Prevalence of Traditional East Asian Medicine Patterns among Older Adults with Sarcopenia: a systematic review of observational studies.

Objectives: Sarcopenia is a major geriatric syndrome that impairs quality of life. Traditional East Asian medicine (TEAM) offers a holistic diagnostic framework through pattern identification. This study aimed to systematically review and meta-analyze the prevalence of TEAM patterns in older adults with sarcopenia. Methods: We searched five electronic databases through May 25, 2025, for observational studies reporting TEAM pattern prevalence in adults aged ≥ 60 with sarcopenia. To ensure methodological homogeneity for quantitative synthesis, the meta-analysis was restricted to studies employing a mutually exclusive diagnostic approach. A random-effects meta-analysis was conducted for patterns reported in two or more of these studies. Results: Six observational studies were included in the systematic review. Five of these studies used a mutually exclusive diagnostic approach and were included in the meta-analysis. The most frequently reported patterns were liver-kidney deficiency, spleen-stomach deficiency, and spleen-stomach damp-heat. Pooled prevalence for liver-kidney deficiency (4 studies) was 39% (95% CI, 31-47%), for spleen-stomach deficiency (3 studies) was 32% (95% CI, 27-37%), and for spleen-stomach damp-heat (2 studies) was 34% (95% CI, 29-39%). The methodological quality of all included studies was assessed as low. Conclusion: Based on a methodologically rigorous meta-analysis of studies with exclusive diagnoses, the predominant TEAM patterns in sarcopenia are liver-kidney deficiency, spleen-stomach damp-heat and spleen-stomach deficiency. These distinct patterns may reflect different pathophysiological characteristics and support individualized treatment approaches. The evidence is limited by the poor quality of primary studies, highlighting an urgent need for high-quality research with standardized diagnostic criteria.