Sarcopenia in the era of precision health: Toward personalized interventions for healthy longevity

Abstract

Sarcopenia, characterized by the progressive loss of skeletal muscle mass and function, significantly impacts health outcomes in older adults. This review explores the evolving landscape of sarcopenia research, with a particular focus on its unique characteristics in Asian populations and emerging pharmaceutical interventions. Recent studies have revealed distinct patterns of muscle mass decline in Asian adults, particularly in women, challenging the universal application of global sarcopenia diagnostic criteria. The Asian Working Group for Sarcopenia has proposed region-specific diagnostic criteria, acknowledging these ethnic variations. Prevalence estimates of sarcopenia vary widely, ranging from 10% to 40% in community-dwelling older adults. For specific chronic conditions, the prevalence of sarcopenia is notably higher, reaching 35% for cardiovascular diseases and 24.5% for chronic kidney disease. Sarcopenia is strongly associated with various chronic conditions, increasing the risk of falls by 1.5 to 3 times and significantly increasing mortality risk by 29% to 51%. Current management strategies primarily involve resistance exercise and nutritional interventions, with a recommended daily protein intake of at least 1.2 g/kg to maintain muscle health. Pharmaceutical development has gained significant momentum, with over 20 compounds in various stages of clinical trials. These include myostatin inhibitors, selective androgen receptor modulators, ghrelin receptor agonists, mesenchymal stem cell therapy, and follistatin gene therapy. However, the unique dietary patterns, cultural contexts, and potentially distinct drug responses in Asian populations necessitate tailored interventions and Asia-specific clinical trials. Future directions include refining Asian-specific diagnostic criteria, conducting large-scale epidemiological studies across multiple Asian countries, developing culturally appropriate interventions, integrating sarcopenia management into chronic disease care, and advancing pharmaceutical research with a focus on Asian populations. In conclusion, sarcopenia emerges as a critical nexus in the aging process, intricately linked with multiple organ systems and chronic conditions, underscoring the imperative for its recognition as a cornerstone in person-centered care and the holistic management of age-related health challenges.

1. INTRODUCTION

Presbyopia, the age-related physiological decline characterized by progressive homeostatic disruption, manifests as a diminishing physiological reserve, weakening of organ function, and increased susceptibility to diseases, further compounded by heightened social vulnerability, all of which collectively contribute to a decline in functional independence and overall well-being in older adults.^1–3 Notably, a key feature of presbyopia is the progressive and multifaceted alteration in body composition, manifested by a gradual loss of lean mass encompassing both skeletal muscle and bone mineral density, alongside a concerning increase in adipose tissue.^4,5 These alterations transcend mere physiological shifts and often culminate in distinct pathological entities.⁶ Skeletal deterioration, characterized by osteoporosis, with its hallmark reduction in bone mineral density and elevated fracture risk,⁷ advances concurrently with a notable increase in adiposity, frequently resulting in obesity, which represents a substantial public health challenge.^8,9 More recently, sarcopenia, defined by a detrimental loss of muscle mass and function, has emerged as a critical feature of presbyopia.^10–12 Age-related alterations in body composition not only manifest as distinct pathologies but also frequently co-occur, forming a spectrum of detrimental conditions. These include sarcopenic obesity, osteosarcopenia, and even osteosarcopenic obesity.¹³ These co-occurring pathologies collectively signify a maladaptive body composition shift during the aging process.

