GLIS; conceptual; definitions; older people; sarcopenia; Male; Humans; Aged; Female; Delphi Technique; Consensus; Leadership; Muscle Strength/physiology; Sarcopenia/diagnosis; Sarcopenia/epidemiology; Geriatrics and Gerontology; Aging; General Medicine
Abstract :
[en] [en] IMPORTANCE: Sarcopenia, the age-related loss of muscle mass and strength/function, is an important clinical condition. However, no international consensus on the definition exists.
OBJECTIVE: The Global Leadership Initiative in Sarcopenia (GLIS) aimed to address this by establishing the global conceptual definition of sarcopenia.
DESIGN: The GLIS steering committee was formed in 2019-21 with representatives from all relevant scientific societies worldwide. During this time, the steering committee developed a set of statements on the topic and invited members from these societies to participate in a two-phase International Delphi Study. Between 2022 and 2023, participants ranked their agreement with a set of statements using an online survey tool (SurveyMonkey). Statements were categorised based on predefined thresholds: strong agreement (>80%), moderate agreement (70-80%) and low agreement (<70%). Statements with strong agreement were accepted, statements with low agreement were rejected and those with moderate agreement were reintroduced until consensus was reached.
RESULTS: 107 participants (mean age: 54 ± 12 years [1 missing age], 64% men) from 29 countries across 7 continents/regions completed the Delphi survey. Twenty statements were found to have a strong agreement. These included; 6 statements on 'general aspects of sarcopenia' (strongest agreement: the prevalence of sarcopenia increases with age (98.3%)), 3 statements on 'components of sarcopenia' (muscle mass (89.4%), muscle strength (93.1%) and muscle-specific strength (80.8%) should all be a part of the conceptual definition of sarcopenia)) and 11 statements on 'outcomes of sarcopenia' (strongest agreement: sarcopenia increases the risk of impaired physical performance (97.9%)). A key finding of the Delphi survey was that muscle mass, muscle strength and muscle-specific strength were all accepted as 'components of sarcopenia', whereas impaired physical performance was accepted as an 'outcome' rather than a 'component' of sarcopenia.
CONCLUSION AND RELEVANCE: The GLIS has created the first global conceptual definition of sarcopenia, which will now serve to develop an operational definition for clinical and research settings.
Disciplines :
Geriatrics Public health, health care sciences & services
Author, co-author :
Kirk, Ben; Department of Medicine, Western Health, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia ; Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, Melbourne, VIC, Australia
Cawthon, Peggy M; California Pacific Medical Center, Research Institute, 550 16th Street, Second Floor, San Francisco, CA 94143USA ; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CAUSA
Arai, Hidenori; National Center for Geriatrics and Gerontology, Obu, AichiJapan
Ávila-Funes, José A ; Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico ; Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Inserm, Bordeaux F-33000, France
Barazzoni, Rocco; Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
Bhasin, Shalender; Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MAUSA
Binder, Ellen F; Division of General Medicine and Geriatrics, School of Medicine, Washington University in St. Louis, St. Louis MO, USA
Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Cederholm, Tommy; Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden ; Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden
Chen, Liang-Kung; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan ; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
Cooper, Cyrus ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé ; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK ; Department of Epidemiology, University of Oxford, Oxford, OXUK
Duque, Gustavo; Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, QC, Canada ; Dr Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada
Fielding, Roger ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé ; Nutrition Exercise, Physiology, and Sarcopenia Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MAUSA
Guralnik, Jack; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MDUSA
Kiel, Douglas P; Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MAUSA
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique ; WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Liège, Belgium ; Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
Sayer, Avan A; AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle Hospitals and Faculty of Medical Sciences Newcastle University, Newcastle, UK
Visser, Marjolein; Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands ; The Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
von Haehling, Stephan; Department of Cardiology and Pneumology, University Medicine Göttingen (UMG), Göttingen, Germany ; German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
Woo, Jean; Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
Cruz-Jentoft, Alfonso J; Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
Global Leadership Initiative in Sarcopenia (GLIS) group
Cawthon PM, Manini T, Patel SM et al. Putative cut-points in sarcopenia components and incident adverse health outcomes: an SDOC analysis. J Am Geriatr Soc 2020; 68: 1429–37.
Cawthon PM, Blackwell T, Cummings SR et al. Muscle mass assessed by the D3-creatine dilution method and incident self-reported disability and mortality in a prospective observational study of community-dwelling older men. J Gerontol A Biol Sci Med Sci 2021; 76: 123–30.
Guralnik JM, Cawthon PM, Bhasin S et al. Limited physician knowledge of sarcopenia: a survey. J Am Geriatr Soc 2023; 71: 1595–602.
