Frailty risk in adults with dynapenia: A cross-sectional study comparing AWGS 2019 and GLIS 2024 consensus enhanced clinical utility.

BACKGROUND

Dynapenia and sarcopenia are common in older adults and strongly associated with frailty. Impaired physical performance has recently been re-defined as an outcome rather than a diagnostic component of sarcopenia.

OBJECTIVE

To compare the predictive performance of 2024 Global Leadership Initiative on Sarcopenia (GLIS) and 2019 Asian Working Group for Sarcopenia (AWGS) criteria for frailty in ambulatory adults seeking medical care, and to examine links between grip strength, muscle mass, and functional tests.

METHODS

In this cross-sectional study we recruited 763 ambulatory adults (mean 66.8 ± 13.2 y) from internal-medicine and geriatrics clinics (2023-2024). Body composition was measured by bioelectrical impedance analysis; dynapenia/sarcopenia were classified with GLIS 2024 and AWGS 2019. Frailty was assessed using the modified Fried Frailty Phenotype (mFFP), Study of Osteoporotic Fractures (SOF) index, and electronic frailty index (eFI). Multivariable logistic regression provided AUCs; net reclassification improvement (NRI) and integrated discrimination improvement (IDI) compared definitions. Pearson coefficients quantified correlations.

RESULTS

GLIS 2024 and AWGS 2019 showed comparable discrimination (AUCs: mFFP 0.80 vs 0.81; SOF 0.73 vs 0.76; eFI 0.87 vs 0.87). GLIS 2024 offered positive and consistent NRIs (0.0009-0.0093) and improved IDI for mFFP and eFI (0.0027-0.0057) while slightly underperforming for SOF (-0.0015) in older adults. Grip strength correlated strongly with appendicular lean mass (r = 0.58, P < 0.0001) and was significantly associated with gait speed and chair-stand time.

CONCLUSION

The GLIS 2024 criteria streamline the AWGS 2019 definitions, enhancing their clinical applicability. Moreover, muscle strength correlates strongly with muscle mass and serves as a reliable predictor of physical performance.