Towards a definition of sarcopenia — results from epidemiologic studies



The age-related loss of muscle mass, also called sarcopenia, is receiving increasing attention in aging research. While the concept is frequently being used in research settings and introduced to clinical settings, thus far no consensus on its definition has been established. This article provides an overview of the history of sarcopenia definitions proposed in the literature thus far. It will describe the methodology used to develop the cutpoints for low muscle mass (or strength) in large epidemiological studies, how sarcopenia based on these cutpoints relates to functional outcomes, and the advantages and disadvantages of the different definitions. This overview will contribute to the current need to develop a consensus definition of sarcopenia which can be used in all relevant settings.


  1. 1.
    Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr 1997;127(Suppl):990S–991S.PubMedGoogle Scholar
  2. 2.
    Roubenoff R, Hughes VA. Sarcopenia: current concepts. J Gerontol A Biol Sci Med Sci 2000;55:M716–724.PubMedGoogle Scholar
  3. 3.
    Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, Garry PJ, Lindeman RD. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 1998;147:755–763.PubMedGoogle Scholar
  4. 4.
    Heymsfield SB, Smith R, Aulet M, Bensen B, Lichtman S, Wang J, Pierson RN Jr. Appendicular skeletal muscle mass: measurement by dual-photon absorptiometry. Am J Clin Nutr 1990;52:214–218.PubMedGoogle Scholar
  5. 5.
    Wang ZM, Visser M, Ma R, Baumgartner RN, Kotler D, Gallagher D, Heymsfield SB. Skeletal muscle mass: evaluation of neutron activation and dual-energy X-ray absorptiometry methods. J Appl Physiol 1996;80:824–831.PubMedGoogle Scholar
  6. 6.
    Gallagher D, Visser M, De Meersman RE, Sepúlveda D, Baumgartner RN, Pierson RN, Harris T, Heymsfield SB. Appendicular skeletal muscle mass: effects of age, gender, and ethnicity. J Appl Physiol 1997;83:229–239.PubMedGoogle Scholar
  7. 7.
    Lau EM, Lynn HS, Woo JW, Kwok TC, Melton LJ 3rd. Prevalence of and risk factors for sarcopenia in elderly Chinese men and women. J Gerontol A Biol Sci Med Sci 2005;60:213–216.PubMedGoogle Scholar
  8. 8.
    Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 2002;50:889–896.CrossRefPubMedGoogle Scholar
  9. 9.
    Janssen I, Baumgartner RN, Ross R, Rosenberg IH, Roubenoff R. Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women. Am J Epidemiol 2004;159:413–421.CrossRefPubMedGoogle Scholar
  10. 10.
    Janssen I. Influence of sarcopenia on the development of physical disability: the Cardiovascular Health Study. J Am Geriatr Soc 2006;54:56–62.CrossRefPubMedGoogle Scholar
  11. 11.
    Rolland Y, Lauwers-Cances V, Cournot M, Nourhashémi F, Reynish W, Rivière D, Vellas B, Grandjean H. Sarcopenia, calf circumference, and physical function of elderly women: a cross-sectional study. J Am Geriatr Soc 2003;51:1120–124.CrossRefPubMedGoogle Scholar
  12. 12.
    Newman AB, Kupelian V, Visser M, Simonsick E, Goodpaster B, Nevitt M, Kritchevsky SB, Tylavsky FA, Rubin SM, Harris TB, Health ABC Study Investigators. Sarcopenia: alternative definitions and associations with lower extremity function. J Am Geriatr Soc 2003;51:1602–1609.CrossRefPubMedGoogle Scholar
  13. 13.
    Delmonico MJ, Harris TB, Lee JS, Visser M, Nevitt M, Kritchevsky SB, Tylavsky FA, Newman AB; Health, Aging and Body Composition Study. Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women. J Am Geriatr Soc 2007;55:769–774.CrossRefPubMedGoogle Scholar
  14. 14.
    Lauretani F, Russo CR, Bandinelli S, Bartali B, Cavazzini C, Di Iorio A, Corsi AM, Rantanen T, Guralnik JM, Ferrucci L. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 2003;95:1851–1860.PubMedGoogle Scholar
  15. 15.
    Visser M, Deeg DJ, Lips P, Harris TB, Bouter LM. Skeletal muscle mass and muscle strength in relation to lower-extremity performance in older men and women. J Am Geriatr Soc 2000;48:381–386.PubMedGoogle Scholar
  16. 16.
    Visser M, Goodpaster BH, Kritchevsky SB, Newman AB, Nevitt M, Rubin SM, Simonsick EM, Harris TB. Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci 2005;60:324–333.PubMedGoogle Scholar
