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Purpose <p>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.</p> Methods <p>From a cohort of 1246 consecutive post-acute stroke admissions, we analyzed 864 inpatients (median age 76&#xa0;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&#xa0;years) and sex, assessed the associations with the Functional Independence Measure motor subscale (FIM-motor) at discharge.</p> Results <p>Confirmed sarcopenia defined by SMI/height<sup>2</sup> was independently and consistently associated with lower discharge FIM-motor scores across all age and sex strata (men ≥ 65&#xa0;years: B − 3.51, <i>P</i> = 0.038; women ≥ 65&#xa0;years: B − 3.08, <i>P</i> = 0.024; men 50–64&#xa0;years: B − 4.59, <i>P</i> = 0.044; women 50–64&#xa0;years: <i>B</i> − 9.19, <i>P</i> = 0.045). In contrast, SMI/BMI-based definitions showed poor prognostic utility, with no significant associations in men. Possible sarcopenia demonstrated limited, inconsistent associations.</p> Conclusion <p>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</p>

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

  • 期刊论文

  • 发表日期：

    2026年7月7日

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

摘要

Purpose

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.

Methods

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.

Results

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.

Conclusion

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