Editorial reviews digital screening for sarcopenia and sarcopenic obesity

An editorial in European Geriatric Medicine describes practical digital tools for identifying people who may have sarcopenia or sarcopenic obesity before the full diagnostic assessment is performed. The article focuses on the expansion of GRASP, a freely accessible multilingual web application that combines handgrip and chair-stand assessments with body-composition support, automated reports and calculations commonly used in nutritional and geriatric care. These are screening and triage aids, not interventions whose effects on clinical outcomes have been demonstrated in a trial.

Sarcopenia is now recognized as a muscle disease characterized by reduced muscle strength, reduced muscle quantity and reduced physical performance. The European Working Group on Sarcopenia in Older People and the Asian Working Group for Sarcopenia have developed diagnostic frameworks that place muscle strength at the center of assessment. Sarcopenia is associated with disability, hospitalization and mortality among older adults, but people at risk may remain unidentified until meaningful functional deterioration becomes apparent.

The editorial argues that simpler screening tools could help clinicians select patients who need detailed diagnostic procedures, particularly in settings where access to body-composition testing is limited. The challenge is becoming more pressing as obesity becomes more common. Excess adiposity is associated with systemic inflammation, insulin resistance, anabolic resistance and physical inactivity, which can contribute to muscle deterioration.

The coexistence of excess fat mass with altered muscle mass and function is termed sarcopenic obesity. Compared with either obesity or sarcopenia alone, this combined condition is associated with poorer physical function, greater frailty, lower quality of life and higher mortality. These are reported associations, not proof that excess fat or impaired muscle has an identical effect in every individual, but they underline why both body composition and muscle performance belong in a contemporary assessment.

Clinical estimates of sarcopenic obesity remain inconsistent because studies use different methods and thresholds to measure muscle mass, strength and function. The ESPEN-EASO consensus has sought to harmonize the definition and diagnosis of the condition by emphasizing assessment of both muscle function and body composition. Yet the available evidence does not support comprehensive reference values across every clinical condition, care setting and age group.

For handgrip strength, the consensus approach uses age-stratified reference values and a pragmatic threshold based on the 25th percentile at 80 years of age. Those general-population values facilitate standardization, although they do not fully represent variation across adulthood and were not established specifically in patients with obesity. The Sarcopenic Obesity Global Leadership Initiative, known as SOGLI, supplies a structured algorithm for screening and staging that incorporates muscle function and body composition.

A review presented in the editorial identified 72 studies applying the SOGLI framework within two years of its publication, indicating that the approach was being adopted rapidly. At the same time, those studies differed in their screening procedures, body-composition techniques and staging practices. That variation may reflect the algorithm’s flexibility, but it also shows that implementation has not been uniform.

Confirmation of sarcopenia or sarcopenic obesity under SOGLI requires body-composition assessment by dual-energy X-ray absorptiometry, or DXA, or bioelectrical impedance analysis, or BIA. Access to those measurements differs by setting. DXA and BIA are increasingly available in outpatient clinics, but they are less available in primary care.

As a result, the editorial notes that a substantial share of people at risk may not receive a full assessment until clinically meaningful functional decline has occurred. GRASP, short for “GRip And Sarcopenia Prediction,” was developed to make the SOGLI framework easier to apply. The web tool was initially centered on handgrip strength and was subsequently extended to include the chair-stand test.

It is connected to the SOGLI approach, allowing functional results to guide the decision to undertake more comprehensive body-composition evaluation. Beyond its two functional assessments, GRASP generates reports and allows results to be exported. It includes calculators for body mass index, resting energy expenditure, ideal body weight and adjusted body weight, as well as assistance with body-composition calculations derived from BIA.

For the impedance calculations, the platform uses validated equations independently of those incorporated into impedance meters. A sample report illustrates the proposed workflow: functional scores from handgrip and chair-stand testing identify a point that may warrant further body-composition assessment for early sarcopenia. The important distinction is that GRASP supports screening, stratification and the direction of further testing; the editorial does not present it as a replacement for comprehensive diagnosis.

The design of the handgrip component draws on a cohort of adults with severe obesity. In that cohort, age- and sex-adjusted handgrip scoring identified substantially more individuals with impaired muscle function than traditional categorical cutoffs. This observation supports the use of individualized scores as a screening approach in a population that may differ from general reference samples.

It does not establish that the GRASP application improves health outcomes, or that its diagnostic performance has been validated across the wider population. Rather, the cited cohort result demonstrates how an adjusted scoring method can identify functional impairment that broad categorical thresholds may overlook. Smartphone-based body-composition tools offer a separate route toward more accessible assessment.

A recent review identified applications that estimate fat mass, fat-free mass and appendicular lean mass through image analysis, digital anthropometry and artificial intelligence. If incorporated into broader screening workflows, these technologies could potentially make preliminary body-composition assessment more scalable in clinical and community settings. The editorial explicitly notes that further validation is required, especially among people with high adiposity.

It therefore presents smartphone estimates as promising supporting tools rather than established replacements for DXA, BIA or other formal diagnostic measurements. Earlier recognition could allow clinicians to address exercise, nutrition, weight management and chronic disease care before sarcopenia is fully established. The editorial cautions that screening should not be confined to frail older adults: people with obesity, multimorbidity, reduced physical activity, metabolic disorders and other catabolic conditions may also be relevant targets for assessment.

This is a proposed clinical application of the tools, not an outcome measured in a trial of GRASP or smartphone software. The central translational claim is that consensus definitions can be translated into practical instruments that help clinicians identify risk, structure further evaluation and monitor muscle function in routine practice. That monitoring role is especially relevant as obesity treatment enters an era of GLP-1 receptor agonists.

GRASP’s chair-stand component, report generation and exportable results are intended to support consistent functional assessment, while its SOGLI framework links screening to more definitive body-composition testing. Whether those functions lead to better treatment decisions has not been established by the evidence presented. The editorial’s message is therefore one of practical possibility: digital screening tools may help close the distance between expert consensus and everyday care, while their role remains centered on screening rather than proven prevention or treatment.

Subject of Research: Digital screening tools for sarcopenia and sarcopenic obesity

Article Title: Sarcopenia and sarcopenic obesity: new tools for early detection

Article References: Boirie, Y., Pouget, M., Pinel, A., Guillet, C., Barazzoni, R., & Donini, L. M. (2026). Sarcopenia and sarcopenic obesity: new tools for early detection. European Geriatric Medicine. https://doi.org/10.1007/s41999-026-01629-1

Image Credits: AI Generated

DOI: 10.1007/s41999-026-01629-1

Keywords: sarcopenia, sarcopenic obesity, muscle strength, body composition, GRASP, SOGLI, digital health, handgrip strength, chair-stand test, bioelectrical impedance, geriatric medicine, sarcopenic