Phase angle and vector analysis in the evaluation of body composition in sarcopenic obesity: A systematic review.

Sarcopenic obesity, the coexistence of sarcopenia and obesity, has been linked to adverse health outcomes due to comorbidity. Evidence on the association between sarcopenic obesity and mortality among individuals with Type 2 diabetes remains limited METHODS: Sarcopenic obesity was defined using Japan Working Group on Sarcopenic Obesity criteria. Participants were divided into four groups based on the presence of sarcopenia and obesity. Cox proportional hazards models evaluated the mortality risk. Subgroup analyses were performed by age (40-75 vs. >75 years). Sensitivity analysis was performed by dichotomizing participants into sarcopenic obesity and non-sarcopenic obesity groups. Of the 799 participants (mean age 68.6 years, 59.3% men), proportions of neither sarcopenia nor obesity, obesity alone, sarcopenia alone and sarcopenic obesity were 56.2%, 34.5%, 6.3% and 3.0%, respectively. During a median follow-up of 46 months, 41 deaths occurred. Compared with neither of them, the adjusted hazard ratios (aHRs) (95% CI) of mortality in obesity alone, sarcopenia alone and sarcopenic obesity were 0.53 (0.18-1.57) (p = 0.25), 2.36 (0.99-5.6) (p = 0.053) and 2.89 (1.01-8.30) (p = 0.048), respectively. Age-stratified analyses revealed that sarcopenic obesity markedly increased mortality risk in participants aged 40-75 years (aHR 13.1 [2.93-58.4], p < 0.001), whereas sarcopenia alone (aHR 3.21 [1.07-8.33], p = 0.004), but not sarcopenic obesity (aHR 1.41 [0.34-8.81], p = 0.51), was associated with increased mortality in those aged > 75 years. Compared with non-sarcopenic obesity, sarcopenic obesity had a significantly higher hazard ratio for mortality (aHR 4.0 [1.44-11.0], p = 0.008). In age-stratified analysis, this association remained significant in participants aged 40-75 years (aHR 14.1 [3.25-61.5], p < 0.001), but not in those aged > 75 years (aHR 1.55 [0.32-7.46], p = 0.59) (interaction p = 0.03). In Japanese individuals with Type 2 diabetes, sarcopenic obesity was significantly associated with increased mortality risk. This relationship was particularly pronounced in individuals aged 40-75 years, whereas sarcopenia alone was associated with increased mortality risk rather than sarcopenic obesity in individuals aged > 75.

Pinch strength and its variability: Novel insights into functional decline in sarcopenic obesity.

The global rise in sarcopenic obesity necessitates identifying key adherence determinants in nutritional and exercise interventions to optimize outcomes. This systematic review identifies characteristics affecting adherence and dropout in these interventions. We searched Web of Science, PubMed, Scopus, and Cochrane Library through January 2025, including reference lists. Using the Cochrane Risk of Bias Tool, we assessed RCTs on nutritional/exercise interventions for sarcopenic obesity. High heterogeneity and insufficient adherence reporting precluded meta-analysis for adherence; outcomes were narratively synthesized. For dropout rates, meta-analysis was conducted, including subgroup analyses (exercise, nutrition, multi-component) and meta-regression to explore moderators. From 1,205 records, 57 studies (4,166 participants) were included. The overall dropout rate was 9%, increasing with intervention duration. Only 45.6% of studies reported adherence data. Among exercise interventions, elastic resistance had the highest adherence (91.5%), resistance training the lowest (85%). In nutritional interventions, low-calorie diets with nutraceuticals outperformed diet-only (92.1% vs. 77%). Professionally supervised interventions showed superior adherence to self-monitored programs. Current trials often inadequately report adherence data, with longer durations correlating to higher dropout rates. Evidence suggests elastic resistance exercise, low-calorie diets with nutraceuticals, and professional supervision may improve adherence. Future research should refine intervention methods and prioritize adherence reporting to enhance sarcopenic obesity care quality.

