Sarcopenia Risk Calculator: SARC-F and SARC-CalF Test

The SARC-F scoring table

Calf circumference cut-off: under 34 cm for men and under 33 cm for women. Source: AWGS 2019 (Chen et al., J Am Med Dir Assoc).

Sarcopenia screening, common questions

What is the SARC-F test?

SARC-F is a five-question screen for sarcopenia, the age-related loss of muscle. It asks about strength, walking, rising from a chair, climbing stairs and falls, and each answer scores 0 to 2. A total of 4 or more is a positive screen. AWGS 2019 recommends it for case finding in Asian populations.

What calf circumference signals sarcopenia?

On AWGS 2019, a calf circumference under 34 cm for men or under 33 cm for women signals low muscle mass. Measure the widest point of the bare calf while seated with your feet flat on the floor.

What is SARC-CalF and how is it scored?

SARC-CalF is SARC-F plus a calf circumference measurement. If your calf is under 34 cm for men or 33 cm for women, 10 points are added to your SARC-F score, giving a 0 to 20 scale, and 11 or more is a positive screen. Barbosa-Silva and colleagues proposed it in 2016 to raise the sensitivity of SARC-F, and AWGS 2019 adopted it for case finding.

I scored 0. Does that rule out muscle loss?

No. SARC-F is built to rule in, not rule out. It picks up established weakness and misses early loss. A grip strength test or an InBody skeletal muscle index catches loss earlier.

How accurate is the SARC-F test?

SARC-F is specific but not sensitive. In validation studies a positive result is usually right, but the test catches well under half of the people who have sarcopenia. Adding calf circumference, the SARC-CalF, raises sensitivity. Treat a negative result as a floor and a positive result as a reason to measure grip strength and muscle mass.

How is sarcopenia confirmed?

AWGS 2019 looks first for low muscle strength (grip under 28 kg for men or under 18 kg for women) or slow physical performance, such as a five-rep chair stand of 12 seconds or more. Muscle mass is then measured by DXA or bioimpedance (BIA).

Check it properly in 30 minutes

A questionnaire narrows the question. It cannot measure the answer. The complimentary 30-minute consultation at our Manulife Tower studio reviews your screen and, where it fits, books the 4-Pillar Healthspan Assessment: grip strength, InBody skeletal muscle index, and the strength pillar measured directly.

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