Sarcopenia and health-related outcomes: an umbrella review of observational studies

  • Nicola VeroneseEmail author
  • Jacopo Demurtas
  • Pinar Soysal
  • Lee Smith
  • Gabriel Torbahn
  • Daniel Schoene
  • Lukas Schwingshackl
  • Cornel Sieber
  • Jurgen Bauer
  • Matteo Cesari
  • Oliviere Bruyere
  • Jean-Yves Reginster
  • Charlotte Beaudart
  • Alfonso J. Cruz-Jentoft
  • Cyrus Cooper
  • Mirko Petrovic
  • Stefania Maggi
  • the Special Interest Groups in Systematic Reviews and Meta-analyses for healthy ageing Sarcopenia and Frailty and resilience in older persons of the European Geriatric Medicine Society (EuGMS)

Key summary points


To investigate associations of sarcopenia with adverse health-related outcomes, through an umbrella review method.


Sarcopenia appears to be significantly associated with several adverse outcomes in older people, with a strong evidence for increased risk of mortality, disability, and falls.


Sarcopenia is associated with several adverse health-related outcomes in older people, indicating the need of assessing this condition in daily practice.



The clinical relevance of sarcopenia has increasingly been recognized. However, whether it is associated with the development of other medical conditions is still unclear. Therefore, we aimed to capture the scale of outcomes that have been associated with the presence of sarcopenia and systematically assess the quality, strength, and credibility of these associations using an umbrella review methodology.


A systematic review in several databases was carried out, until 20th February 2019. For each association, random-effects summary effect size, 95% confidence intervals (CIs), heterogeneity (I2), evidence for small-study effect, evidence for excess significance bias, and 95%-prediction intervals were estimated. We used these metrics to categorize the evidence of significant outcomes (p < 0.05) from class I (convincing) to class IV (weak), according to pre-established criteria.


From 358 abstracts, 6 meta-analyses with 14 associations were included. Sarcopenia was associated with higher risk of other comorbidities and mortality in 11 of 14 outcomes explored. However, only 3 outcomes (i.e., association between sarcopenia and increased risk of death in community-dwelling older people [odds ratio, OR = 3.60; 95% CI 2.96–4.37; n = 14,305], disability [OR = 3.04; 95% CI 1.80–5.12; n = 8569], and falls [OR = 1.60; 95% CI 1.31–1.97; n = 12,261]) presented a highly suggestive evidence (class II). Other association was classified as having only a weak evidence.


Sarcopenia is associated with several adverse health-related outcomes in older people, and its associations with mortality, disability, and falls are supported by a highly suggestive evidence. The effect of interventions on sarcopenia to improve these outcomes needs to be investigated.


Sarcopenia Health Umbrella review Meta-analysis Mortality Fall Disability Risk factor 


Compliance with ethical standards

Conflict of interest

All authors declare no conflict of interest.

Ethical approval

It was not requested being a revision of already published literature.

Informed consent

No patients were included in this review.

Sponsor’s role


Supplementary material

41999_2019_233_MOESM1_ESM.docx (32 kb)
Supplementary material 1 (DOCX 32 kb)


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Copyright information

© European Geriatric Medicine Society 2019

Authors and Affiliations

  • Nicola Veronese
    • 1
    Email author
  • Jacopo Demurtas
    • 2
  • Pinar Soysal
    • 3
  • Lee Smith
    • 4
  • Gabriel Torbahn
    • 5
  • Daniel Schoene
    • 6
  • Lukas Schwingshackl
    • 7
  • Cornel Sieber
    • 5
    • 8
  • Jurgen Bauer
    • 9
  • Matteo Cesari
    • 10
  • Oliviere Bruyere
    • 11
  • Jean-Yves Reginster
    • 11
  • Charlotte Beaudart
    • 11
  • Alfonso J. Cruz-Jentoft
    • 12
  • Cyrus Cooper
    • 13
    • 14
  • Mirko Petrovic
    • 15
  • Stefania Maggi
    • 1
  • the Special Interest Groups in Systematic Reviews and Meta-analyses for healthy ageing Sarcopenia and Frailty and resilience in older persons of the European Geriatric Medicine Society (EuGMS)
  1. 1.National Research Council, Neuroscience InstitutePaduaItaly
  2. 2.Primary Care Department AziendaUSL Toscana Sud EstGrossetoItaly
  3. 3.Department of Geriatric MedicineBezmialem Vakif UniversityIstanbulTurkey
  4. 4.The Cambridge Centre for Sport and Exercise SciencesAnglia Ruskin UniversityCambridgeUK
  5. 5.Institute for Biomedicine of AgingFriedrich-Alexander-Universität Erlangen-NürnbergNurembergGermany
  6. 6.Institute of Medical PhysicsFriedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany
  7. 7.Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical CenterUniversity of FreiburgFreiburgGermany
  8. 8.Kantonsspital WinterthurWinterthurSwitzerland
  9. 9.Center for Geriatric MedicineUniversity of Heidelberg, Agaplesion Bethanien HospitalHeidelbergGermany
  10. 10.Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoUniversity of MilanMilanItaly
  11. 11.WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health EconomicsUniversity of LiègeLiègeBelgium
  12. 12.Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS)MadridSpain
  13. 13.MRC Life Course Epidemiology UnitUniversity of Southampton, Southampton General HospitalSouthamptonUK
  14. 14.NIHR Musculoskeletal Biomedical Research UnitUniversity of OxfordOxfordUK
  15. 15.Department of GeriatricsGhent University HospitalGhentBelgium

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