Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People — TEI-tagged view

Alfonso J. Cruz‐Jentoft, Jean‐Pierre Baeyens, Jürgen M. Bauer, Yves Boirie‌, Tommy Cederholm, Francesco Landi, Finbarr C. Martin, Jean‐Pierre Michel, Yves Rolland, S. Schneider, Eva Topinková, M. Vandewoude, Mauro Zamboni · 2010 · medicine · doi:10.1093/ageing/afq034 · TEI xml · tagged edition · index · concepts · authors
Where this record's text came from. 2026-08-23 schema-0.3 pass: every quote verified as an exact substring of the staged text and anchored at merge time; concept terms verified present; every edge endpoint an existing node.
This record’s own method is expert-consensus, and the tags below follow from that. A review’s findings, quantities and statistics are things stated IN this paper, and some of them report results obtained elsewhere. No tag on this page names a different author. Measured across every review in this corpus, 81% of a review’s tags carry no citation at all — most of them are the review speaking. The corpus does not adjudicate the rest: read an unmarked tag as a claim this paper makes, not necessarily one it made first.
Other fields define these differently the same word, defined another way in another discipline
standard deviation 3 fields
Tags on this paper every tag the record carries, whether or not the words occur in the text below — a number is how many papers in the corpus carry that tag; a tag with no number is unique to this paper
sarcopenia3 syndrome3 cachexia2 dynapenia primary sarcopenia2 secondary sarcopenia frailty4 expert-consensus69
Method, as described: consensus working group: four societies nominated representatives, three meetings in 2009 plus extensive email, literature reviews guided by four questions, then circulation to the four boards for input, revision and final endorsement

Our tag layer for this paper

Cross-disciplinary analysis
content-tags & facets: phenomenon · claim-type · cross-domain-transfer · mechanism · claim-relation · replication-status · limitation — grounded in the full text
phenomenona term in wide use whose prevalence estimate depends on which definition of it the estimator chose— “Depending on the literature definition used for sarcopenia, the prevalence in 60–70-year-olds is reported as 5–13%, while the prevalence ranges from 11 to 50% in people >80 years [ 71 ].”
claim-typemethod— “Sarcopenia is a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and death [ 17, 18 ]. The EWGSOP recommends using the presence of both low muscle mass and low muscle function (strength or performance) for the…
method — evidence— “While age-related sarcopenia is common and has huge personal and financial costs, sarcopenia still has no broadly accepted clinical definition, consensus diagnostic criteria, International Classification of Diseases 9th Revision (ICD-9) codes or treatment guidelines.”
object of study — evidence— “While age-related sarcopenia is common and has huge personal and financial costs, sarcopenia still has no broadly accepted clinical definition, consensus diagnostic criteria, International Classification of Diseases 9th Revision (ICD-9) codes or treatment guidelines.”
research question — evidence— “Sarcopenia is a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and death [ 17, 18 ]. The EWGSOP recommends using the presence of both low muscle mass and low muscle function (strength or performance) for the…
contribution — evidence— “Sarcopenia is a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and death [ 17, 18 ]. The EWGSOP recommends using the presence of both low muscle mass and low muscle function (strength or performance) for the…
mechanismA TERM COINED IN 1989 THAT STILL HAD NO AGREED DEFINITION IN 2010: `In 1989, Irwin Rosenberg proposed the term `SARCOPENIA` (GREEK `SARX` or flesh + `PENIA` or loss) to describe this age-related decrease of muscle mass. Sarcopenia has since been defined as the loss of skeletal muscle mass and strength that occurs with advancing age. However, a widely accepted definition of sarcopenia suitable for use in research and clinical practice is still lacking.` The coinage is dated, attributed and given its etymology, and the gap it left is stated in the next sentence— “In 1989, Irwin Rosenberg proposed the term ‘sarcopenia’ (Greek ‘sarx’ or flesh + ‘penia’ or loss) to describe this age-related decrease of muscle mass [ 1, 2 ]. Sarcopenia has since been defined as the loss of skeletal muscle mass and strength that occurs with advancing age [ 3 ]. However, a widely accepted definition of sarcopenia suitable…mechanisms[0]
mechanismAND THE ABSENCE IS ENUMERATED, INCLUDING THE ADMINISTRATIVE ONE: `sarcopenia still has no broadly accepted clinical definition, consensus diagnostic criteria, International Classification of Diseases 9th Revision (ICD-9) codes or treatment guidelines.` A missing ICD code is a missing SLOT IN A CONTROLLED VOCABULARY, listed beside the missing definition as the same kind of lack - the clearest statement in this corpus that a definition and its administrative code are one problem— “While age-related sarcopenia is common and has huge personal and financial costs, sarcopenia still has no broadly accepted clinical definition, consensus diagnostic criteria, International Classification of Diseases 9th Revision (ICD-9) codes or treatment guidelines.”mechanisms[1]
