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A focus shift from sarcopenia to muscle health in the Asian Working Group for Sarcopenia 2025 Consensus Update

Nature Aging volume 5, pages 2164–2175 (2025)Cite this article

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Abstract

The Asian Working Group for Sarcopenia (AWGS) presents an updated 2025 consensus reframing sarcopenia management through a life-course approach to muscle health promotion. While aligning with the Global Leadership Initiative in Sarcopenia (GLIS), this update provides healthcare providers with Asia-specific guidance. The consensus introduces three key refinements: first, expanding sarcopenia diagnosis to middle-aged adults (50‒64 years) with validated diagnostic thresholds; second, simplifying the diagnostic algorithm to require only concurrent low muscle mass and strength, with physical performance as an outcome measure; and third, introducing an enhanced muscle health framework recognizing skeletal muscle as vital for healthy longevity, emphasizing cross-talk with brain, bone, adipose tissue and immune systems. This framework leverages the World Health Organization’s Integrated Care for Older People (ICOPE) implementation for enhanced case-finding through natural overlap between muscle health and ICOPE’s intrinsic capacity domains. The consensus provides evidence-based recommendations for multimodal interventions that combine resistance exercise with nutritional supplementation, representing advancement toward proactive muscle health promotion and establishing a framework for reducing age-related decline in Asian populations.

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Fig. 1: Integration of muscle health promotion into the WHO ICOPE framework in the AWGS 2025 consensus.
Fig. 2: The AWGS 2025 algorithm for diagnosing sarcopenia.

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Acknowledgements

We acknowledge the contributions of L. Kang (China), S. B. Kamaruzzaman (Malaysia) and S. Zhang (Japan) for their participation in consensus discussions and data provision. We also thank D. Neil, of Dr. Word Ltd, Taiwan, who provided editing and graphic design services, which were funded by the AWGS and the National Yang Ming Chiao Tung University, Taiwan. This research was funded by the National Science and Technology Council, the Interdisciplinary Research Center for Healthy Longevity of National Yang Ming Chiao Tung University from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan, Taiwan Association for Integrated Care, and Asian Association for Frailty and Sarcopenia.

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Authors and Affiliations

  1. Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan

    Liang-Kung Chen & Li-Ning Peng

  2. Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Liang-Kung Chen, Wei-Ju Lee & Li-Ning Peng

  3. Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan

    Liang-Kung Chen

  4. Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Fei-Yuan Hsiao

  5. School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Fei-Yuan Hsiao

  6. Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan

    Fei-Yuan Hsiao

  7. Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan

    Masahiro Akishita

  8. Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Prasert Assantachai & Weerasak Muangpaisan

  9. Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yilan, Taiwan

    Wei-Ju Lee

  10. Department of Geriatric Medicine and Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore

    Wee Shiong Lim

  11. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Wee Shiong Lim & Reshma Aziz Merchant

  12. Department of Health Sciences and Technology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea

    Miji Kim

  13. Division of Geriatric Medicine, Department of Medicine, National University of Singapore, Singapore, Singapore

    Reshma Aziz Merchant

  14. Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

    Maw Pin Tan

  15. Department of Family Medicine, College of Medicine, Kyung Hee University, Kyung Hee University Medical Center, Seoul, Republic of Korea

    Chang Won Won

  16. Faculty of Human Sciences, University of Tsukuba, Tokyo, Japan

    Minoru Yamada

  17. Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong SAR, People’s Republic of China

    Jean Woo

  18. National Center for Geriatrics and Gerontology, Obu, Japan

    Hidenori Arai

Authors
  1. Liang-Kung Chen
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  2. Fei-Yuan Hsiao
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  3. Masahiro Akishita
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  4. Prasert Assantachai
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  5. Wei-Ju Lee
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  6. Wee Shiong Lim
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  7. Weerasak Muangpaisan
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  8. Miji Kim
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  9. Reshma Aziz Merchant
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  10. Li-Ning Peng
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  11. Maw Pin Tan
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  12. Chang Won Won
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  13. Minoru Yamada
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  14. Jean Woo
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  15. Hidenori Arai
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Contributions

L.-K.C. wrote the first draft and was a major contributor in writing the manuscript. L.-K.C., J.W. and H.A. contributed to conception of the consensus update. L.-K.C. and F.-Y.H. performed systematic evidence review and prepared the figures/tables. L.-K.C., F.-Y.H. and H.A. revised subsequent drafts to address reviewer comments. All authors participated in consensus discussions, contributed to critical review of the manuscript for important intellectual content and approved the final version. All authors agree to be accountable for the accuracy and integrity of this work.

Corresponding authors

Correspondence to Liang-Kung Chen, Jean Woo or Hidenori Arai.

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Competing interests

The authors declare no competing interests.

Peer review

Peer review information

Nature Aging thanks Marco Narici, who co-reviewed with Fabio Sarto; Alejandro Álvarez-Bustos; and Theresa Mau for their contribution to the peer review of this work.

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Supplementary information

Supplementary Information

Supplementary Table 1, Members of the Asian Working Group for Sarcopenia (AWGS); and Supplementary Table 2, Comparison of muscle assessment methods.

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Chen, LK., Hsiao, FY., Akishita, M. et al. A focus shift from sarcopenia to muscle health in the Asian Working Group for Sarcopenia 2025 Consensus Update. Nat Aging 5, 2164–2175 (2025). https://doi.org/10.1038/s43587-025-01004-y

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