Funders
- Foundation for the National Institutes of Health (P30 AG024827)
- Amgen
- Eli Lilly and Company
- National Institutes of Health (AG024827)
- National Institute on Aging (AG 024827, K23AG040168, U13AG04158, P30AG024827)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- sarcopenia, prevalence, diagnostic agreement, older adults, appendicular lean mass, grip strength, walking speed, sex differences
- MeSH terms
- Age Factors, Aged, Female, Gait, Humans, Male, National Institutes of Health (U.S.), Sex Factors, Thinness, United States, Body Mass Index, Prevalence, Hand Strength, Sarcopenia
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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