Sarcopenia in Hospitalized Older Adults: A Cross-Sectional Study Comparing Diagnostic Thresholds and Handgrip Strength Measurement Tools

Background: Sarcopenia is highly prevalent among hospitalized older adults and is associated with poor clinical outcomes. Multiple diagnostic criteria exist, but the comparative implications of different handgrip strength (HGS) thresholds and measurement tools are less explored. Objectives: This study aimed to assess the prevalence of sarcopenia, comparing the diagnostic yield of different HGS thresholds using two measurement instruments (dynamometer and vigorimeter) in hospitalized older adults. Design: This was a cross-sectional observational study. Setting: A tertiary geriatric hospital with acute, rehabilitation, and long-term care wards was included. Participants: A total of 376 hospitalized older adults with complete HGS and bioelectrical impedance analysis (BIA) data were recruited. Measurements: HGS was measured using both a hydraulic dynamometer and a pneumatic vigorimeter. Sarcopenia was defined using cut-offs from EWGSOP2, SDOC, and two DO-HEALTH-derived thresholds. Low muscle mass was identified using the fat-free mass index (FFMI) by BIA. Multivariate logistic regression was used to identify predictors of sarcopenia. Results: The prevalence of probable sarcopenia ranged from 68.1% to 89.4%, and confirmed sarcopenia from 39.6% to 50.3%, depending on the thresholds applied. Sarcopenic patients were older (86.1 ± 9.8 vs. 80.4 ± 11.0 years; p < 0.001), had lower BMI (20.7 ± 2.9 vs. 26.1 ± 4.8 kg/m2; p < 0.001), and were more frequently in long-term care (p = 0.014–0.043). Older age (OR 1.03–1.07 per year; p < 0.05) and lower BMI (OR 0.59–0.68 per kg/m2; p < 0.001) were independently associated with sarcopenia; sex and fall history were not. Conclusions: Sarcopenia prevalence was high and varied widely across diagnostic definitions and measurement tools, reflecting both methodological variability and the high vulnerability of hospitalized older adults. These findings highlight the need for standardized, context-adapted diagnostic strategies to guide timely intervention in high-risk hospitalized older adults.