  17. 17.
    Lee JS, Auyeung TW, Kwok T, Lau EM, Leung PC, Woo J. Associated factors and health impact of sarcopenia in older chinese men and women: a cross-sectional study. Gerontology 2007;53:404–410.CrossRefPubMedGoogle Scholar
  18. 18.
    Misic MM, Rosengren KS, Woods JA, Evans EM. Muscle quality, aerobic fitness and fat mass predict lower-extremity physical function in community-dwelling older adults. Gerontology 2007;53:260–266.CrossRefPubMedGoogle Scholar
  19. 19.
    Newman AB, Kupelian V, Visser M, Simonsick EM, Goodpaster BH, Kritchevsky SB, Tylavsky FA, Rubin SM, Harris TB. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci Med Sci 2006;61:72–77.PubMedGoogle Scholar
  20. 20.
    Gale CR, Martyn CN, Cooper C, Sayer AA. Grip strength, body composition, and mortality. Int J Epidemiol 2007;36:228–235.CrossRefPubMedGoogle Scholar
  21. 21.
    Manini TM, Visser M, Won-Park S, Patel KV, Strotmeyer ES, Chen H, Goodpaster B, De Rekeneire N, Newman AB, Simonsick EM, Kritchevsky SB, Ryder K, Schwartz AV, Harris TB. Knee extension strength cutpoints for maintaining mobility. J Am Geriatr Soc 2007;55:451–457.CrossRefPubMedGoogle Scholar
  22. 22.
    Cress ME, Meyer M. Maximal voluntary and functional performance levels needed for independence in adults aged 65 to 97 years. Phys Ther 2003;83:37–48.PubMedGoogle Scholar
  23. 23.
    Buchner D, deLateur B. The importance of skeletal muscle strength to physical function in older persons. Ann Behav Med 1991;13:91–98.Google Scholar
  24. 24.
    Buchner DM, Larson EB, Wagner EH, Koepsell TD, de Lateur BJ. Evidence for a non-linear relationship between leg strength and gait speed. Age Ageing 1996;25:386–391.CrossRefPubMedGoogle Scholar
  25. 25.
    Clark BC, Manini TM. Sarcopenia =/= dynapenia. J Gerontol A Biol Sci Med Sci 2008;63:829–834.PubMedGoogle Scholar
  26. 26.
    Visser M, Langlois J, Guralnik JM, Cauley JA, Kronmal RA, Robbins J, Williamson JD, Harris TB. High body fatness, but not low fat-free mass, predicts disability in older men and women: the Cardiovascular Health Study. Am J Clin Nutr 1998;68:584–590.PubMedGoogle Scholar
  27. 27.
    Zoico E, Di Francesco V, Guralnik JM, Mazzali G, Bortolani A, Guariento S, Sergi G, Bosello O, Zamboni M. Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women. Int J Obes Relat Metab Disord 2004;28:234–241.PubMedGoogle Scholar
  28. 28.
    Zoico E, Di Francesco V, Mazzali G, Zivelonghi A, Volpato S, Bortolani A, Dioli A, Coin A, Bosello O, Zamboni M. High baseline values of fat mass, independently of appendicular skeletal mass, predict 2-year onset of disability in elderly subjects at the high end of the functional spectrum. Aging Clin Exp Res 2007;19:154–159.PubMedGoogle Scholar
  29. 29.
    Visser M, Harris TB, Langlois J, Hannan MT, Roubenoff R, Felson DT, Wilson PW, Kiel DP. Body fat and skeletal muscle mass in relation to physical disability in very old men and women of the Framingham Heart Study. J Gerontol A Biol Sci Med Sci 1998;53:M214–M221.PubMedGoogle Scholar
  30. 30.
    Lebrun CE, van der Schouw YT, de Jong FH, Grobbee DE, Lamberts SW. Fat mass rather than muscle strength is the major determinant of physical function and disability in postmenopausal women younger than 75 years of age. Menopause 2006;13:474–481.CrossRefPubMedGoogle Scholar
  31. 31.
    Baumgartner RN, Wayne SJ, Waters DL, Janssen I, Gallagher D, Morley JE. Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res 2004;12:1995–2004.CrossRefPubMedGoogle Scholar
  32. 32.
    Stenholm S, Harris TB, Rantanen T, Visser M, Kritchevsky SB, Ferrucci L. Sarcopenic obesity: definition, cause and consequences. Curr Opin Clin Nutr Metab Care 2008;11:693–700.CrossRefPubMedGoogle Scholar

Copyright information

© Serdi and Springer Verlag France 2009

Authors and Affiliations

  1. 1.Department of Health Sciences, Faculty of Earth and Life SciencesVU University AmsterdamAmsterdamthe Netherlands
  2. 2.EMGO InstituteVU University Medical CenterAmsterdamthe Netherlands
  3. 3.Department of Health Sciences, Faculty of Earth and Life SciencesVU University AmsterdamAmsterdamthe Netherlands

Personalised recommendations