The sarcopenia definition is not a loose description of getting weaker with age. It is a formal set of criteria with published cut-off points, and it has been rewritten twice since 2010.
Key takeaways
- EWGSOP2, the 2019 European consensus, defines sarcopenia as a muscle disease and places low muscle strength at the front of the definition, with low muscle quantity or quality used to confirm it and poor physical performance marking severe cases.
- The published European cut-off points are grip strength below 27 kg in men and 16 kg in women, more than 15 seconds for five chair rises, and gait speed of 0.8 m/s or less.
- The Asian Working Group for Sarcopenia publishes its own criteria, because cut-off points derived from European populations do not transfer cleanly.
- A 2024 global Delphi consensus agreed sarcopenia is a skeletal muscle disease defined by reduced muscle mass and strength, and that physical performance is an outcome rather than a component. The operational version of that definition is still being written.
- Sarcopenia has been billable under ICD-10 code M62.84 since October 2016, which separates it from muscle wasting NEC and from cachexia.
Where the word came from
Sarcopenia is built from two Greek roots. Irwin Rosenberg, writing in the Journal of Nutrition in 1997, set out the origins of the term: sarx for flesh and penia for loss. His argument in that paper was that clearly defining the condition would let investigators classify patients properly and let funding bodies target a taxonomically distinct syndrome.
That argument took two decades to be settled, and the settlement is what this page describes.
The sarcopenia definition in current use
In Europe and much of the English-language literature, the reference standard is EWGSOP2, the revised European consensus published in Age and Ageing in 2019.
Its central statement is that sarcopenia is a muscle disease, described as muscle failure, rooted in adverse muscle changes that accrue across a lifetime. It is common in older age but is explicitly not restricted to it.
The structural change EWGSOP2 made was to put strength first. The original 2010 consensus led with muscle mass. The 2019 revision elevates low muscle strength as the primary indicator of probable sarcopenia, uses low muscle quantity or quality to confirm the diagnosis, and treats poor physical performance as an indicator of severity. The reasoning is practical: strength predicts outcomes better than mass does, and it is far easier to measure in a clinic.
The group also set out an algorithm, abbreviated F-A-C-S, for Find, Assess, Confirm, Severity. Case finding uses the SARC-F questionnaire or clinical suspicion, assessment uses grip strength or a chair stand test, confirmation uses DXA or bioelectrical impedance in usual care and DXA, MRI or CT in research and specialist settings, and severity is judged on physical performance.
The EWGSOP2 cut-off points
The 2010 consensus deliberately declined to publish thresholds, and the resulting disagreement held the field back. EWGSOP2 published them.
| Measure | Men | Women |
|---|---|---|
| Grip strength | Below 27 kg | Below 16 kg |
| Chair stand, five rises | More than 15 seconds | More than 15 seconds |
| Appendicular skeletal muscle mass (ASM) | Below 20 kg | Below 15 kg |
| ASM divided by height squared | Below 7.0 kg/m2 | Below 5.5 kg/m2 |
| Gait speed | 0.8 m/s or less | 0.8 m/s or less |
| Short Physical Performance Battery | Score of 8 or less | Score of 8 or less |
| Timed Up and Go | 20 seconds or more | 20 seconds or more |
| 400 m walk | Non-completion, or 6 minutes or more | Non-completion, or 6 minutes or more |
These numbers are for reading a report, not for self-assessment. A grip strength result on its own does not make a diagnosis.
Probable, confirmed and severe
The three-stage structure is the part clinicians use most, and it is worth stating plainly.
- Probable sarcopenia is low muscle strength.
- Confirmed sarcopenia is low muscle strength together with low muscle quantity or quality.
- Severe sarcopenia is all of the above plus low physical performance.
EWGSOP2 adds two further axes. Sarcopenia is called primary when ageing is the only evident cause and secondary when other causes are present, such as a systemic disease that provokes inflammation, immobility or inadequate intake. And it distinguishes acute sarcopenia, lasting less than six months and usually tied to an acute illness or injury, from chronic sarcopenia lasting six months or more, which is associated with progressive conditions and increased mortality risk.
Why the Asian criteria differ
The Asian Working Group for Sarcopenia published its 2019 consensus update in JAMDA, retaining its earlier definition of age-related loss of muscle mass plus low muscle strength and/or low physical performance, while revising the diagnostic algorithm and protocols.
The existence of a second set of criteria is not a disagreement about what sarcopenia is. It reflects the fact that cut-off points are population-derived. Thresholds calibrated on European body sizes will misclassify people in populations with different average stature and body composition, so regional reference data is a methodological necessity rather than a political one.
What the 2024 global consensus changed
The Global Leadership Initiative in Sarcopenia published an executive summary of its global conceptual definition in 2024, based on a two-phase Delphi study with 107 participants from 29 countries.