Sarcopenia and sarcopenic obesity may increase surgical complications and impact recovery and function after total joint arthroplasty (TJA). We assessed the feasibility of identifying these conditions in an orthopedic practice setting using published consensus criteria. Patients in a lower extremity TJA clinic were assessed for sarcopenia and sarcopenic obesity using EWGSOP2 and ESPEN/EASO diagnostic frameworks, respectively. Low strength testing involved maximal handgrip strength (HGS) and number of chair sit-to-stands in 30 seconds (CSTS). Same day dual-energy x-ray absorptiometry (DXA) testing was used to assess for low muscle mass (i.e. appendicular lean soft tissue) in patients with low strength. One hundred-one of a possible 128 patients were assessed in clinic (93% male, mean age 69.6±8.9 years and BMI 31.7±7.9 kg/m2). HGS was completed in 99% of screened patients; only 44.5% completed CSTS due to joint pain and balance limitations. Thirty-nine patients had low strength and were recommended for DXA. In 16 patients who completed DXA, 3 had sarcopenia and 5 had sarcopenic obesity. Screening for sarcopenia and sarcopenic obesity was challenging to complete in all patients during routine clinic flow with dedicated personnel. Despite our pragmatic approach and limited screening completion in all patients, we identified sarcopenic and sarcopenic obesity in 6.25% of patients. This is likely a lower bound for the true prevalence but suggests an opportunity to assess and intervene for these conditions before surgery to improve total joint arthroplasty outcomes.

Background: Sarcopenic obesity (SO) is a metabolic myopathy characterized by the coexistence of obesity and decline of muscle mass and function. Obesity-related muscle atrophy represents a central pathological feature of this condition. Polygonati Rhizoma is widely used as a dietary herb with tonic effects in traditional Asian medicine. This study aims to investigate the effects and underlying molecular mechanisms of the water extract of Polygonati Rhizoma (WPR) on obesity-related muscle atrophy. Methods: The effects and potential mechanisms of WPR were explored using an obesity-induced muscle atrophy (OIMA) mouse model, palmitic acid (PA)- or lipopolysaccharide (LPS)-induced myotube atrophy models, and a myogenic differentiation model in C2C12 cells. Results: In OIMA mice, WPR attenuated obesity-related skeletal muscle atrophy and improved muscle strength and endurance. In the gastrocnemius muscle, WPR-treated mice showed lower levels of oxidative stress and inflammation, increased markers of mitochondrial biogenesis, and an improved balance between protein synthesis and degradation. In PA- or LPS-induced myotube atrophy models, WPR treatment suppressed the ubiquitin–proteasome system (UPS)-mediated proteolysis and NFκB/MAPK-related inflammatory signaling. In addition, WPR promoted myogenic differentiation in C2C12 myoblasts, which was associated with regulation of the p38 MAPK/MyoD/Myogenin axis. Conclusions: Our study suggests that WPR exerts a potential mitigating effect on obesity-related muscle atrophy, and this effect may be associated with the modulation of skeletal muscle inflammatory signaling, mitochondrial function, and protein metabolic balance. These findings are exploratory and provide mechanistic clues for future research aimed at developing potential intervention strategies for obesity-related muscle atrophy.