Like other geriatric syndromes, sarcopenia is often overlooked in clinical practice despite its profound influence on patient outcomes.¹⁴ This underdiagnosis necessitates heightened awareness and the integration of sarcopenia assessment into standard care for older adults.^15,16 Timely identification coupled with interventions such as exercise programs and optimized protein intake can significantly improve patients’ functional ability and quality of life. This proactive approach can be implemented during routine consultations for any medical condition in older adults.¹⁷ For example, despite demonstrably improved quality of care through deprescribing potentially inappropriate medications in older populations with multimorbidity or disability, a knowledge translation gap hinders widespread implementation.¹⁸ Moreover, inherent variability in the clinical response among older adults undergoing therapeutic interventions has been reported.¹⁹ Therefore, incorporating an assessment and management of geriatric syndromes, such as sarcopenia, into routine clinical evaluations for older adults is essential for optimizing the quality of care. This approach transcends a simplistic reliance on chronological age as the sole determinant of healthcare needs as people age.

Coined in the 1980s from the Greek words “sarco” (flesh) and “penia” (loss), sarcopenia has transitioned from a geriatric syndrome to a recognized disease entity with its own ICD-10 code (M62.84).²⁰ Characterized by an age-related loss of skeletal muscle mass and its function, sarcopenia presents as a potent risk factor for a cascade of adverse outcomes in older adults. These outcomes include falls, fractures, functional limitations, hospitalizations, nursing home placement, and mortality,²¹ ultimately contributing to a decline in quality of life and increased healthcare burden. Currently, the understanding of sarcopenia has undergone a significant evolution. The initial definition, which exclusively emphasized diminished skeletal muscle mass, has been supplanted by a revised conceptualization of sarcopenia that acknowledges the critical interplay between concurrent loss of muscle mass and impaired muscle function.¹² The burgeoning growth of the global older adult population, coupled with increased life expectancy, has propelled sarcopenia to the forefront of healthcare concerns. Consequently, the international research community has focused on refining diagnostic approaches, optimizing treatment and management strategies, and exploring novel pharmaceutical interventions with diverse mechanisms of action for sarcopenia.²² This review presents a comprehensive narrative analysis of sarcopenia diagnosis, epidemiology, and associated clinical outcomes, with particular emphasis on the unique diagnostic considerations for Asian populations and an exploration of promising therapeutic avenues for future development.

2. EVOLVING DIAGNOSTIC CRITERIA AND ASSESSMENT TOOLS

In the initial stages of sarcopenia diagnosis, the focus was predominantly on quantifying appendicular skeletal muscle (ASM).²³ This mirrored the approach taken for osteoporosis assessment, where low bone mineral density was defined using reference values derived from a young, healthy population.²⁴ While computed tomography (CT) and magnetic resonance imaging (MRI) are considered the gold standard diagnostic modalities, sarcopenia can also be diagnosed by using dual-energy X-ray absorptiometry (DXA) as a standard tool and bioelectrical impedance analysis (BIA) in some scenarios.²⁵ In 2010, a paradigm shift occurred. The European Working Group on Sarcopenia in Older People (EWGSOP) introduced a structured algorithm incorporating muscle strength and physical performance alongside ASM assessment.²⁶ The 2010 EWGSOP consensus advocated for initial screening via the usual gait speed in older adults, with a cutoff of 0.8 m/s. Individuals demonstrating both reduced ASM and diminished muscle strength, or those exhibiting low physical performance, could be diagnosed with sarcopenia. The revised EWGSOP2 has updated its definition and diagnostic criteria for sarcopenia in 2018,²⁷ building upon the original 2010 EWGSOP guidelines. The EWGSOP2 considers low muscle strength as the primary parameter for identifying sarcopenia. Specific cutoff points are provided, including a grip strength <27 kg for men and <16 kg for women and a chair stand of >15 seconds for five rises or a usual gait speed ≤0.8 m/s for low physical performance. For muscle mass, the cutoffs are <20 kg for men and <15 kg for ASM. By incorporating a novel distinction between acute (<6 months) and chronic (≥6 months) sarcopenia, alongside a refined classification for “probable sarcopenia” on the basis of the hand grip strength and chair rise time, the EWGSOP2 framework aims to streamline early detection and facilitate timely management of sarcopenia in clinical practice.