Anker SD, Morley JE, von Haehling S. Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle 2016; 7: 512–4.
Mayhew AJ, Amog K, Phillips S et al. The prevalence of sarcopenia in community-dwelling older adults, an exploration of differences between studies and within definitions: a systematic review and meta-analyses. Age Ageing 2019; 48: 48–56.
Kirk B, Mooney K, Amirabdollahian F, Khaiyat O. Exercise and dietary-protein as a countermeasure to skeletal muscle weakness: Liverpool Hope University – Sarcopenia Aging Trial (LHU-SAT). Front Physiol 2019; 10: 445.
Kirk B, Mooney K, Cousins R et al. Effects of exercise and whey protein on muscle mass, fat mass, myoelectrical muscle fatigue and health-related quality of life in older adults: a secondary analysis of the Liverpool Hope University—Sarcopenia Ageing Trial (LHU-SAT). Eur J Appl Physiol 2020; 120: 493–503.
Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ. High-intensity strength training in nonagenarians: effects on skeletal muscle. JAMA 1990; 263: 3029–34.
Pahor M, Guralnik JM, Ambrosius WT et al. Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial. JAMA 2014; 311: 2387–96.
Bernabei R, Landi F, Calvani R et al. Multicomponent intervention to prevent mobility disability in frail older adults: randomised controlled trial (SPRINTT project). BMJ 2022; 377: 1–13.
Chen LK, Liu LK, Woo J et al. Sarcopenia in Asia: consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc 2014; 15: 95–101.
Chen L-K, Woo J, Assantachai P et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc 2020; 21: 300–307.e2.
Zanker J, Sim M, Anderson K et al. Consensus guidelines for sarcopenia prevention, diagnosis and management in Australia and New Zealand. J Cachexia Sarcopenia Muscle 2023; 14: 142–56.
Zanker J, Scott D, Reijnierse EM et al. Establishing an operational definition of sarcopenia in Australia and New Zealand: Delphi method based consensus statement. J Nutr Health Aging 2019; 23: 105–10.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al. Sarcopenia: European consensus on definition and diagnosis. Age Ageing 2010; 39: 412–23.
Cruz-Jentoft AJ, Bahat G, Bauer J et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019; 48: 16–31.
Studenski SA, Peters KW, Alley DE et al. The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci 2014; 69: 547–58.
Fielding RA, Vellas B, Evans WJ et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc 2011; 12: 249–56.
Bhasin S, Travison TG, Manini TM et al. Sarcopenia definition: the position statements of the sarcopenia definition and outcomes consortium. J Am Geriatr Soc 2020; 68: 1410–8.
Cawthon PM, Travison TG, Manini TM et al. Establishing the link between lean mass and grip strength cut points with mobility disability and other health outcomes: proceedings of the sarcopenia definition and outcomes consortium conference. J Gerontol A Biol Sci Med Sci 2020; 75: 1317–23.
Donini LM, Busetto L, Bischoff SC et al. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement. Clin Nutr 2022; 41: 990–1000.
Jensen GL, Cederholm T, Correia MITD et al. GLIM criteria for the diagnosis of malnutrition: a consensus report from the global clinical nutrition community. JPEN J Parenter Enteral Nutr 2019; 43: 32–40.
Cederholm T, Jensen GL. To create a consensus on malnutrition diagnostic criteria: a report from the Global Leadership Initiative on Malnutrition (GLIM) meeting at the ESPEN Congress 2016. Clin Nutr 2017; 36: 7–10.
Cao L, Morley JE. Sarcopenia is recognized as an independent condition by an international classification of disease, tenth revision, clinical modification (ICD-10-CM) code. J Am Med Dir Assoc 2016; 17: 675–7.
Rolland Y, Cruz-Jentoft AJ. Editorial: sarcopenia: keeping on search for the best operational definition. J Nutr Health Aging 2023; 27: 202–4.
Sanchez-Rodriguez D, Marco E, Cruz-Jentoft AJ. Defining sarcopenia: some caveats and challenges. Curr Opin Clin Nutr Metab Care 2020; 23: 127–32.
Cruz-Jentoft AJ, Gonzalez MC, Prado CM. Sarcopenia ≠ low muscle mass. Eur Geriatr Med 2023; 14: 225–8.
Cawthon PM, Visser M, Arai H et al. Defining terms commonly used in sarcopenia research: a glossary proposed by the Global Leadership in Sarcopenia (GLIS) steering committee. Eur Geriatr Med 2022; 13: 1239–44.
Cruz-Jentoft AJ. Diagnosing sarcopenia: turn your eyes back on patients. Age Ageing 2021; 50: 1904–5.