Prognostic performance of Asian Working Group for Sarcopenia 2025 Constructs for activities of daily living at discharge after stroke: a head-to-head validation.

Authors

Yoshihiro Yoshimura, Hidetaka Wakabayashi, Ayaka Matsumoto, Fumihiko Nagano, Sayuri Shimazu, Kouki Yoneda

Published in

European geriatric medicine. Jul 07, 2026. Epub Jul 07, 2026.

Abstract

To compare the prognostic performance of the Asian Working Group for Sarcopenia (AWGS) 2025 diagnostic constructs-specifically height- versus body mass index (BMI)-indexed muscle mass-for discriminating functional outcomes in patients with stroke.
From a cohort of 1246 consecutive post-acute stroke admissions, we analyzed 864 inpatients (median age 76 years; 47.2% women) who met the inclusion criteria. Sarcopenia was classified according to AWGS 2025 criteria: possible sarcopenia (low handgrip strength) and confirmed sarcopenia (low strength plus low skeletal muscle mass). Skeletal muscle mass was indexed by height-squared (SMI/height2) and BMI (SMI/BMI). Multivariable linear regression analysis, stratified by age (50-64 vs. ≥ 65 years) and sex, assessed the associations with the Functional Independence Measure motor subscale (FIM-motor) at discharge.
Confirmed sarcopenia defined by SMI/height² was independently and consistently associated with lower discharge FIM-motor scores across all age and sex strata (men ≥ 65 years: B - 3.51, P = 0.038; women ≥ 65 years: B - 3.08, P = 0.024; men 50-64 years: B - 4.59, P = 0.044; women 50-64 years: B - 9.19, P = 0.045). In contrast, SMI/BMI-based definitions showed poor prognostic utility, with no significant associations in men. Possible sarcopenia demonstrated limited, inconsistent associations.
AWGS 2025 confirmed sarcopenia utilizing height-indexed muscle mass provided superior prognostic discrimination for discharge ADL compared with BMI-indexed or possible sarcopenia constructs in post-stroke inpatients. These findings support prioritizing height-indexed confirmed sarcopenia for functional risk stratification in this setting.

PMID:
42412390
Bibliographic data and abstract were imported from PubMed on 07 Jul 2026.

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