Comparison of the cut-off for sarcopenia diagnosis among elderly Indians using reference data of young healthy Indians and the Asian working group on sarcopenia (AWGS) definition

Objectives: The study addresses the growing concern of sarcopenia among the ageing population, highlighting the lack of standardised diagnostic criteria and the necessity of population-specific criteria for optimal diagnosis. It aims to compare the presence of sarcopenia in elderly Indians using population-specific versus existing criteria to improve accuracy in diagnosis and timely management. Materials and Methods: Indian adults aged 60 years and above ( n = 33) were recruited, excluding those with specific health conditions. Body composition (whole-body potassium counter and bio-electrical impedance analysis), muscle strength (isokinetic dynamometer), physical performance (short physical performance battery) and frailty (FRAIL) were assessed. Population-specific cut-offs for sarcopenia were derived and applied based on young adult reference values published earlier. Results: Using the Asian working group on sarcopenia (AWGS) cut-offs demonstrated a much higher diagnosis of probable sarcopenia (91%) and no diagnosis of sarcopenia among the Indian population. However, using the population-specific reference data demonstrated 57% of the population to have probable sarcopenia and 7% each to have sarcopenia and severe sarcopenia. There was a significant difference in the proportion of individuals with sarcopenia as assessed by the McNemar Chi-square test ( P < 0.001). Conclusion: The study shows that while the AWGS criteria have been valuable in providing standardised diagnostic guidelines, their universal applicability to diverse populations might result in the misclassification of individuals and delayed intervention.