Sarcopenia: European consensus on definition and diagnosis

Abstract

The European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria for age-related sarcopenia. EWGSOP included representatives from four participant organisations, i.e. the European Geriatric Medicine Society, the European Society for Clinical Nutrition and Metabolism, the International Association of Gerontology and Geriatrics—European Region and the International Association of Nutrition and Aging. These organisations endorsed the findings in the final document.The group met and addressed the following questions, using the medical literature to build evidence-based answers: (i) What is sarcopenia? (ii) What parameters define sarcopenia? (iii) What variables reflect these parameters, and what measurement tools and cut-off points can be used? (iv) How does sarcopenia relate to cachexia, frailty and sarcopenic obesity?For the diagnosis of sarcopenia, EWGSOP recommends using the presence of both low muscle mass + low muscle function (strength or performance). EWGSOP variously applies these characteristics to further define conceptual stages as ‘presarcopenia’, ‘sarcopenia’ and ‘severe sarcopenia’. EWGSOP reviewed a wide range of tools that can be used to measure the specific variables of muscle mass, muscle strength and physical performance. Our paper summarises currently available data defining sarcopenia cut-off points by age and gender; suggests an algorithm for sarcopenia case finding in older individuals based on measurements of gait speed, grip strength and muscle mass; and presents a list of suggested primary and secondary outcome domains for research.Once an operational definition of sarcopenia is adopted and included in the mainstream of comprehensive geriatric assessment, the next steps are to define the natural course of sarcopenia and to develop and define effective treatment.

Changes in body composition and metabolic profile during interleukin 6 inhibition in rheumatoid arthritis

“…We observed that almost one‐third of RA patients had a muscle mass below the cut‐off value for sarcopaenia defined by the European Working Group on Sarcopenia in Older People (EWGSOP),5 contrasting with normal fat mass. Moreover, for the majority of sarcopaenic patients, the decrease in lean mass was associated with a low BMI (<20) supporting the evidence for rheumatoid cachexia in these patients with active and refractory disease.…”

“…The frequency of rheumatoid cachexia in the literature depends upon the definition of cachexia and/or sarcopaenia, the methods for assessing muscle mass, and the cut‐off values. Although the definition of sarcopaenia should include both low muscle mass and low muscle function,5 a combination of the two criteria was not reported in rheumatoid cachexia or sarcopaenia studies. Cachexia was diagnosed in two‐third of patients by using anthropometric method,29 whereas Giles et al .…”

“…Among patients with RA, low body mass index (BMI) is associated with cardiovascular death which could be related to cachexia‐associated metabolic disorders 4. Sarcopaenia is defined by both low muscle mass and muscle function (strength or performance) with a risk of physical disability, poor quality of life, and death 5, 6. During ageing and chronic diseases, decrease in lean mass is frequently associated with preserved or even increased body fat, notably ectopic fat in the muscles, regardless of changes in total body weight, thus defining sarcopaenic obesity.…”

Muscle wasting in young patients with dilated cardiomyopathy

“…The relative skeletal muscle mass was calculated by dividing the appendicular skeletal muscle mass to the square of height. The values less than 7.26 kg/m 2 in men and 5.45 kg/m 2 in women were considered as muscle wasting 12, 13…”

Proposal for new selection criteria considering pre‐transplant muscularity and visceral adiposity in living donor liver transplantation

“…The European Working Group on Sarcopenia in Older People has proposed that measuring and evaluating muscle mass, muscle strength, and physical performance are necessary in order to diagnose sarcopenia 1. Among various imaging modalities, such as dual‐energy X‐ray absorptiometry, computed tomography (CT), magnetic resonance imaging, and bioimpedance analysis, CT seems the best suited to measuring skeletal muscle mass in clinical settings, particularly in the surgical field, as CT is usually performed as part of the pre‐operative work‐up and during follow‐up.…”