Calcified Tissue International

, Volume 93, Issue 3, pp 201–210 | Cite as

Tools in the Assessment of Sarcopenia

  • C. CooperEmail author
  • R. Fielding
  • M. Visser
  • L. J. van Loon
  • Y. Rolland
  • E. Orwoll
  • K. Reid
  • S. Boonen
  • W. Dere
  • S. Epstein
  • B. Mitlak
  • Y. Tsouderos
  • A. A. Sayer
  • R. Rizzoli
  • J. Y. Reginster
  • J. A. Kanis
Original Research


This review provides a framework for the development of an operational definition of sarcopenia and of the potential end points that might be adopted in clinical trials among older adults. While the clinical relevance of sarcopenia is widely recognized, there is currently no universally accepted definition of the disorder. The development of interventions to alter the natural history of sarcopenia also requires consensus on the most appropriate end points for determining outcomes of clinical importance which might be utilized in intervention studies. We review current approaches to the definition of sarcopenia and the methods used for the assessment of various aspects of physical function in older people. The potential end points of muscle mass, muscle strength, muscle power, and muscle fatigue, as well as the relationships between them, are explored with reference to the availability and practicality of the available methods for measuring these end points in clinical trials. Based on current evidence, none of the four potential outcomes in question is sufficiently comprehensive to recommend as a uniform single outcome in randomized clinical trials. We propose that sarcopenia may be optimally defined (for the purposes of clinical trial inclusion criteria as well as epidemiological studies) using a combination of measures of muscle mass and physical performance. The choice of outcome measures for clinical trials in sarcopenia is more difficult; co-primary outcomes, tailored to the specific intervention in question, may be the best way forward in this difficult but clinically important area.


Sarcopenia Muscle mass Muscle strength Muscle power Muscle fatigue Older adults 



This review was based on a workshop supported by the European Society for the Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the International Osteoporosis Foundation (IOF). We are grateful to the NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, and NIHR Nutrition Biomedical Research Unit, University of Southampton, UK.


C. C. has received consultancy fees/honoraria from Servier, Eli Lilly, Merck, Amgen, Novartis, GSK, Alliance, Medtronic; W. D. is an employee and stockholder of Amgen; W. E. is an employee of GlaxoSmithKline; B. M. is an employee and shareholder of Eli Lilly and Company; Y. T. is an employee of Servier. Y. R. has spoken for and prepared an education module with Nutricia and is on the expert board of Cheisi and Lactalis. S. B. was senior clinical investigator of the Fund for Scientific Research, Flanders, Belgium, and holder of the Leuven University Chair in Gerontology and Geriatrics.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • C. Cooper
    • 1
    • 2
    • 3
    Email author
  • R. Fielding
    • 4
  • M. Visser
    • 5
  • L. J. van Loon
    • 6
  • Y. Rolland
    • 7
  • E. Orwoll
    • 8
  • K. Reid
    • 4
  • S. Boonen
    • 9
    • 10
  • W. Dere
    • 11
  • S. Epstein
    • 12
  • B. Mitlak
    • 13
  • Y. Tsouderos
    • 14
  • A. A. Sayer
    • 1
  • R. Rizzoli
    • 15
  • J. Y. Reginster
    • 16
  • J. A. Kanis
    • 17
  1. 1.MRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton General HospitalSouthamptonUK
  2. 2.NIHR Nutrition Biomedical Research CentreUniversity of SouthamptonSouthamptonUK
  3. 3.NIHR Musculoskeletal Biomedical Research UnitUniversity of OxfordOxfordUK
  4. 4.Jean Mayer USDA Human Nutrition Research Center on AgingTufts UniversityBostonUSA
  5. 5.Department of Health Sciences VU University Medical Center, VU University Amsterdam and EMGO + InstituteAmsterdamThe Netherlands
  6. 6.Department of Human Movement SciencesMaastricht University Medical CentreMaastrichtThe Netherlands
  7. 7.Gérontopôle de Toulouse, INSERM Unit 1027, Department of Geriatric MedicineToulouse University HospitalToulouseFrance
  8. 8.Department of MedicineOregon Health & Science UniversityPortlandUSA
  9. 9.Division of Gerontology and Geriatrics and Center for Musculoskeletal Research, Department of Experimental MedicineLeuven UniversityLeuvenBelgium
  10. 10.Division of Geriatric Medicine and Center for Metabolic Bone Diseases, Department of Internal MedicineLeuven University HospitalLeuvenBelgium
  11. 11.Amgen LtdUxbridgeUK
  12. 12.Division of EndocrinologyMount Sinai School of MedicineNew YorkUSA
  13. 13.Lilly Research LaboratoriesEli Lilly & CoIndianapolisUSA
  14. 14.Institut de Recherches Internationales ServierSuresnes CedexFrance
  15. 15.Division of Bone DiseasesGeneva University HospitalsGenevaSwitzerland
  16. 16.Bone and Cartilage Metabolism UnitLiègeBelgium
  17. 17.WHO Collaborating Centre for Metabolic Bone DiseasesUniversity of Sheffield Medical SchoolSheffieldUK

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