Sarcopenia Definition: The Position Statements of the Sarcopenia Definition and Outcomes Consortium

TLDR

The study aimed to create an evidence‑based definition of sarcopenia to identify older adults at risk for mobility limitation, falls, fractures, and mortality. The authors developed 13 position statements on sarcopenia components, reviewed and voted on by an international expert panel, covering grip strength, lean mass (DXA), and gait speed. The analyses showed that low grip strength and low gait speed independently predict falls, mobility limitation, hip fractures, and mortality, whereas lean mass measured by DXA was not associated with adverse outcomes, leading to the recommendation that sarcopenia be defined by weakness and slowness. Published in J Am Geriatr Soc 68:1410‑1418, 2020.

Abstract

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.