mechanismAND A BETTER TERM WAS REJECTED BECAUSE THE WORSE ONE IS ALREADY KNOWN: `Some have argued that the term dynapenia is better suited to describe age-associated loss of muscle strength and function. However, sarcopenia is already a widely recognised term, so replacing it might lead to further confusion.` THE EXACT MIRROR OF haas2018: Banff DELETED the word `acute` because it confused clinicians; EWGSOP KEPT `sarcopenia`, against a term it concedes is better suited, because replacing it would confuse. Two consensus bodies, opposite decisions, the same reason - and neither decision is about the biology— “Some have argued that the term dynapenia is better suited to describe age-associated loss of muscle strength and function [ 20 ]. However, sarcopenia is already a widely recognised term, so replacing it might lead to further confusion.”mechanisms[2]
mechanismAND THE PREVALENCE RANGE IS ATTRIBUTED TO THE DEFINITION IN ONE SENTENCE: `Depending on the literature definition used for sarcopenia, the prevalence in 60-70-year-olds is reported as 5-13%, while the prevalence ranges from 11 to 50% in people >80 years.` bellomo2004 and hoste2006 each gave a range and left the reader to infer the cause; this paper names it— “Depending on the literature definition used for sarcopenia, the prevalence in 60–70-year-olds is reported as 5–13%, while the prevalence ranges from 11 to 50% in people >80 years [ 71 ].”mechanisms[3]
mechanismAND A THRESHOLD SET BY WHAT DATA EXISTED, CALLED ARBITRARY BY THE PAPER ITSELF: `Because population norms for young adult blacks and whites are not currently available, the gender-specific 20th percentile was arbitrarily chosen as the cut-off point for each method.` The class boundary is where the reference data ran out, and the sentence says which population's absence set it— “Because population norms for young adult blacks and whites are not currently available, the gender-specific 20th percentile was arbitrarily chosen as the cut-off point for each method.”mechanisms[4]
mechanismAND THE CONVENTION BEHIND EVERY OTHER CUT-OFF IS STATED AS A CHOICE: `EWGSOP recommends use of normative (healthy young adult) rather than other predictive reference populations, with cut-off points at two standard deviations below the mean reference value. More research is urgently needed in order to obtain good reference values for populations around the world.` Two decisions - which population is the reference, and how many SDs below it - and the paper concedes the first is under-supplied— “Cut-off points depend upon the measurement technique chosen and on the availability of reference studies. EWGSOP recommends use of normative (healthy young adult) rather than other predictive reference populations, with cut-off points at two standard deviations below the mean reference value. More research is urgently needed in order to…mechanisms[5]
mechanismAND THE INTENSION IS DECLARED TOO NARROW, WITH THE REASON: `muscle strength does not depend solely on muscle mass, and the relationship between strength and mass is not linear. Thus, defining sarcopenia only in terms of muscle mass is too narrow and may be of limited clinical value.` The two-criterion rule is derived from a non-linearity rather than asserted— “The rationale for use of two criteria is: muscle strength does not depend solely on muscle mass, and the relationship between strength and mass is not linear [ 18, 19 ]. Thus, defining sarcopenia only in terms of muscle mass is too narrow and may be of limited clinical value.”mechanisms[6]
mechanismand the category is adopted BECAUSE the causes are unknown, not despite it: `We suggest it may be likewise helpful to recognise sarcopenia as a geriatric syndrome because this view promotes its identification and treatment even when the exact causes remain unknown.` A class chosen for what it lets clinicians do, with the aetiological ignorance stated as part of the justification— “We suggest it may be likewise helpful to recognise sarcopenia as a geriatric syndrome because this view promotes its identification and treatment even when the exact causes remain unknown [ 5, 6 ].”mechanisms[7]
extends Rosenberg's 1989 coinage of 'sarcopenia' for the age-related decrease of muscle mass - this paper keeps the name and widens the intension to require functionclaim_relations[0]
critiques the literature's definitions of sarcopenia by muscle mass alone, which the paper calls 'too narrow and may be of limited clinical value'
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
claim_relations[1]
sense`sarcopenia` (Rosenberg 1989) - the COINAGE: Greek `sarx` (flesh) + `penia` (loss), for the age-related decrease of muscle MASS alone
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
senses[0]
sense`sarcopenia` (EWGSOP 2010) - MASS PLUS FUNCTION: `a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength`, diagnosed as `low muscle mass PLUS low muscle strength or low physical performance`. The 1989 sense is declared `too narrow`
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
senses[1]
sense`dynapenia` - the term EWGSOP concedes is `better suited to describe age-associated loss of muscle strength and function`, and declines to adopt because `sarcopenia is already a widely recognised term`
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
senses[2]
sense`primary` vs `secondary sarcopenia` - the same condition split by whether a cause OTHER THAN AGEING is evident; the paper adds that in many older people the aetiology is multi-factorial so neither label applies
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
senses[3]
sense`presarcopenia` / `sarcopenia` / `severe sarcopenia` - three CONCEPTUAL stages by how many of the three criteria are met
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senses[4]
controlrequiring BOTH low muscle mass and low muscle function for the diagnosis, rather than mass alone — held
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
