Sarcopenia Definition: The Position Statements of the Sarcopenia Definition and Outcomes Consortium
Open accessAbstract
OBJECTIVES: To develop an evidence‐based definition of sarcopenia that can facilitate identification of older adults at risk for clinically relevant outcomes (eg, self‐reported mobility limitation, falls, fractures, and mortality), the Sarcopenia Definition and Outcomes Consortium (SDOC) crafted a set of position statements informed by a literature review and SDOC's analyses of eight epidemiologic studies, six randomized clinical trials, four cohort studies of special populations, and two nationally representative population‐based studies. METHODS: Thirteen position statements related to the putative components of a sarcopenia definition, informed by the SDOC analyses and literature synthesis, were reviewed by an independent international expert panel (panel) iteratively and voted on by the panel during the Sarcopenia Position Statement Conference. Four position statements related to grip strength, three to lean mass derived from dual‐energy x‐ray absorptiometry (DXA), and four to gait speed; two were summary statements. RESULTS: The SDOC analyses identified grip strength, either absolute or scaled to measures of body size, as an important discriminator of slowness. Both low grip strength and low usual gait speed independently predicted falls, self‐reported mobility limitation, hip fractures, and mortality in community‐dwelling older adults. 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. CONCLUSION: The panel agreed that both weakness defined by low grip strength and slowness defined by low usual gait speed should be included in the definition of sarcopenia. These position statements offer a rational basis for an evidence‐based definition of sarcopenia. The analyses that informed these position statements are summarized in this article and discussed in accompanying articles in this issue of the journal. J Am Geriatr Soc 68:1410‐1418, 2020.
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All regional working groups on the definition of sarcopenia have moved from recommending using lean mass alone to adding muscle strength and function, and switching focus from lean mass to muscle strength and function.
“All regional working groups on the definition of sarcopenia have moved from recommending using lean mass alone to adding muscle strength and function, and switching the focus of the definition from lean mass to muscle strength and function.[46][47][48]”
From Changes in lean body mass with <scp>glucagon‐like peptide</scp> ‐1‐based therapies and mitigation strategies (2024) · cites this paper as [48]
The Abstract Conclusion says the SDOC panel agreed that grip strength and gait speed should be included in the definition of sarcopenia. The Results discussion on DXA-derived lean mass says muscle mass was historically important, but panelists disagreed about excluding lean mass. The paper supports a shift in emphasis by this panel, not the claim that all regional working groups previously recommended lean mass alone and have made the same change. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe reason for the shift in focus is heterogeneity in the association of lean mass with mortality, muscle function, and mobility limitations.
“The reason for the shift in focus is the aforementioned heterogeneity in the association of lean mass with mortality, muscle function, and mobility limitations.[48][49][50][51][52]”
From Changes in lean body mass with <scp>glucagon‐like peptide</scp> ‐1‐based therapies and mitigation strategies (2024) · cites this paper as [48]
In Results, under “Supporting Evidence for Position Statements Related to DXA-Derived Lean Mass” (page unavailable), the paper reports that DXA-derived lean mass did not discriminate slowness and had associations near null with physical function and mortality. The “Discussion Regarding DXA-Derived Lean Mass” also says it was not a good predictor of mobility limitations or mortality. This supports a shift away from lean mass, but the paper does not identify heterogeneity in its associations with those outcomes as the reason for that shift. (LLM, conf=0.80)
Experimental — accuracy not yet measuredThe Sarcopenia Definitions and Outcomes Consortium position statement states that lean mass measured by DXA should not be included in the definition of sarcopenia.
“The Sarcopenia Definitions and Outcomes Consortium (SDOC) has gone the furthest by including in their position statement that 'lean mass measured by DXA should not be included in the definition of sarcopenia'. 48”
From Changes in lean body mass with <scp>glucagon‐like peptide</scp> ‐1‐based therapies and mitigation strategies (2024) · cites this paper as [48]
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References 46 · Cited by 723
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- Authors
- Bhasin, S., Travison, T. G., Manini, T. M., Patel, S., Pencina, K. M., Fielding, R. A., Magaziner, J. M., Newman, A. B., Kiel, D. P., Cooper, C., Guralnik, J. M., Cauley, J. A., Arai, H., Clark, B. C., Landi, F., Schaap, L. A., Pereira, S. L., Rooks, D., Woo, J., Woodhouse, L. J., Binder, E., Brown, T., Shardell, M., Xue, Q., DʼAgostino, R. B., Orwig, D., Gorsicki, G., Correa‐De‐Araujo, R., & Cawthon, P. M.
- Affiliations
- Brigham and Women's Hospital (US)
- Beth Israel Deaconess Medical Center (US)
- University of Florida (US)
- California Pacific Medical Center (US)
- Tufts University (US)
- University of Maryland, Baltimore (US)
- University of Pittsburgh (US)
- MRC Lifecourse Epidemiology Unit (GB)
- National Center for Geriatrics and Gerontology (JP)
- Ohio University (US)
- Università Cattolica del Sacro Cuore (IT)
- Department of Health Sciences, Faculty of Science Vrije Universiteit Amsterdam, Amsterdam Public Health Research institute Amsterdam The Netherlands
- Abbott (United States) (US)
- Muscle Group, Translational Medicine Novartis Institutes for Biomedical Research Cambridge Massachusetts
- Chinese University of Hong Kong (HK)
- University of Alberta (CA)
- Washington University in St. Louis (US)
- Johns Hopkins University (US)
- National Institute on Aging (US)
- Division of Geriatric Medicine and Gerontology and Center on Aging and Health Johns Hopkins Medical Institute Baltimore Maryland
- Department of Mathematics Framingham Heart Study, Boston University Boston Massachusetts
- Georgia Southern University (US)
- National Institutes of Health (US)
- Corresponding author
- Bhasin, Shalender
- ORCID
- Bhasin, Shalender
- Travison, Thomas G.
- Manini, Todd M.
- Pencina, Karol M.
- Fielding, Roger A.
- Newman, Anne B.
- Kiel, Douglas P.
- Cooper, Cyrus
- Guralnik, Jack M.
- Cauley, Jane A.
- Arai, Hidenori
- Clark, Brian C.
- Landi, Francesco
- Pereira, Suzette L.
- Rooks, Daniel
- Woo, Jean
- Woodhouse, Linda J.
- Binder, Ellen
- Brown, Todd
- Shardell, Michelle
- Orwig, Denise
- Cawthon, Peggy M.
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2020-03-09
- Volume
- 68
- Issue
- 7
- Pages
- 1410-1418
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC12132920
- OpenAlex
- W3009975500
- Cited by
- 723
- References
- 46
- Citations by year
- 2026: 124 · 2025: 133 · 2024: 116 · 2023: 125 · 2022: 103 · 2021: 78 · 2020: 41 · 2019: 1 · 2014: 1 · 2012: 1
- FWCI
- 52.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- U.S. Department of Agriculture (58‐1950‐4‐003)
- Foundation for the National Institutes of Health (CAWT16SARC2, BHAS16SARC2)
- National Institute on Aging (1UO1AG051421, 1R13AG060712‐01)
- 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, sarcopenia definitions, grip strength, walking speed, lean body mass, dual-energy X-ray absorptiometry, muscle weakness, mobility limitations, falls, hip fracture, mortality, older adults, position statement
- MeSH terms
- Accidental Falls, Walking Speed, Aged, Aged, 80 and over, Female, Hip Fractures, Humans, Male, Mortality, United States, Absorptiometry, Photon, Hand Strength, Consensus, Mobility Limitation, Sarcopenia, Independent Living
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