Background/Objectives: Sarcopenia, obesity, and sarcopenic obesity (SO) are common in older adults and may be associated with functional limitations in Basic (BADL) and Instrumental (IADL) Activities of Daily Living. This study aimed to evaluate the association between body composition phenotypes and BADL/IADL limitations among older adults. Methods: A cross-sectional study included 440 community-dwelling adults aged ≥60 years (281 women, 159 men; mean age 74.7 ± 7.8 years). Sarcopenia was diagnosed according to EWGSOP2 criteria, obesity was defined as Percent Body Fat &gt; 42% in women and &gt;30% in men, and SO was classified based on the ESPEN/EASO recommendations. The reference phenotype was ‘non-sarcopenic, non-obese’. Functional status was evaluated using the Katz and Lawton scales, with limitations defined as BADL ≤ 5 and IADL ≤ 26 points, respectively. Multivariate logistic regression was performed to determine associations between body composition phenotypes and BADL/IADL limitations. Results: Over half of the participants (57.1%) had abnormal body composition: 31.6% obesity, 11.4% sarcopenia, and 13.2% SO. Sarcopenic obesity was associated with nearly threefold higher odds of BADL limitations (OR = 2.86; p = 0.003) and 3.7-fold higher odds of IADL limitations (OR = 3.68; p &lt; 0.001), compared to the reference phenotype. Sarcopenia was associated with IADL limitations only in the unadjusted model (OR = 2.44; p = 0.010). Beyond adverse body composition phenotypes, BADL/IADL limitations were also associated with lower muscle strength, multimorbidity, and poorer nutritional status. Conclusions: SO was linked to both BADL and IADL limitations, while sarcopenia was associated only with IADL deficits. Isolated obesity showed no consistent relationship with functional impairment. These findings support prioritizing SO in screening and prevention, although the cross-sectional design precludes causal inference.

Preoperative assessment of sarcopenia and osteosarcopenia prevalence in bariatric surgery candidates over 60.

Sarcopenic obesity (SO), defined as the coexistence of excess fat mass and low muscle mass/function, has been linked to adverse outcomes. Epigenetic alterations are central hallmarks of aging. Evaluating how obesity, sarcopenia, and SO are related to epigenetic aging biomarkers may provide insights into cellular aging and disease risk. In this cross-sectional study, 30 older women were classified into the control, obesity, sarcopenia, and SO groups and underwent anthropometry measurements, body composition analysis, and handgrip strength. Blood DNA methylation (DNAm) biomarkers were used to estimate eight epigenetic clocks (Horvath, Hannum, DNAmTL, PhenoAge, GrimAge, GrimAge2, Zhang, and FitAge) and to calculate intrinsic and extrinsic epigenetic age acceleration (IEAA and EEAA). Associations were tested with Bayesian linear and quantile regressions, adjusted for age and HOMA-IR. SO was associated with higher EEAA, DNAmFitAge, and Hannum clock estimates, and shorter DNAmTL in both models. Obesity showed positive associations with these clocks in adjusted models and higher quantiles. SO is associated with accelerated aging and shorter DNAmTL. Obesity contributes to biological aging, whereas sarcopenia without obesity does not. These findings suggest that excess adiposity combined with low muscle mass may worsen age-related decline, although the small sample size should be considered.

Background/Objectives: Sarcopenia (Sp) and obesity (Ob) have significant negative effects on steatotic liver disease (SLD). Here, we examined the effects of sarcopenic Ob (SO) on liver fibrosis in patients with SLD. Methods: We included 811 patients who visited our outpatient clinic and underwent FibroScan (Echosens, France). Liver stiffness (LS) was assessed using body mass index (BMI) and grip strength (GS). We conducted a similar analysis by converting the difference in estimated glomerular filtration rate (dGFR) based on creatinine and cystatin C levels into GS. Results: The cutoff values for distinguishing metabolic dysfunction-associated steatotic liver disease (MASLD; 298 patients) with LS > 10 kPa (advanced fibrosis) were set separately for men and women using receiver operating characteristic analysis. BMI was set at >26 kg/m2 in women and >27 kg/m2 in men (modified Ob (mOb)), and GS was set at <16 kg in women and <31 kg in men (modified Sp (mSp)). The ratio of advanced fibrosis was higher in the group with both mSp and mOb (mSpOb) than in the group with mSp alone or mOb alone in MASLD or alcoholic liver disease (ALD, 97 patients). However, this association has not yet been observed in other diseases. The dGFR was used to set the cutoff value corresponding to advanced fibrosis. Sp-dGFR (SpdG) was >1.14 in women and >−0.76 in men in the MASLD group. mSpOb, SpdG and Ob are associated with advanced fibrosis in MASLD logistic regression analysis. Conclusions: SO, assessed using BMI and GS or dGFR, was associated with elevated LS in patients with SLD.

