Sex differences of sarcopenia in Asian populations: The implications in diagnosis and management

Sarcopenia, a well-known geriatric syndrome, is defined as the age-related loss of muscle mass plus declined muscle function (muscle strength and/or physical performance). Sarcopenia is associated with a number of adverse outcomes, including poor quality of life, falls, disability, and mortality. The clinical impact of sarcopenia on older people will escalate along with the rapid growth of elderly population in Asia. Moreover, the differences of ethnic backgrounds between Asian people and Westerners have trigger the need for specific diagnostic criteria for Asian populations. After the publication of Asian Working Group for Sarcopenia consensus, sarcopenia has gained even more extensive research attention in Asia. In general, the reported prevalence of sarcopenia in Asia was lower than Western countries, ranging from 2.5% to 45.7%. Asian people tend to have lower muscle mass, weaker grip strength, slower gait speed, and higher body fat mass with central distribution. Compared to Western populations, the rate of age-related muscle mass decline in older Asian people remain relatively unchanged, but the decline rate in muscle strength or physical performance was more significant along with aging. With aging, Asian people presented with greater increase in fat mass and higher prevalence of central obesity, especially in women. Due to the great impact of sarcopenia, a life course program for good nutrition and physical activities would be of great benefit. However, various research challenges remain to be resolved in the future and more outcome-based trials are needed to formulate the most optimal strategy for sarcopenia in Asia.