The multifaceted diagnosis of sarcopenia, which involves muscle mass, strength, and physical performance, presents a susceptibility to confounding factors such as ethnicity, body composition, dietary patterns, and the socioeconomic milieu. In recognition of this challenge, the Asian Working Group for Sarcopenia (AWGS) established in 2013 aimed to develop a culturally sensitive sarcopenia diagnostic algorithm that aligns with international perspectives while acknowledging regional specificities.²⁵ Leveraging data primarily from Taiwan, Japan, and Hong Kong, the AWGS published a consensus statement in 2014. This landmark initiative, which is largely concordant with the EWGSOP consensus, established ethnicity-specific diagnostic cutoffs, and pioneering advancements in Asian sarcopenia research. In 2019, the AWGS released a revised consensus outlining a novel diagnostic pathway tailored to healthcare settings.²⁸ While the core diagnostic criteria remained consistent, the AWGS 2019 proposal streamlined the approach for primary care settings, facilitating the integration of sarcopenia management into routine clinical practice. Within primary care settings, the AWGS recommends initial screening of muscle strength (via handgrip dynamometry) and physical performance (assessed by gait speed or the five-times chair stand test). Individuals demonstrating impairments in either domain are classified as having “possible sarcopenia” and are recommended for further evaluation of muscle mass via DXA or BIA (depending on availability). Conversely, hospital and research settings are required to use the comprehensive sarcopenia diagnostic protocol. Crucially, the AWGS 2019 consensus emphasizes the paramount importance of incorporating sarcopenia prevention and management strategies into chronic disease management programs for older people and demonstrates better prediction for clinical outcomes.²⁹

Multiple expert groups, including International Working Group on Sarcopenia (IWGS),³⁰ Society of Cachexia and Wasting Disorders (SCWD),³¹ and Sarcopenia Diagnosis and Outcomes Consortium (SDOC),³² have proposed diagnostic criteria for sarcopenia. While specific details may differ slightly, there is substantial agreement that sarcopenia is characterized by low muscle mass and impaired muscle function. The IWGS proposed a more clinically practical diagnostic algorithm. This approach incorporates a higher gait speed cutoff (1 m/s) than the EWGSOP criteria. However, a previous investigation evaluating sarcopenia prevalence via established IWGS and EWGSOP criteria revealed only moderate concordance between the diagnostic methods. This underscores the critical need for standardized cutoffs that account for variations in sex and ethnicity.³³

Recently, the Global Leadership Initiative in Sarcopenia (GLIS) has emerged as a significant effort to establish an international consensus on sarcopenia diagnosis. The GLIS aims to bridge the inconsistencies in definitions and diagnostic criteria across expert panels that have hindered progress in sarcopenia research and clinical practice. The initiative follows a two-step process: first, developing a standardized glossary for key sarcopenia terminology, and then using this common language to create a unified global definition and diagnostic approach. The first GLIS report provided clear definitions for various measures of muscle mass, strength, and physical performance, laying the groundwork for harmonizing sarcopenia research globally.³⁴ In 2024, the GLIS published a Delphi-based conceptual definition of sarcopenia, involving 107 experts from 29 countries.³⁵ This consensus acknowledges muscle mass, muscle strength, and muscle-specific strength as components of sarcopenia while considering impaired physical performance as an outcome rather than a diagnostic component. The GLIS approach simplifies the conceptual definition by focusing on core components without severity levels. Moving forward, the GLIS will work on operationalizing this conceptual definition, which has the potential to revolutionize clinical practice and research in sarcopenia by enabling standardized diagnosis, assessment, and comparison of findings across different studies and populations.