Sarcopenic obesity (SO), characterized by the coexistence of excess adiposity and diminished muscle mass and function, represents an increasing health concern among the older adults. Resistance and aerobic exercises are effective strategies for managing this condition. However, due to low exercise adherence among older adults, the current state of prevention and control of SO remains challenging. Moreover, qualitative insights into the specific exercise experiences of this population, particularly in the Chinese context, are lacking. This study seeks to elucidate the barriers and facilitators to exercise adherence among elderly individuals affected by SO through the application of the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation-Behavior (COM-B) model. This study employed a descriptive qualitative research methodology. From March to September 2024, 21 community-dwelling older adults with SO were recruited in Southwest China to participate in face-to-face, semi-structured interviews. Participants were aged 60 years or older and diagnosed with SO. The interview outline was developed based on the TDF, and interviews were audio-recorded and transcribed verbatim. Data were analyzed using both deductive and inductive approaches, and the identified themes were mapped onto the TDF and the COM-B model. This study analyzed a total of 488 utterances, which comprehensively covered 12 domains of the TDF and the 3 core components of the COM-B model. Six barrier themes and three facilitator themes were identified. The main barriers included inadequate capability (e.g., lack of knowledge, insufficient exercise confidence, poor self-control), limited opportunity (e.g., unsafe environments, body image pressure), and insufficient motivation (e.g., lack of security). The facilitators included motivation (e.g., perceived benefits of exercise, perceived disease threat) and opportunity (e.g., multidimensional social support). This study revealed that exercise adherence among geriatric individuals with SO is influenced by a complex interplay of factors. The key barriers identified were insufficient exercise confidence and lack of security. Future research should incorporate targeted behavioral intervention strategies, such as demonstration of the behavior, verbal persuasion about capability, pros and cons, and restructuring the physical environment, to effectively address the multifaceted challenges associated with SO in older adults. These strategies should be central to the development of effective intervention programs aimed at promoting physical activity among this cohort.

Air pollution and muscle-fat imbalance: How PM2.5 components and ozone drive sarcopenic obesity through inflammation

Acyclovir (ACV) is the first-line agent for varicella zoster virus (VZV) encephalitis. Acute kidney injury (AKI) remains a clinical concern. We report the case of a sarcopenic obese woman with VZV encephalitis. She developed AKI 2 days after receiving intravenous ACV based on her actual body weight. After temporarily discontinuing ACV and confirming recovery of the renal function, ACV was restarted at a dose based on her ideal body weight. The patient recovered without any further complications. This case underscores the importance of dose adjustment of water-soluble medications, such as ACV, in obese patients, particularly in those with sarcopenic obesity.

BackgroundUrinary incontinence (UI) is a common complaint among middle-aged and older women, associated with many negative impacts in health. The aim of this study was to analyze whether an association exists between UI and sarcopenic obesity (SO) among middle-aged and older women living in northeastern Brazil. The association of UI with sarcopenia or obesity alone was also assessed.MethodsIn a cross-sectional, analytical study, 531 women living in Santa Cruz and Parnamirim, Rio Grande do Norte state (Brazil), aged between 40 and 80 years, were assessed for the presence of UI in the last 12 months by self-reporting. Waist circumference equal to or greater than 88 cm was considered to classify obesity, while skeletal muscle mass below 5.93 kg/m2, assessed by bioelectrical impedance, classified the presence of sarcopenia. Based on these measurements, the participants were classified into four profiles: neither condition, sarcopenia, obesity, and sarcopenic obesity. Binary logistic regression investigated the association of UI with sarcopenia, obesity, and SO, adjusted for the covariates age, schooling, family income, marital status, hypertension, diabetes, parity, and menopausal status, considering p < 0.05.ResultsA total of 10.7% had no sarcopenia or obesity, 10.7% had only sarcopenia, 69.7% had only obesity and 8.9% had SO. Obesity alone was associated with a higher odss of UI compared to the group with neither conditions (OR = 1.95; p = 0.025). The associations between UI and sarcopenia alone or combined with obesity were not significant.ConclusionObesity alone was associated with UI. The results highlight the need for screening UI symptoms among women with abdominal obesity for early detection and timely interventions.

