Embedding Sarcopenia Screening and Assessment in Routine Geriatric Services at a District General Hospital

Introduction

Frailty is increasingly prevalent in ageing populations and contributes to rising age‑related conditions such as sarcopenia, which is linked to falls, functional decline and greater healthcare use. Early identification is recommended in EWGSOP2 (2019); SARC‑F offers simple screening, while handgrip strength (HGS) provides objective assessment but is harder to implement routinely. This observational study examined the feasibility of embedding Guideline‑aligned frailty and sarcopenia assessment across inpatient and outpatient services.

Methods

In March 2022, 70 older inpatients were screened using the Clinical Frailty Scale (CFS) and SARC‑F, with scores ≥4 indicating high sarcopenia risk. Sarcopenia was assessed using HGS, with probable sarcopenia defined as <27 kg for men and <16 kg for women (EWGSOP2, 2019). A multidisciplinary team conducted this study as part of Comprehensive Geriatric Assessment. Following successful inpatient implementation, the same protocol was replicated for 27 patients attending outpatient clinics in July 2025. Data were tested for normality, and associations between SARC‑F and HGS were examined using Pearson’s correlation.

Results

Inpatient cohort (mean age 87 years; 70% female) demonstrated predominantly mild to moderate frailty (32.9% and 51.4%). Outpatients were younger (mean age 81 years) and majority male (55.6%), with mild to moderate frailty in 37% and 20.7%. SARC‑F screening indicated high sarcopenia risk in both settings, with mean scores of 5.6 for inpatients and 5.0 for outpatients. Most participants scored ≥4, with 85.7% of inpatients and 59.3% of outpatients meeting this threshold. HGS findings suggested probable sarcopenia in 85.7% of men and 81.6% of women in the inpatient cohort, and 73.3% of men and 41.7% of women in the outpatient cohort. Pooled analysis demonstrated a moderate negative correlation between SARC‑F and HGS (R = –0.44, P <0.001), indicating that higher muscle strength was associated with lower SARC‑F scores.

Conclusions

Routine use of SARC‑F alongside HGS is feasible across inpatient and outpatient geriatric services. Integrating these tools into clinical practice enables earlier identification of probable sarcopenia, supports targeted interventions, and strengthen frailty‑focused assessment and management pathways. These findings highlight a scalable opportunity for services to operationalise guideline‑recommended sarcopenia assessment across both inpatient and outpatient settings to enhance care quality.