3. EPIDEMIOLOGY OF SARCOPENIA AND COMORBID CONDITIONS

Overall, sarcopenia affects approximately 10% to 16% of the older population worldwide³⁶ and is associated with multifaceted challenges.³⁷ However, its prevalence is significantly higher in certain patient groups, ranging from 18% in people with diabetes mellitus (DM) to 66% in those with unresectable esophageal cancer, 25% to 70% in patients with liver cirrhosis, and 37% in those with colorectal cancer. Sarcopenia is associated with various adverse outcomes, especially in patients receiving aggressive treatment, such as increased mortality risk (emergency laparotomy patients with an odds ratio [OR] of 3.50) and poor overall survival (lung cancer patients with an OR of 3.07). In the general population, sarcopenia is significantly associated with cognitive impairment, osteoporosis, falls, fractures, hospitalization, metabolic syndrome, and DM. Risk factors for sarcopenia include physical inactivity, malnutrition, smoking, extreme sleep durations (<6 hours: OR: 1.71, >8 hours: OR: 1.52), and DM.³⁶ However, significant variability in the prevalence of sarcopenia was reported in a meta-analysis, ranging from 10% to 27%, depending on the diagnostic criteria used. The EWGSOP2 criteria yielded the lowest prevalence at 10%, whereas the muscle mass criteria alone resulted in the highest prevalence at 27%. Regional variations were notable, with Oceania showing the highest prevalence and Europe the lowest. Age-related differences were observed, with the prevalence ranging from 8% to 36% in individuals under 60 years of age and 10% to 27% in those 60 years and older. Sex-specific differences in prevalence were also noted, varying according to the criteria applied. Severe sarcopenia (the concomitant presence of low muscle mass, reduced muscle strength, and low physical performance), although less studied, has a prevalence ranging from 2% to 9%, with European studies reporting up to 12% using the EWGSOP criteria. The substantial impact of different diagnostic criteria, measurement methods, and study populations on prevalence estimates has been observed, highlighting the need for more standardized approaches to accurately assess the global burden of sarcopenia.³⁸

Among community-dwelling older adults, a connection between sarcopenia and several sociodemographic, behavioral, and disease-related factors has been reported. A meta-analysis, which included over 98 500 participants from 68 studies, revealed that older age is a significant risk factor, while being single, divorced, or widowed, living alone, having difficulty with daily activities, and being underweight were all independently associated factors. Engaging in unhealthy behaviors such as smoking, physical inactivity, or poor nutrition was also linked to increased risk. On the other hand, some protective factors against sarcopenia have been reported, such as being overweight or obese and consuming moderate amounts of alcohol, which may be secondary to better nutrition and social networking.³⁹

A robust association exists between sarcopenia and a multitude of chronic illnesses of a wasting nature, such as cardiovascular diseases (CVDs), chronic obstructive pulmonary disease (COPD), DM, and chronic kidney disease (CKD). An analysis of 38 studies with 4327 people with CVDs and 9541 controls revealed a significantly higher pooled prevalence of sarcopenia in the CVD population (35%) than in the general population (13%). Specifically, the prevalence of sarcopenia was 61% for acute decompensated heart failure, 32% for chronic heart failure, 43% for coronary artery disease, 30% for cardiac arrhythmia, 35% for congenital heart disease, and 12% for unclassed CVDs. Subgroup analyses revealed a greater prevalence of sarcopenia in hospitalized patients (44%) than in ambulatory patients (22%). The high prevalence of sarcopenia in older adults with CVDs underscores the necessity for refined care plans that meticulously balance the management of both conditions in this vulnerable population.⁴⁰ In addition, a recent systematic review and meta-analysis encompassing 10 studies and 2565 people with COPD estimated a pooled prevalence of sarcopenia of 21.6%. However, the prevalence varied across different population settings: 12.4% to 28.1% in clinic-based studies, 7.9% to 8.4% in population-based studies, and 53.8% to 66.7% in nursing home-based studies. There was high heterogeneity between studies, largely due to differences in population settings and measurement methods. The prevalence of sarcopenia in people with COPD was approximately twice as high as that in healthy older people. Factors associated with sarcopenia in COPD patients included older age, disease severity, lower body mass index, symptoms of dyspnea, and higher levels of inflammatory markers.⁴¹