BackgroundSarcopenic obesity (SO) is characterized by the coexistence of sarcopenia and excess adipose tissue, increasing the risk of falls and related adverse outcomes in older adults. However, diagnostic criteria for SO remain inconsistent, warranting further investigation. This study aimed to examine the association between SO, defined according to the criteria proposed by the 2022 European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO), and the history of falls among hospitalized older Italian adults.MethodsThis cross-sectional study included 90 older Italian adults (≥ 60 years) with severe obesity (body mass index ≥ 35 kg/m2). The exposure variable, SO, was defined by the concomitant presence of reduced muscle function, high fat mass, and low muscle mass adjusted for body weight. Muscle function was assessed using the Five-Times Sit-to-Stand (5×STS) test and handgrip strength (HGS). Fat mass percentage (FM%) was measured using dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA). Appendicular muscle mass (AMM/W) and skeletal muscle mass (SMM/W), both adjusted for body weight, were assessed using DXA and BIA, respectively. Four diagnostic definitions of SO were analyzed according to the following combinations of tests and instruments: 1) 5×STS + FM% DXA + AMM/W, 2) 5×STS + FM% BIA + SMM/W, 3) HGS + FM% DXA + AMM/W, and 4) HGS + FM% BIA + SMM/W. The outcome was self-reported falls in the past year. Multivariable logistic regression models were adjusted for sex, age, education, marital status, fall-related multimorbidity, alcohol consumption, and regular physical activity.ResultsSignificant associations between SO and falls were found only when muscle function was assessed using HGS, regardless of the method used to estimate FM% and muscle mass. In adjusted analyses, participants classified as having SO according to combinations HGS + FM% BIA + SMM/W and HGS + FM% DXA + AMM/W had approximately almost fourfold (OR=3.61; 95% CI: 1.28–10.19) and sixfold (OR=6.03; 95% CI: 1.80–20.23) higher odds of reporting falls in the previous year, respectively, when compared to those without SO considering the same diagnostic tests.ConclusionSO defined by low HGS combined with high FM% and low muscle mass adjusted for body weight—whether measured using DXA or BIA—was associated with greater odds of falls in older Italian adults. These findings support the use of muscle strength-based definitions of SO when evaluating fall risk in this population.

Objective: To investigate the association between sarcopenic obesity (SO) phenotype and mild cognitive impairment (MCI) in community-dwelling old adults. Methods: The base line data from Hubei Memory and Aging Cohort Study during 2018-2023 were used in this study. Old adults aged ≥65 years, including those from 4 urban communities in Wuhan and 48 rural villages in Dawu, Hubei Province, were recruited through cluster random sampling. They were divided into four groups: control (without sarcopenia or obesity), obesity only, sarcopenia only, and SO. MCI was diagnosed by using Peterson criteria. The associations of obesity only, sarcopenia only, SO with MCI risk were evaluated by binary logistic regression analysis, then stratified analyses was conducted. Results: A total of 2 738 old adults aged ≥65 years [(72.59±5.36) years] were included in this study, in whom 53.98% were women.The crude prevalence rates of obesity, sarcopenia, and SO were 50.62%, 18.37%, and 10.01%, respectively. The prevalence of MCI was 22.62% in the control, 24.46% in the obesity only, 43.67% in the sarcopenia only, 43.43% in the SO. After adjusting for all variables. The risk for MCI increased by 71% (OR=1.71, 95%CI: 1.24-2.37) in sarcopenia only group and 60% (OR=1.60, 95%CI: 1.18-2.16) in SO group compared with the control. In subgroup analysis, the moderation effect of age and residence were statistically significant (all P interactions <0.05). In the rural old adults, compared with control, obesity only group showed a 28% (OR=0.72, 95%CI: 0.54-0.97) lower risk for MCI, while the sarcopenia only group showed a 53% (OR=1.53, 95%CI: 1.07-2.20). In the urban adults, compared with control, SO group showed a 116% (OR=2.16, 95%CI: 1.11-4.19) higher risk for MCI. Conclusion: Both sarcopenia only and SO are the potential risk factors for MCI in community-dwelling old adults aged ≥65 years with heterogeneity across populations.

