Prevalence and diagnostic variability of sarcopenia in India: A systematic review and meta-analysis.

Background and objectives Sarcopenia is a recognised determinant of adverse health outcomes yet remains insufficiently quantified in India. We conducted a systematic review and meta-analysis to estimate the prevalence of sarcopenia and document the diagnostic criteria used across community and hospital-based populations in India. Methods We searched PubMed, EMBASE, Web of Science, and Scopus databases from their inception to December 2, 2025 (PROSPERO registration: CRD420251252940). Cross-sectional and cohort studies reporting prevalence were included. The primary outcome was the prevalence of different types of sarcopenias (probable, confirmed, or severe). Risk of bias was assessed using the Joanna Briggs Institute tool. Pooled prevalence with 95% confidence intervals (CI) was calculated using a random-effects model in R software. Results Of the 5,486 records retrieved, we included 44 studies for final review. Consensus-based definitions, such as Asian and European working group criteria, were used in 54.5% (n= 24) studies, while the remaining used heterogeneous, nonuniform operational criteria. The pooled prevalence of probable, confirmed, and severe sarcopenia was 36.3% (95% CI: 26-48%, 18 studies), 35.4% (95% CI: 28.8-42.5%, 38 studies), and 9.9% (95% CI: 5.6-16.7%, 11 studies), respectively. Interpretation and conclusions Over one in three individuals in India had sarcopenia. We documented an inconsistency in diagnostic criteria across studies, limiting comparability and hindering accurate burden estimation. Our review recommends the need for standardised, setting-specific definitions to enable timely identification, and strengthen evidence-informed public health planning in India.