To investigate the prevalence and risk factors for sarcopenia in people with DM, a meta-analysis of 45 studies encompassing 12 237 participants was conducted and revealed an overall prevalence of 18%. Subgroup analysis revealed that sarcopenia was more prevalent in males (20%) than in females (17%) and was more common in Asia (19%) than in South America (13%) and Oceania (9%). The prevalence was higher in hospitalized patients (18%) than in community settings (15%). Several risk factors were identified, including older age, higher HbA1c levels, a greater visceral fat area, the presence of diabetic nephropathy, a longer duration of DM, and higher high-sensitivity C-reactive protein levels. Protective factors included exercise and metformin use.⁴² In addition to DM, in an analysis of 140 studies with 42 041 participants from 25 countries, the overall prevalence of sarcopenia in CKD patients was 24.5% (95% CI, 20.9%-28.3%), with no significant differences among CKD stages. The overall prevalence of severe sarcopenia was 21.0%, but it was significantly greater in people receiving dialysis (26.2%). There were no significant differences in prevalence between men (25.8%) and women (25.7%) or between Asian (26.0%) and non-Asian countries (22.3%). The high prevalence of sarcopenia and its traits, particularly low muscle strength, in CKD patients highlights the importance of regular screening and early intervention, especially for dialysis-dependent patients.⁴³

Not only do chronic wasting illnesses exhibit a strong association with sarcopenia, but mental health conditions also demonstrate a compelling link to this age-related muscle decline. A systematic review investigating the association between sarcopenia and depression in older adults revealed a concerning co-occurrence of depression in approximately 28% of the nearly 1500 sarcopenia cases, with the average participant age being 75.5 years. However, notably, the studies exhibited substantial heterogeneity. A significant 57% increased risk of depression was revealed in subjects with sarcopenia after adjusting for confounding factors. The study highlights a relatively high prevalence of depression among those with sarcopenia and suggests a link between the two conditions.⁴⁴ Another study examined the prevalence and correlation of mild cognitive impairment (MCI) with sarcopenia. On the basis of 13 studies with 27 428 cases, the pooled prevalence of MCI in participants with sarcopenia was 20.5%. The overall adjusted OR between MCI and sarcopenia was 1.46. However, the strength of the association between sarcopenia and MCI diminished when both conditions were diagnosed in accordance with established guidelines. The concerning co-occurrence and significant association between sarcopenia and cognitive decline necessitate the integration of cognitive performance screening into the clinical evaluation of individuals with sarcopenia, and vice versa.⁴⁵ The link between sarcopenia and cognitive impairment extends beyond global cognition, specifically impacting non-memory domains.^46,47

4. UNIQUE CHARACTERISTICS OF SARCOPENIA IN ASIAN POPULATIONS

Despite the high degree of biological similarity among humans with different ethnic backgrounds, sociocultural factors, particularly dietary patterns, can influence physiological responses. Notably, Asian populations tend to exhibit greater adiposity (body fat percentage) than Caucasians do, even at lower body weights.⁴⁸ This phenomenon is relevant to sarcopenia, as although previous studies in Caucasians consistently demonstrated muscle mass, strength, and performance reductions with aging in both sexes,⁴⁹ data from Asians are less conclusive.^50,51 The greater adiposity in Asians may mask lower muscle mass, suggesting the need for ethnicity-specific cutoffs for defining low muscle mass. Additionally, a Korean study revealed a “cohort effect,” where younger Korean women had surprisingly lower muscle mass than older women did. Compared with that of their older counterparts, skeletal muscle mass in younger Korean females exhibits a multifactorial disparity.⁵² This discrepancy can be attributed to, first, a higher prevalence of underweight status among younger women. This, in turn, is likely influenced by contemporary societal pressures surrounding body image. Second, Korea’s economic boom in recent decades has significantly reduced the need for physically demanding activities, such as manual labor or nonmechanized transportation, in younger generations. This stands in stark contrast to the experiences of their grandparents. This challenges the definition of low muscle mass on the basis of young adult reference values. Interestingly, Asian men seem to follow the Caucasian pattern of muscle mass decline with age, whereas Asian women exhibit an age-related decrease in muscle strength despite stable muscle mass.