Background/Objectives: Preoperative body composition has been implicated as a factor affecting clinical outcomes in several types of cancer. However, there is limited evidence regarding whether preoperative body composition can predict the prognosis following gastrectomy for gastric cancer (GC). We aimed to investigate the role of preoperative body composition as a prognostic factor for overall survival (OS) and relapse-free survival (RFS) after gastrectomy for GC. Methods: This prospective study included 540 patients who underwent gastrectomy for GC at the Kanagawa Cancer Center, Japan, between December 2013 and November 2017. Preoperative body composition was assessed using the skeletal muscle index and visceral adipose tissue area derived from computed tomography scans. Patients were classified into four groups: non-sarcopenic non-obesity (NN), sarcopenic non-obesity (SN), non-sarcopenic obesity (NO), and sarcopenic obesity (SO). Results: A total of 448 patients (NN, 184; SN, 52; NO, 186; SO, 26) were included in the final analysis. In terms of OS, the SO group showed significantly worse survival than the NN group (72.1% vs. 87.6%, p = 0.01). Similarly, regarding RFS, the SO group had significantly worse outcomes than the NN group (68.4% vs. 86.2%, p = 0.007). Multivariate analysis identified SO as an independent risk factor for both OS (hazard ratio [HR], 3.18; 95% confidence interval [CI], 1.33-7.64; p = 0.01) and RFS (HR, 3.08; 95% CI, 1.36-6.95; p = 0.01). Conclusions: Preoperative SO was associated with poorer outcomes in patients undergoing gastrectomy for GC.

Ongoing evidence indicates increased risk of sarcopenic obesity among children and young people (CYP) with acute lymphoblastic leukemia (ALL), often beginning early in treatment, persisting into survivorship. This review evaluates current literature on body composition in CYP with ALL during and after treatment. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelinesand was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023480732). Three databases (PubMed, MEDLINE (OVID), and CINAHL) were searched until March 2024. Studies with individuals aged 0-21 years with ALL during or after treatment were included. The Joanna Briggs Institute checklist was used to assess the bias risk. Of the 126 studies, 13 were included (eight cross-sectional and five prospective). Eight studies used dual-energy X-ray absorptiometry, three used bioelectrical impedance analysis, two used air-displacement plethysmography, and one applied the four-compartment model. Fat mass (FM) increased early (T2-T3 ≈ +1standard deviation score [SDS]), and remained elevated at treatment end, and was above reference at follow-up (T5 ≈ +0.7 SDS). Fat-free mass (FFM) declined during therapy (lowest at T4 ≈ -0.7 SDS) with partial recovery by T5 (confidence interval crossing 0). Body mass index was elevated in the ALL groups versus controls. Heterogeneity was substantial, reflecting variation in age, assessment timing, and methodology. Despite methodological limitations, this review demonstrates persistent increases in FM and a reduction in FFM during and after treatment. Large, international studies using standardized body composition methodologies and clinically relevant cut-offs are needed to define long-term risks.