Three of its agreed positions matter for anyone reading the literature:
- Sarcopenia is a disease of skeletal muscle, and the definition should be the same for research and for clinical practice.
- The definition should not depend on age, care setting or clinical condition.
- The components are reduced muscle mass and strength, together with muscle-specific strength. Physical performance is explicitly not a component. It is an outcome.
That third point is a real change from EWGSOP2, which uses physical performance to grade severity. GLIS is a conceptual definition only; working groups were still developing the operational version, with its measurements and thresholds, at the time of publication. Until that lands, EWGSOP2 and AWGS remain the criteria in day-to-day use.
How the definition changes the numbers
Prevalence estimates for sarcopenia vary widely, and the definition used is a large part of the reason. StatPearls summarises the range as roughly 5% to 13% in adults aged 60 and above and 11% to 50% in those aged 80 and above, attributing the spread to inconsistent diagnostic criteria and heterogeneous study populations.
When you see two studies report very different sarcopenia rates in similar populations, check which criteria each applied before concluding anything about the populations themselves.
The diagnostic code
Sarcopenia has been a billable ICD-10-CM code since October 2016: M62.84. Having its own code is what separated it administratively from generic muscle wasting and atrophy, coded under M62.5-, and from cachexia, which is coded R64 when no underlying condition is documented and E88.A, with that condition coded first, when one is. Our sarcopenia ICD-10 page covers documentation requirements and the miscodes that come up most often.
What the definition does not settle
None of these consensus documents specifies a mechanism, and that gap is where the drug development story sits.
Myostatin, or GDF-8, is a negative regulator of skeletal muscle mass, identified in 1997 when mice lacking the gene grew markedly larger muscles. The obvious inference was that blocking it might treat sarcopenia. What the trials actually produced is covered on our page on myostatin and sarcopenia, and the short version is that lean mass responds while function has not followed. Because the diagnostic criteria above are anchored on strength and performance rather than on mass, a drug that moves only mass does not, by the current definition, treat the disease.
Frequently asked questions
What is the medical definition of sarcopenia?
Under EWGSOP2, sarcopenia is a muscle disease characterised by low muscle strength, with low muscle quantity or quality confirming the diagnosis and low physical performance indicating that it is severe. It is described as muscle failure arising from adverse muscle changes that accumulate across a lifetime.
Is sarcopenia the same as normal ageing?
No. Some loss of muscle with age is expected, but sarcopenia is a defined disease state with published thresholds, and most older adults do not meet them. EWGSOP2 also notes that sarcopenia can occur earlier in life, and that it can be secondary to disease, immobility or inadequate intake rather than to ageing alone.
Why do EWGSOP2 and AWGS use different cut-off points?
Because cut-off points are derived from reference populations. Grip strength and muscle mass distributions differ between populations, so a European threshold applied in an Asian population would misclassify people. AWGS 2019 keeps the same underlying concept and publishes its own criteria and algorithm.
What is the difference between probable and confirmed sarcopenia?
Probable sarcopenia means low muscle strength has been found, which is enough to start assessment and treatment. Confirmed sarcopenia requires evidence of low muscle quantity or quality as well, usually from DXA or bioelectrical impedance. Severe sarcopenia adds low physical performance on top of both.
Does the 2024 GLIS definition replace EWGSOP2?
Not yet. GLIS published a conceptual definition agreed by Delphi consensus, and working groups were still developing the operational definition with its measurements and thresholds. Until that operational version is published and adopted, EWGSOP2 and AWGS remain the criteria used in practice.
Sources
- Cruz-Jentoft AJ et al. Sarcopenia: revised European consensus on definition and diagnosis (EWGSOP2). Age Ageing 2019;48(1):16-31
- Cruz-Jentoft AJ, Sayer AA. Sarcopenia. Lancet 2019;393(10191):2636-2646
- Chen LK et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc 2020;21(3):300-307
- Kirk B et al. An executive summary on the Global conceptual definition of Sarcopenia. Aging Clin Exp Res 2024;36(1):153
- Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr 1997;127(5 Suppl):990S-991S
- Ardeljan AD, Hurezeanu R. Sarcopenia. StatPearls, NCBI Bookshelf
- ICD-10 code M62.84, sarcopenia (AAPC)
- ICD-10 codes R64, cachexia, and E88.A, wasting disease due to underlying condition (AAPC)
- McPherron AC, Lawler AM, Lee SJ. Regulation of skeletal muscle mass in mice by a new TGF-beta superfamily member. Nature 1997;387:83-90
This article is for educational purposes only and is not medical advice. The cut-off points listed here are published research and clinical criteria, presented so that readers can understand a report or a study. They are not a self-assessment tool and do not constitute a diagnosis. If you are concerned about muscle loss or weakness, speak with a qualified healthcare professional.