Muscle strength, screened
SARC-F sarcopenia screening questionnaire
Sarcopenia is the loss of muscle strength and mass that can come with age. SARC-F is a 5-question checklist its developers built so people at risk can be found without equipment. Each answer scores 0 to 2 points, for a total from 0 to 10. A score of 4 or more is a positive screen, not a diagnosis.
Your answers
5 questions about how you manage now. Nothing you enter leaves this page.
What you will see
Your SARC-F score out of 10, whether it is a positive screen (4 or more) as defined by the developers, and the points for each question.
Educational only, not medical advice. A screening questionnaire, not a diagnosis of sarcopenia.
Source
Malmstrom TK and Morley JE, Journal of the American Medical Directors Association 2013 (first description). The 5 items, the 0 to 2 points per item and the 4+ cut point are as printed in the Methods of the developers' validation paper, Malmstrom et al., Journal of Cachexia, Sarcopenia and Muscle 2016.
Validated in
Three US cohorts: 853 African Americans from St. Louis who were 49 to 65 when the African American Health study began in 2000 to 2001; 1,053 adults aged 60 and older in the Baltimore Longitudinal Study of Aging; and 3,288 adults aged 60 to 85 in NHANES 1999 to 2002.
Limits
A self-report screen, not a diagnosis: sarcopenia is confirmed with tests of strength, walking speed and muscle mass. In NHANES the falls question was only approximated (balance or falling problems), and the Baltimore cohort was healthier than average when it joined. Not studied in people under about 50.
What SARC-F asks
The developers chose 5 items that reflect the main features or consequences of sarcopenia: strength, needing help to walk, getting up from a chair, climbing stairs and falls (Malmstrom 2016). Each item scores 0 (best) to 2 (worst), so the total runs from 0 to 10. Scores of 4 or more were counted as symptomatic, 0 to 3 as healthy (Malmstrom 2016).
| Item | Question | 0 points | 1 point | 2 points |
|---|---|---|---|---|
| Strength | How much difficulty do you have lifting or carrying 10 pounds (about 4.5 kg)? | No difficulty | Some difficulty | A lot of difficulty, or unable |
| Assistance walking | How much difficulty do you have walking across a room? | No difficulty | Some difficulty | A lot of difficulty, use aids, or unable without help |
| Rise from a chair | How much difficulty do you have getting up from a chair or bed? | No difficulty | Some difficulty | A lot of difficulty, use aids, or unable without help |
| Climb stairs | How much difficulty do you have climbing a flight of 10 steps? | No difficulty | Some difficulty | A lot of difficulty, or unable |
| Falls | How many times have you fallen in the past year? | None | 1 to 3 falls | 4 or more falls |
Items and points as described in the Methods of Malmstrom 2016 (Malmstrom 2016), in our own plain wording. SARC-F was first described in 2013 (Malmstrom 2013).
What a score of 4 or more went with
In the validation study, 18.4% of the St. Louis cohort, 6.3% of the Baltimore cohort and 15.4% of the NHANES group scored 4 or more (Malmstrom 2016). People scoring 4 or more had more trouble with daily tasks such as shopping and housework, weaker grip, slower chair stands and a higher chance of an overnight hospital stay in the past year (Malmstrom 2016).
Over 6 years in the St. Louis cohort, a score of 4 or more went with more decline in daily tasks and higher odds of dying (odds ratio 1.87). In the Baltimore cohort, followed for about 2 years, the odds ratio for dying was 3.0 (Malmstrom 2016). These are links seen in groups, not a forecast for one person.
The authors suggest SARC-F as a quick screen in primary care, with people who screen positive referred for fuller testing, such as walking speed and a measure of muscle mass (Malmstrom 2016). They name resistance exercise, possibly with more protein, as the main treatment at present (Malmstrom 2016).
Limits
The authors note that the NHANES data had no count of falls, so that item was estimated from reported balance or falling problems; that the St. Louis cohort was middle-aged when it started; and that the Baltimore cohort was high functioning when enrolled (Malmstrom 2016). SARC-F is answered by the person, so it reflects how they rate their own difficulty.
Falls, bones and what to do next
For adults 65 and older living in the community who are at increased risk for falls, the USPSTF recommends exercise to prevent falls (USPSTF 2024); see the fall risk check. Weak muscles and falls also matter for bones: the osteoporosis screening check shows when the USPSTF recommends a bone density test (USPSTF 2025). If your score is 4 or more, or you are losing strength or falling, tell your doctor.
For a wider 5-question screen that also asks about tiredness, long-term illnesses and weight loss, see the FRAIL scale from the same research group (Morley 2012).
Sources
- Malmstrom TK, Miller DK, Simonsick EM, Ferrucci L, Morley JE. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle. 2016;7(1):28-36. doi:10.1002/jcsm.12048. PMC4799853. (Developers' validation paper; prints the 5 items, 0 to 2 points each and the 4+ cut point in its Methods.) pmc.ncbi.nlm.nih.gov/articles/PMC4799853/
- Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc. 2013;14(8):531-532. doi:10.1016/j.jamda.2013.05.018. PMID 23810110. (First description of SARC-F; not open to us, cited for origin only.) pubmed.ncbi.nlm.nih.gov/23810110/
- Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging. 2012;16(7):601-608. doi:10.1007/s12603-012-0084-2. PMID 22836700. PMC4515112. (Developers' validation paper; prints the 5 FRAIL items, the scoring of each and the robust, pre-frail and frail bands in its Methods and Appendix 1.) pmc.ncbi.nlm.nih.gov/articles/PMC4515112/
- US Preventive Services Task Force. Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2024;332(1):51-57. www.uspreventiveservicestaskforce.org/uspstf/recommendation/falls-prevention-community-dwelling-older-adults-interventions
- US Preventive Services Task Force. Screening for Osteoporosis to Prevent Fractures: US Preventive Services Task Force Recommendation Statement. JAMA. 2025;333(6):498-508. www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-01. Spotted an error? See About.