Operationalizing the Global Leadership Initiative in Sarcopenia: Muscle-Specific Strength, Optimal Criteria and...

Area of Science:

• Gerontology
• Musculoskeletal Health
• Aging Research

Background:

• The Global Leadership Initiative on Sarcopenia (GLIS) offers a framework for standardized sarcopenia diagnosis, but its practical application requires definition.
• Operationalizing GLIS is crucial for consistent sarcopenia identification and management.

Purpose of the Study:

• To operationalize the GLIS framework for sarcopenia diagnosis.
• To evaluate the feasibility, diagnostic concordance, and clinical relevance of different GLIS operationalizations.
• To assess the performance of proposed sarcopenia diagnostic criteria against existing standards and functional outcomes.

Main Methods:

• A three-stage, multicenter study involving over 12,000 participants from a national survey in China.
• Development of the lower limb skeletal muscle mass to five-time chair stand test ratio (LFR) to assess muscle-specific strength (MSS).
• Evaluation of six GLIS diagnostic criteria combinations using handgrip strength (HGS), appendicular skeletal muscle mass index (ASMI), and MSS, comparing them with the Asian Working Group for Sarcopenia 2019 (AWGS) criteria and functional outcomes.

Main Results:

• Sarcopenia prevalence varied significantly across different GLIS definitions, ranging from 3.3% to 31.9%.
• The handgrip strength or muscle-specific strength (H/M) method demonstrated the strongest correlation with functional outcomes and superior discrimination for impaired activities of daily living.
• The H/M method showed comparable or superior performance in identifying disabilities in an external validation cohort of chronic kidney disease patients.

Conclusions:

• An operational framework for GLIS was established using nationally representative data and validated in a clinical setting.
• The LFR method is a feasible approach for assessing MSS, and the H/M method effectively captures functional impairment for sarcopenia diagnosis.
• Findings provide benchmarks for sarcopenia research and clinical practice, potentially guiding refined prevention and intervention strategies.