— rules out a definition that the paper argues is too narrow, on the grounds that 'muscle strength does not depend solely on muscle mass, and the relationship between strength and mass is not linear'
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controls[0]
controlnormative (healthy young adult) reference populations rather than predictive ones, with cut-offs two standard deviations below the mean — partial
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
— rules out cut-off points that drift with whichever study population happens to be at hand
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
controls[1]
controlthe primary/secondary split by whether a cause other than ageing is evident — partial
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
— rules out treating disease-, activity- and nutrition-related muscle loss as age-related sarcopenia
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
controls[2]
weightRosenberg's 1989 coinage of 'sarcopenia' for the age-related decrease of muscle mass - this paper keeps the name and widens the intension to require function — 0.9
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
claim_relations[0]
weightthe literature's definitions of sarcopenia by muscle mass alone, which the paper calls 'too narrow and may be of limited clinical value' — 0.85
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
claim_relations[1]
notesarcopenia —distinct-from→ cachexia — 'most cachectic…' Distinct, asymmetrically overlapping, and one is a component of the other's DEFINITION - which the schema cannot say, so it is in the note
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concept_edges[0]
relationsarcopenia —distinct-from→ cachexia — the overlap runs ONE WAY: most cachectic individuals are sarcopenic, most sarcopenic individuals are not cachectic
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Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
concept_edges[0]
weightsarcopenia —distinct-from→ cachexia — 0.95
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concept_edges[0]
notesarcopenia —is-a→ syndrome — Weight 0.9, not 0.95: 'syndrome' is a broad endpoint, and the paper's sharper claim is the narrower class 'GERIATRIC syndrome', argued separately and adopted BECAUSE the causes are unknown - 'this view promotes…'
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concept_edges[1]
relationsarcopenia —is-a→ syndrome — 'Sarcopenia is a syndrome characterised by ...' - the working definition's own opening clause
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Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
concept_edges[1]
weightsarcopenia —is-a→ syndrome — 0.9
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concept_edges[1]
noteprimary sarcopenia —distinct-from→ secondary sarcopenia — `Sarcopenia can be considered `primary` (or age-related) when no other cause is evident but ageing itself, while sarcopenia can be considered `secondary` when one or more other causes are evident.` The split is by AETIOLOGY, not by presentation - and the paper immediately concedes that `in many older people the aetiology is multi-factorial so that it may not be possible to characterise each individual as having a primary or secondary condition`
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
concept_edges[2]
relationprimary sarcopenia —distinct-from→ secondary sarcopenia — one condition split by whether a cause OTHER THAN AGEING is evident
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
concept_edges[2]
weightprimary sarcopenia —distinct-from→ secondary sarcopenia — 0.95
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
concept_edges[2]
outcomecontrol — held
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
controls[0]
outcomecontrol — partial
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
controls[1]
outcomecontrol — partial
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
controls[2]
limitationTHE NEIGHBOURING CONSTRUCTS OVERLAP ASYMMETRICALLY AND ONE IS PART OF THE OTHER'S DEFINITION: `most cachectic individuals are also sarcopenic, but most sarcopenic individuals are not considered cachectic. Sarcopenia is one of the elements of the proposed definition for cachexia.` A concept that is a COMPONENT OF ANOTHER CONCEPT'S DEFINITION while also being distinguished from it - the corpus has no edge type for `is part of the definition of`, only for parts of things
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limitations[0]
limitationAND FRAILTY OVERLAPS IT WHILE EXTENDING BEYOND IT: `Frailty and sarcopenia overlap; most frail older people exhibit sarcopenia, and some older people with sarcopenia are also frail. The general concept of frailty, however, goes beyond physical factors to encompass psychological and social dimensions as well.` Overlap without containment in either direction, said in one sentence
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limitations[1]
limitationand there is no standard outcome to test a treatment against: `only a handful of clinical trials are under way to test potential sarcopenia treatments. The absence of standardised primary outcomes is a major challenge for the design of such studies.` The definition is proposed so that trials become possible, and the paper says in the same paragraph that the outcomes for those trials do not exist either
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limitations[2]
limitationand the stages are labelled CONCEPTUAL, with presarcopenia reachable only by an instrument most clinics do not have: `This stage can only be identified by techniques that measure muscle mass accurately and in reference to standard populations` - so the first stage of the classification is, in practice, unobservable wherever the reference populations are the ones the paper says are missing
