BACKGROUND: in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. OBJECTIVES: to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. RECOMMENDATIONS: sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. CONCLUSIONS: EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.

Center for Geriatric Medicine University Heidelberg Agaplesion Bethanien Krankenhaus Heidelberg Germany

Department Geriatrics University of Antwerp Ziekenhuisnetwerk Antwerpen Antwerp Belgium

Department of Gastroenterology and Clinical Nutrition Centre Hospitalier Universitaire de Nice Université Côte d'Azur Nice France

Department of Geriatrics 1st Faculty of Medicine Charles University and General Faculty Hospital Prague Czech Republic

Department of Geriatrics Hospital and University of Toulouse Toulouse France

Department of Health Sciences Faculty of Science Vrije Universiteit Amsterdam; and the Amsterdam Public Health Research Institute; Amsterdam The Netherlands

Department of Internal Medicine Division of Geriatrics Istanbul Medical School Istanbul University Istanbul Turkey

Department of Internal Medicine Geriatrics Institute for Biomedicine and Ageing Friedrich Alexander University Erlangen Nürnberg Germany

Department of Medicine Geriatric section University of Verona Verona Italy

Department of Public Health and Caring Sciences Clinical Nutrition and Metabolism Uppsala University Uppsala and Theme Ageing Karolinska University Hospital Stockholm Sweden

Department of Public Health Epidemiology and Health Economics University of Liège Liège Belgium

Instituto di Medicina Interna e Geriatria Università Cattolica del Sacro Cuore Roma Italy

MRC Lifecourse Epidemiology Unit University of Southampton; Southampton UK; and Department of Epidemiology University of Oxford OX UK

NIHR Newcastle Biomedical Research Centre Newcastle upon Tyne Hospitals NHS Foundation Trust and Faculty of Medical Sciences Newcastle University Newcastle UK

Research Department Centre Hospitalier Universitaire de Clermont Ferrand Clermont Ferrand France

Servicio de Geriatría Hospital Universitario Ramón y Cajal Madrid Spain

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