Sarcopenia in Older Adults: Screening, Strength and Functional Rehabilitation

Recognize and assess

Sarcopenia involves low muscle strength, with low muscle quantity/quality supporting confirmation and poor physical performance indicating greater severity in EWGSOP2. It can coexist with frailty, malnutrition, chronic disease and inactivity.

SARC-F can support case-finding but a low score does not rule out impairment. Assess grip strength or chair-rise performance, gait speed or another suitable functional test, nutrition, falls, medication burden and the person's priorities. Interpret thresholds in context and use local pathways.

Differential and precautions

• Consider pain, neurological disease, cardiopulmonary limitation, arthritis, depression, acute illness and medication effects as contributors to weakness or slow mobility.
• New focal weakness, acute functional loss, unexplained weight loss or suspected systemic illness needs medical review. Check orthostatic symptoms, falls risk, cognition and safe equipment before challenging tasks.

Rehabilitation prescription

• Progressive resistance exercise is central: begin with safe sit-to-stand, step, push/pull and targeted limb exercises, then increase resistance or task difficulty as technique and recovery allow.
• A practical starting template is 2–3 sessions weekly, 1–3 sets of 6–12 controlled repetitions for selected exercises, individualized to function and comorbidity. Include balance and gait practice when indicated.
• Review protein/energy intake and refer to a dietitian or medical team when malnutrition or complex nutrition needs are suspected; exercise alone may be insufficient.

Progression and summary

Track strength, chair-rise performance, gait speed, falls, confidence and participation. Increase one training variable at a time; adapt after illness or prolonged interruption. Screening is not a diagnosis, and treatment should target strength and meaningful function rather than age alone.