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
limitations[3]
Content tags
content-observations: finding · quantity · variable · definition · key-term — grounded in the full text
finding
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content_tags.findings[0]
finding
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content_tags.findings[1]
finding
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content_tags.findings[2]
finding
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content_tags.findings[3]
finding
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content_tags.findings[4]
finding
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content_tags.findings[5]
quantity5-13% —
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content_tags.quantities[0]
quantity11 to 50% —
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content_tags.quantities[1]
quantitytwo standard deviations below the mean of a normative (healthy young adult) reference population —
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content_tags.quantities[2]
quantitythe gender-specific 20th percentile, arbitrarily chosen —
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content_tags.quantities[3]
variablemuscle mass
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content_tags.variables[0]
variablemuscle strength
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content_tags.variables[1]
definitionsarcopenia
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content_tags.definitions[0]
definitionsarcopenia
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content_tags.definitions[1]
definitionpresarcopenia
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content_tags.definitions[2]
Concepts
terms this paper carries, each with the sentence it was cut from — the layer that joins one paper to another. Terms with no quote yet are on CONCEPTS.html.
conceptsarcopenia — not defined in this paper's own words; the syndrome this working group convened to define, named in 1989 and undefined for twenty-one years
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concepts[0]
conceptsyndrome — not defined in this paper's own words; the class EWGSOP places sarcopenia in, chosen because it permits identification and treatment while the causes remain unknown
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concepts[1]
conceptcachexia — not defined in this paper's own words; the neighbouring wasting syndrome: most cachectic individuals are sarcopenic, most sarcopenic individuals are not cachectic
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concepts[2]
conceptdynapenia — not defined in this paper's own words; the competing term, conceded to be better suited and declined on grounds of recognisability
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concepts[3]
conceptprimary sarcopenia — not defined in this paper's own words; sarcopenia with no cause evident but ageing itself
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concepts[4]
conceptsecondary sarcopenia — not defined in this paper's own words; sarcopenia with one or more other causes evident - activity, disease or nutrition
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concepts[5]
conceptfrailty — not defined in this paper's own words; the geriatric syndrome that overlaps sarcopenia and extends beyond physical factors into psychological and social ones
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concepts[6]
Statistics — cross-field join keys
field-invariant statistical terms, used in their statistical sense (gated on a number / symbol / test). A p-value or a standard deviation means the SAME thing in physics, biology, psychology and sociology — so these are the strongest cross-field join keys. Grounded verbatim.
standard deviation
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content_tags.statistics[0]

When we have changed our mind. Some entries in the table begin with a word in capitals and the reason for it. EVIDENCE CORRECTED — the finding still stands, but we had quoted the wrong sentence from the paper, and the quotation has been replaced with the right one. RETRACTED — the entry itself was wrong; it stays on the page, marked, with the reason, rather than being deleted. WITHDRAWN AND REPLACED — the entry was wrong, and a corrected version of it appears in the entries below. Each mark carries its own reason, in brackets, because the reasons differ from one entry to the next. An entry we have WITHDRAWN is removed from this page and kept in the record, with its reason. A line reading Audit and a date is a later re-reading of the entry against its whole sentence: DOUBTFUL means it was kept, and the reason says what is loose about it. Quotation marks inside the tagger's sentence. Where a tag is the tagger's own sentence, a phrase in quotation marks inside it is borrowed from the paper — the tagger's wording around it is not. The paper's own sentence is the evidence quote for that row; on this page it is withheld with the article, and the article is at its publisher. Nothing inside quotation marks anywhere on this page is ours: if it is quoted, it is the paper's. Whose words a concept carries. A concept entry records a term the paper itself uses, so the term, the sense given for it, and its evidence are the paper's own words, quoted where the paper fixes them. This is the opposite of a sense entry in the tag table, which is the tagger's sentence about how the paper uses a term. Where a concept entry could not be grounded in the paper's words, the entry says so on its own row.

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