In addition to cross-sectional comparisons of muscle mass between sexes and age groups, longitudinal studies have revealed sex-disparate patterns of muscle loss over time. Asian men exhibit a gradual decline in muscle mass after middle age, whereas women do not experience a similar trajectory until their 80s.⁵³ This convergence of cross-sectional and longitudinal data underscores a sex-specific pattern of muscle loss during aging that appears unique to Asian populations. This observation stands in contrast to the current understanding and definition of sarcopenia, as established by Western research. While the specific etiology underlying this sex-specific pattern of muscle loss in Asian populations remains elusive, two potential explanations warrant investigation. First, Asian dietary patterns, characterized by greater carbohydrate intake, may contribute to a generally higher body fat percentage across both sexes, regardless of obesity status. This elevated adiposity could influence muscle mass dynamics.⁵⁴ Second, the limitations of DXA must be considered. DXA struggles to differentiate between intramuscular adipose tissue and skeletal muscle mass. Consequently, as adiposity increases with age, DXA measurements may overestimate appendicular muscle mass in older populations, potentially confounding the observed sex differences in muscle loss.⁵⁵ Therefore, acknowledging the sex-specific disparities in age-related muscle loss, the AWGS advocates for using sex-specific cutoffs derived from the lowest quintile within each sex for diagnosing low muscle mass. This approach departs from the traditional method of referencing young adults and instead emphasizes the importance of sex-stratified baselines when defining sarcopenia. The identification of the most accurate diagnostic threshold for Asian women remains an ongoing challenge, necessitating further investigation to optimize cutoff points.

5. PREVENTION AND MANAGEMENT STRATEGIES

Given the significant age-related detriment of sarcopenia to healthspan and quality of life in older adults, a multifaceted management strategy is crucial. This necessitates a comprehensive approach encompassing lifestyle modifications, tailored nutritional interventions, and investigations of potentially beneficial pharmacological therapies (Fig. 1). Until now, exercise has remained the cornerstone of sarcopenia management, similar to many other health conditions. Resistance training is particularly effective in promoting muscle strength and mass.^56,57 Studies have shown that combining resistance exercise with aerobic and balance training yields the best results for improving overall physical function, including measures such as gait speed and timed up-and-go performance. Exercise intensity matters, with moderate-to-vigorous resistance training showing greater benefits than moderate-intensity resistance training alone.⁵⁸

Fig. 1.

Pathophysiology of sarcopenia, clinical outcomes, and potential therapeutic approaches.

Nutritional interventions complement exercise in managing sarcopenia.⁵⁹ Adequate protein intake is crucial, with research suggesting that older adults may benefit from increased protein consumption (maintaining no lower than 1.2 g/kg/d) to support muscle protein synthesis. Both animal- and plant-based proteins can be beneficial, although careful planning may be needed with plant-based diets to ensure sufficient essential amino acid intake.⁶⁰ Several nutritional supplements hold promise in mitigating sarcopenia. Branched-chain amino acids (BCAAs), particularly leucine, have been shown to stimulate muscle protein synthesis, potentially leading to improved muscle strength and mass when combined with exercise programs.^61,62 Beta-hydroxy-beta-methylbutyrate (HMB) also has benefits, potentially increasing muscle strength and improving overall muscle composition by reducing intramuscular fat.^63,64 While the impact of vitamin D supplementation on muscle mass remains less clear, it may compromise some aspects of physical performance.⁶⁵ Similarly, omega-3 fatty acids exhibit promise in bolstering lower body strength and overall physical function, but the results remain uncertain.⁶⁶ Finally, some studies suggest that probiotics may improve muscle mass and overall strength, warranting further investigation.⁶⁷

