A research framework for evaluating upstream multimodal sarcopenia risk domains in older adults.
- 1Institute of Human Behavior and Genetics, Korea University College of Medicine, Seoul, Republic of Korea.
Abstract
Established sarcopenia definitions identify clinically important impairment, but their thresholds are not designed to characterize all biological changes associated with subsequent muscle decline. Whether additional measurements improve assessment before these thresholds are reached remains uncertain. This structured narrative review proposes a research framework for evaluating upstream, multimodal sarcopenia risk domains in older adults. It integrates diagnostic consensus statements with mechanistic, observational, diagnostic-accuracy, prognostic, and intervention literature identified through purposive searches and citation tracking. Candidate domains comprise circulating biomarkers, creatine-pool-based muscle mass estimation, neuromuscular measurements, imaging and bioelectrical measures, and digital mobility assessments. The evidence supporting these domains is heterogeneous. Cross-sectional differences and biological plausibility do not establish prediction of incident sarcopenia, incremental clinical value, or differential treatment benefit. Neuromuscular abnormalities may reflect aging rather than sarcopenia specifically, and measures commonly grouped as muscle quality assess distinct constructs. The proposed domains are therefore nonexclusive and nonsequential; no diagnostic stages, validated multimodal score, or biomarker-guided treatment algorithm are proposed. Conventional clinical assessments provide reference phenotypes, while falls, disability, fractures, quality of life, hospitalization, and mortality remain separate validation outcomes. The principal contribution is an evidence-to-validation framework that distinguishes demonstrated measurement capabilities from untested applications. Priorities are longitudinal assessment, reproducibility, external validation, incremental prediction beyond inexpensive clinical measures, and trials of clinical utility before implementation.
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BibTeX
@article{kim2026research,
title = {{A research framework for evaluating upstream multimodal sarcopenia risk domains in older adults.}},
author = {Nackhwan Kim},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1928432},
url = {https://europepmc.org/article/MED/42953499},
note = {CC BY},
}
RIS
TY - JOUR
TI - A research framework for evaluating upstream multimodal sarcopenia risk domains in older adults.
AU - Nackhwan Kim
PY - 2026
DA - 2026/10/14
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1928432
UR - https://europepmc.org/article/MED/42953499
AB - Established sarcopenia definitions identify clinically important impairment, but their thresholds are not designed to characterize all biological changes associated with subsequent muscle decline. Whether additional measurements improve assessment before these thresholds are reached remains uncertain. This structured narrative review proposes a research framework for evaluating upstream, multimodal sarcopenia risk domains in older adults. It integrates diagnostic consensus statements with mechanistic, observational, diagnostic-accuracy, prognostic, and intervention literature identified through purposive searches and citation tracking. Candidate domains comprise circulating biomarkers, creatine-pool-based muscle mass estimation, neuromuscular measurements, imaging and bioelectrical measures, and digital mobility assessments. The evidence supporting these domains is heterogeneous. Cross-sectional differences and biological plausibility do not establish prediction of incident sarcopenia, incremental clinical value, or differential treatment benefit. Neuromuscular abnormalities may reflect aging rather than sarcopenia specifically, and measures commonly grouped as muscle quality assess distinct constructs. The proposed domains are therefore nonexclusive and nonsequential; no diagnostic stages, validated multimodal score, or biomarker-guided treatment algorithm are proposed. Conventional clinical assessments provide reference phenotypes, while falls, disability, fractures, quality of life, hospitalization, and mortality remain separate validation outcomes. The principal contribution is an evidence-to-validation framework that distinguishes demonstrated measurement capabilities from untested applications. Priorities are longitudinal assessment, reproducibility, external validation, incremental prediction beyond inexpensive clinical measures, and trials of clinical utility before implementation.
SN - 2296-858X
ER -