BackgroundThis study examines the epidemiology of sarcopenic obesity (SO) in China, focusing on national prevalence, modifiable influencing factors, and its longitudinal association with dementia risk in middle-aged and older adults.MethodsUsing the 2015 wave of the China Health and Retirement Longitudinal Study (CHARLS), SO prevalence was estimated nationally and regionally using Bayesian spatial modeling. Modifiable influencing factors were identified via multivariable logistic regression, with their relative contributions quantified using Extreme Gradient Boosting (XGBoost). The association between baseline SO (2015) and incident dementia risk (2018) was assessed using multivariable logistic regression.ResultsAmong 10,256 participants aged ≥ 45 years, the national SO prevalence was 6.40% (95% Bayesian confidence intervals [BCIs]: 6.39–6.41%), with significant regional variation (Northern region: 8.60% [8.59–8.61%]; Southern region: 4.90% [4.86–4.94%]). Older age, female sex, hypertension, and depressive symptoms showed statistically significant associations with SO. Age emerged as the strongest predictor in XGBoost analysis. Compared to normal-weight individuals without sarcopenia, those with normal-weight sarcopenia had 63% higher dementia risk (odds ratio [OR] = 1.63; 95% confidence interval [CI]: 1.04–2.58), while SO individuals showed 89% increased risk (OR = 1.89; 95% CI: 1.67–2.15).ConclusionThese findings emphasize the significant geographic disparity in SO prevalence across China and reveal that SO is associated with a substantially elevated risk of dementia, underscoring the need for targeted interventions in aging populations.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40520-025-03318-8.

Sarcopenia, which is a progressive loss in muscle function and mass, significantly aggravates the quality of life of the elderly. Traditional face-to-face rehabilitation is of limited accessibility with poor compliance. The purpose of this article is to discuss the application of telemedicine among exercise interventions for sarcopenia, emphasizing its technical architectures, effectiveness, and issues. This article applied literature review, content analysis, and inductive summary methods to combine research progress regarding remote monitoring of exercise therapy in treating sarcopenia among older adults. Utilizing keywords such as "sarcopenia," "exercise prescription," "remote monitoring," and "aging," literature was retrieved, analyzed, and summarized by means of Chinese and foreign databases, including CNKI, Web of Science, and PubMed. Telemedicine, facilitated by internet-based platforms (e.g., mobile applications, video conferencing, and smart devices), enables comprehensive investigation and diagnosis of sarcopenia patients and customized exercise prescriptions and real-time feedback adjustments. The core remote exercise intervention protocol involves multimodal interventions, with resistance training as the primary component, supplemented by balance training, aerobic exercise, whole-body vibration training (WBVT), and traditional exercises such as Tai Chi and Baduanjin. This approach reflects considerable clinical effectiveness in enhancing musculature functioning (e.g., grip force and gait speed), reducing healthcare costs, and bettering quality of life through a systematic monitoring plan that reduces the dangers of exercise-linked injury. Digital platforms enable enhanced therapeutic compliance via machine-based reminders and personalized feedback tools, employing data-based algorithms to optimize intervention parameters. Technical difficulties still exist with older populations, particularly regarding smart device operation ability and robustness in remote data collection precision. Subsequent studies must address these implementation concerns with a view to determining the long-term viability of telemedicine-based sarcopenia care models. Telemedicine provides scalable solutions to managing sarcopenia, particularly treatment compliance and access. However, challenges such as barriers to using devices for older patients and remote muscle mass evaluation need to be addressed. This paper further explores how telemedicine technologies could be combined with conventional training protocols, focusing on precision challenges, including data calibration and subtype management, especially sarcopenic obesity. Future activities should integrate personalized prescriptions and guarantee their efficacy in the different subtypes. Multidisciplinary collaboration and technological optimization will enhance the role of remote healthcare in comprehensive sarcopenia management.