Sarcopenia—progressive loss of muscle strength, mass, and physical performance—is increasingly prevalent in aging populations. The EWGSOP2 revised consensus positions muscle strength, particularly handgrip dynamometry, as the primary diagnostic criterion, with DEXA or bioelectrical impedance analysis confirming mass loss and functional tests grading severity. The SARC-F questionnaire serves as an accessible clinical screener. No pharmacological agent is currently approved; the evidence-based intervention stack remains resistance training combined with protein intake of 1.2–1.5 g/kg body weight per day and correction of vitamin D deficiency.
This clinical review consolidates a conceptual shift that has been building since EWGSOP2's 2018 publication: strength, not mass, drives prognosis. That reframing matters practically—a person can retain muscle volume while losing contractile force, and treating mass as the primary endpoint misses those patients. The protein recommendation (1.2–1.5 g/kg/day) meaningfully exceeds standard RDA of 0.8 g/kg/day, aligning with accumulating evidence that older adults have elevated anabolic resistance. However, this is a narrative clinical overview, not primary data—no new cohort, effect sizes, or mechanistic discoveries are introduced. Its value lies in synthesizing diagnostic standards for practicing clinicians rather than advancing the science. For health-conscious adults over 50, the actionable takeaway is clear: grip strength testing, progressive resistance training, and adequate protein are the evidence-anchored triad for sarcopenia prevention. Waiting for an approved drug means waiting too long.
