With higher cutoff scores, the prevalence of probable sarcopenia quadrupled (from 10.6% to 40.1%), that of diagnosed sarcopenia increased from 1.4% to 5%, and that of severe sarcopenia more than doubled (from 3.9% to 8.8%) (<image: Freepik)

Published on 03/30/2026

By Maria Fernanda Ziegler  |  Agência FAPESP – Researchers at the Federal University of São Carlos (UFSCar) in Brazil analyzed data from over 7,000 Brazilians and found that stricter criteria for measuring muscle weakness can enhance sarcopenia screening. Sarcopenia is a condition associated with aging that is characterized by progressive muscle mass and function loss. In addition to facilitating an early diagnosis, the approach with higher cutoff points helps identify the risk of death associated with sarcopenia in advance.

Sarcopenia is linked to loss of functionality in older adults, as well as an increased risk of falls and mortality. According to the updated consensus of the European Working Group on Sarcopenia in Older People (EWGSOP2), sarcopenia has three stages: probable sarcopenia, characterized solely by low muscle strength; sarcopenia proper, characterized by low muscle strength and mass; and severe sarcopenia, characterized by low muscle mass and strength and low physical performance.

Using data from the Longitudinal Study of Health in Brazilian Older Adults (ELSI-Brasil), the study compared the prevalence and associated factors of sarcopenia. It used the EWGSOP2 standard to define low muscle strength (handgrip strength less than 27 kg for men and 16 kg for women) and higher cutoff points (less than 36 kg for men and less than 23 kg for women). The higher cutoff points have already been associated with mortality in previous studies.

“Measuring handgrip strength is a simple, practical, and inexpensive way to screen for sarcopenia. And by using stricter criteria, we can identify the condition earlier, increasing the chances of reversal through strength training and proper nutrition. In gerontology, it’s essential to act before problems worsen. Thus, the sooner sarcopenia is detected, the greater the chance of preventing falls, loss of functionality, and even death,” explains Tiago da Silva Alexandre, a professor at UFSCar and author of the study funded by FAPESP. 

The study found that using higher cutoff points added more than 2,000 people to the “probable sarcopenia” screening group. “When we used higher cutoff points, the prevalence of this initial stage quadrupled, rising from 10.6% to 40.1%. Sarcopenia proper increased from 1.4% to 5%. Meanwhile, severe sarcopenia more than doubled from 3.9% to 8.8%,” says Sara Souza Lima, a FAPESP scholarship recipient who conducted the study as part of her master’s thesis.

The researchers state that numerous cutoff points have been suggested for detecting sarcopenia, and Brazil currently uses the international EWGSOP2 criteria for diagnosis. “However, we’d already noticed that the standard cutoff point was beginning to create some diagnostic difficulties. In another study conducted by our research group, we found that the lower cutoff point – 36 kg for men and 23 kg for women – was the only one that identified a risk of death across all stages of sarcopenia,” Lima explains (read more at agencia.fapesp.br/39837). 

Malnutrition and sarcopenia

Another important finding of the study relates to malnutrition. Using the higher cutoff points revealed an even stronger association between malnutrition and severe sarcopenia. Of the participants, 41.5% were at nutritional risk, and 10% were malnourished.

“Nutrition plays a key role in maintaining muscle health, especially in the older population. When we use more sensitive criteria, we can more clearly see the impact of malnutrition on sarcopenia,” Alexandre explains.

Since the same individuals were assessed using both screening criteria, the researchers point out that the classic factors associated with sarcopenia – such as advanced age, low income, and a sedentary lifestyle – remained the same. “The difference is that the higher cutoff points allowed us to identify the risk of sarcopenia earlier. This highlights the importance of diagnostic criteria being based on relevant clinical outcomes, such as mortality, and not just statistics, as was the case with EWGSOP2,” Alexandre concludes.

The article “How does the cut-off point for grip strength affect the prevalence of sarcopenia and associated factors? Findings from the ELSI-Brazil Study” can be read at doi.org/10.1590/0102-311XEN155624.

 

Source: https://agencia.fapesp.br/57629