Recently, a new consensus paper presenting the updated Asian guideline for sarcopenia has been published.
1) Intriguingly, the guideline expands the target population for sarcopenia diagnosis and management to include adults aged 50–64 years, emphasizing that disruptions in muscle health during midlife can readily progress to sarcopenia in older age. The 2025 Asian Working Group for Sarcopenia (AWGS) guideline emphasizes sarcopenia management through a life-course approach to muscle health promotion, adopting a framework aligned with the World Health Organization’s Integrated Care for Older People (ICOPE) by leveraging the natural overlap between muscle health and ICOPE’s intrinsic capacity domains.
2) This guideline provides cutoff values for muscle mass, handgrip strength, and physical performance (gait speed and five-times chair stand test) for middle-aged Asian adults. To our knowledge, this is the first global sarcopenia guideline to offer recommendations for this age group. The 2019 AWGS guideline introduced the innovative concept of “possible sarcopenia” and proposed its diagnostic algorithm tailored for primary healthcare and preventive services.
3) Since its publication, the 2019 AWGS guideline has been cited in 5,465 articles in the Web of Science database as of December 2, 2025. The outstanding success of the 2019 AWGS guideline is very encouraging to Korean researchers and, surely, to Asian researchers who have been timid and even shy in the international research field. Is this success merely the result of the leadership of the guideline authors? Recent bibliometric trends suggest another explanation. In a bibliometric analysis of global sarcopenia research from 2001 to 2020, the United States contributed the largest proportion of publications (25.7%), followed by Japan (13.4%), Italy (8.6%), England (7.5%), and South Korea (6.6%).
4) However, based on our analysis of publications indexed in the Web of Science database, published between 2015 and 2025, with “sarcopenia” in the title, as of December 2, 2025, China now ranks first (20.2%), followed by the United States (12.7%), Japan (10.7%), South Korea (7.3%), and Italy (6.9%). Including the recent surge in sarcopenia publications from China, Asian research output as a whole has begun to dominate the global sarcopenia literature, whereas the relative contribution from Western countries has gradually declined (
Fig. 1,
Table 1). Importantly, this growth is not limited to publication volume. When we examined highly cited papers, defined by the Web of Science database as publications ranking within the top approximately 1% by citations within the same academic field and publication year, several of these influential studies originated from Asian countries, including China (25.7%), Japan (11.4%), South Korea (7.2%), and Taiwan (5.4%) (
Table 2). These findings indicate that the increasing contribution of Asian research to the field of sarcopenia is accompanied by impactful scientific outputs.
Since 2021, the Global Leadership Initiative in Sarcopenia (GLIS) has been working to establish an international guideline for sarcopenia and formed a steering committee composed of experts nominated by related societies and organizations.
5) Among the 22 steering committee members, only four are from Asia (Japan, Taiwan, Hong Kong, and Saudi Arabia), with the vast majority representing Western countries.
6) It is regrettable that only a small number of Asian researchers constitute the GLIS steering committee, but this may come as no surprise considering that there are not many well-recognized societies or organizations in this field in Asia except for the AWGS. Though the Korean Working Group on Sarcopenia (KWGS) developed clinical practice guidelines for the diagnosis of sarcopenia in older Korean adults, but its scope is within a regional boundary.
7) This implies that Asian researchers need to work together more than they do now, convene more frequently, and endeavor to develop consensus statements or guidelines that include Asian research outputs.
To date, Asian scientists have often been reserved and far behind on the global stage. That could be due to traditional cultural backgrounds or foreign language anxiety.
8) However, when Asian researchers work together, these barriers can be more easily overcome, as we have seen from the success of the AWGS sarcopenia guidelines. Many Asian countries share the saying “silence is golden,” as was the case for me. However, Asian researchers, not to mention Korean researchers, need to develop scientific confidence in their achievements in sarcopenia research and to present their scientific evidence more actively in this field. We should communicate clearly to the global scientific community that we are ready to contribute. It is now time to say, “We are here, we are working to advance aging research, and we want to contribute to global initiatives.”