Diagnosing Sarcopenia

Consensus among groups such as the European Society on Clinician Nutrition and Metabolism (ESPEN) and Special Interest Groups (SIG) on geriatric nutrition and on cachexia-anorexia in chronic wasting disease, have concluded using a test called DXA (dual-energy X-ray absorptiometry), in combination with measuring gait speed (walking speed) can be used to diagnose sarcopenia1.

DXA measures lean body mass in reference to a normal population. The European Working Group on Sarcopenia in Older People (EWGSOP) developed a diagnostic definition that measures muscle strength and physical performance using well-validated techniques. See attached tables developed by the EWGSOP2.

Table 1: Definition of sarcopenia for clinical and epidemiological studies3

Diagnosis is based on documentation of criterion 1 plus criterion 2 and/or 3

1.1. Low muscle mass

2.2 Low muscle strength

3.3 Low physical performance 

Table 2   Measurements of muscle mass, strength, and function in research and practice. Adapted from2

Variable Research Clinical Practice
Muscle Mass

Computed tomography (CT)

Magnetic resonance

Imaging (MRI)

Dual-energy X-ray

Absorptiometry (DXA)

Bio-electrical impedance analysis (BIA)

Total or partial body

Potassium per fat-free

Soft tissue




Muscle Strength

Handgrip strength

Knee flexion / extension

Peak expiratory flow

Handgrip strength
Physical Performance

Short Physical Performance

Battery (SPPB) 

Usual gait speed

Timed get-up-and-go test

Stair climb power test


Usual gait speed

Get-up-and-go test




1. Muscaritoli M, Anker S Argilés J, et al (2010) Consensus definition of sarcopenia, cachexia and pre-cachexia : Joint document elaborated by Special Interest Groups (SIG). “Cachexia-anorexia in chronic wasting diseases” and “nutrition in geriatrics”. Clinical Nutrition 29(2):154-9
2. Sarcopenia: European consensus on definition and diagnosis, Report of the European Working Group on Sarcopenia in Older People," Age and Ageing Advance Access originally published online on April 13, 2010, Age and Ageing 2010 39(4):412-423
3. Mithal A, Bonjour J-P, Boonen S, Burckhardt P, Degens H, El Hajj Fuleihan G,  Josse R,  Lips P, Morales Torres J, Rizzoli R, Yoshimura N, Wahl D.A., Cooper C, Dawson-Hughes B(2011) Impact of nutrition on muscle strength and performance in older adults. Osteoporosis International (in press)