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Is Appendicular Lean Soft Tissue Mass a Clinically Valid Diagnostic Marker for Sarcopenia?
Yosuke Osuka1,2, Sho Hatanaka2, Narumi Kojima2
1Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
Geriatrics & Gerontology International
|November 18, 2025
Summary
Excluding appendicular lean soft tissue mass (ALSTM) from sarcopenia diagnosis is equivalent to including it for predicting health outcomes. This suggests ALSTM may not be essential for diagnosing sarcopenia.
Area of Science:
- Geriatrics
- Aging Research
- Clinical Diagnostics
Background:
- Sarcopenia diagnosis criteria are debated among geriatric experts.
- The role of appendicular lean soft tissue mass (ALSTM) in sarcopenia diagnosis is a key point of discussion.
Purpose of the Study:
- To evaluate if sarcopenia diagnostic models excluding ALSTM are equivalent to those including ALSTM in discriminating health outcomes.
- To assess the necessity of ALSTM measurement in sarcopenia diagnosis.
Main Methods:
- Utilized data from the Itabashi Longitudinal Study on Aging in Tokyo, Japan.
- Developed two sarcopenia diagnostic models based on AWGS2019 criteria: Model 1 (includes ALSTM) and Model 2 (excludes ALSTM).
- Compared the models' ability to discriminate self-reported falls and hospitalization using receiver operating characteristic curve analysis.
Main Results:
- Analyzed 2432 community-dwelling older adults (median age 76 years).
- Both models showed similar discrimination ability for falls (AUC difference: -0.004) and hospitalization (AUC difference: -0.004).
- The differences in AUCs were within the pre-specified equivalence margin of ±0.05.
Conclusions:
- Diagnostic models for sarcopenia that exclude ALSTM demonstrated equivalent discrimination of health-related outcomes compared to models that include it.
- The findings question the routine necessity of assessing ALSTM for sarcopenia diagnosis in older adults.