The search for effective pharmacological interventions for sarcopenia remains ongoing, with several promising avenues under investigation. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have shown potential in enhancing physical function and mitigating muscle loss in some early studies,^68,69 but no significant effects were observed in randomized trials.⁷⁰ Selective androgen receptor modulators (SARMs) have been shown to increase muscle mass in trials, although corresponding improvements in strength have not been as robust.⁷¹ Myostatin pathway inhibitors, including myostatin-neutralizing antibodies and activin receptor blockers, hold promise in early trials, but their effectiveness compared with that of exercise alone remains unclear.⁷² Researchers are also exploring the therapeutic potential of ghrelin receptor agonists,⁷³ fast skeletal muscle troponin activators,⁷⁴ and drugs that target bone–muscle crosstalk.⁷⁵ Additionally, emerging therapies such as cell-based treatments utilizing mesenchymal stem cells⁷⁶ and gene therapy approaches such as follistatin gene therapy are being investigated for their potential role in sarcopenia management.⁷⁷

6. FUTURE DIRECTIONS FOR SARCOPENIA RESEARCH IN ASIA AND THE WORLD

Research on sarcopenia in Asia presents a dynamic landscape brimming with both challenges and possibilities. As we delve deeper into the unique characteristics of sarcopenia in Asian populations, refining and standardizing diagnostic criteria is critical. This requires accounting for ethnic variations in body composition and muscle distribution patterns. Standardized criteria will pave the way for more accurate prevalence estimates and facilitate meaningful comparisons across studies. Large-scale, multicountry epidemiological investigations are essential to comprehensively examine the prevalence, risk factors, and outcomes of sarcopenia in diverse Asian populations.⁷⁸ Intriguingly, Asians exhibit a sex-specific pattern of muscle loss, with women experiencing a delayed decline. This phenomenon warrants further exploration, potentially leading to more targeted prevention and intervention strategies. Nutritional interventions tailored to traditional Asian diets, emphasizing protein and other muscle-supportive nutrients, hold promise. Likewise, culturally appropriate exercise programs that integrate elements of traditional practices alongside evidence-based resistance training could improve adherence and outcomes. Technology-driven solutions, such as mobile health apps and wearable devices, offer promising tools for the early detection, monitoring, and management of sarcopenia in community-dwelling older adults.

Moving forward, a key priority should be developing integrated care models that address sarcopenia alongside common comorbidities in Asian seniors, such as diabetes, CVD, and osteoporosis. This holistic approach has the potential to significantly improve overall health and quality of life. Broader policy initiatives are necessary to advocate for the inclusion of sarcopenia screening and management in national health guidelines across Asia. This would drive resources toward research and care for sarcopenia. Capacity building through enhanced education and training for healthcare professionals across Asia is crucial to improve awareness, diagnosis, and management of sarcopenia in clinical practice. Establishing pan-Asian research collaborations and networks would facilitate knowledge sharing, resource pooling, and coordinated efforts in advancing the field. As pharmacological interventions for sarcopenia emerge, Asian-specific clinical trials will be necessary to ensure efficacy and safety. Finally, future research should explore the economic impact of sarcopenia on Asian healthcare systems, informing policymakers and healthcare planners. By addressing these multifaceted aspects, the field can evolve toward more personalized, effective, and culturally sensitive approaches to sarcopenia management in Asia. This will ultimately contribute to healthier aging for millions of older adults across the region.

ACKNOWLEDGMENTS

The author would like to thank the Interdisciplinary Research Center for Healthy Longevity of National Yang Ming Chiao Tung University for their support through the Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan and the National Health Research Institutes (NHRI-13A1-CG-CO-05-2426-3) in Taiwan.