The Present and Future of Sarcopenia Diagnosis and Exercise Interventions: A Narrative Review

The aim of this review was to harmonize major consensus statements (European Working Group on Sarcopenia in Older People 2; Asian Working Group for Sarcopenia 2019; Foundation for the National Institutes of Health Sarcopenia Project operational criteria) into a stage- and setting-stratified algorithm. It maps diagnostic strata to dose-defined resistance and combined training, integrates multimodal and technology-enabled options (whole-body electrical muscle stimulation, whole-body vibration, virtual reality, AI-assisted telerehabilitation) with safety cues, and embeds nutrition (≥1.2 g/kg/day protein, vitamin D, key micronutrients) and education to sustain adherence. Sarcopenia is a consequential geriatric syndrome linked to falls, loss of independence, hospitalization, mortality, and psychosocial burden, yet translation to practice is hindered by heterogeneous definitions, diagnostics, and treatment guidance. Literature searches via PubMed/MEDLINE, EBSCO, SciELO, and Google Scholar (January 2000 to August 2025) yielded 354 records; after screening and deduplication, 132 peer-reviewed studies were included. We summarize tools for screening, strength, muscle mass, and function (e.g., Sarcopenia Five-Item Questionnaire, grip strength, dual-energy X-ray absorptiometry, gait speed) and identify resistance exercise as the cornerstone, with aerobic, balance, and flexibility training adding functional and metabolic benefits. Clinic-ready tables and figures operationalize a stepwise program across primary to severe sarcopenia and across acute or iatrogenic to community settings. Early screening plus structured, exercise-centered care, augmented by targeted nutrition and education, offers pragmatic, scalable benefits.