Design: Prospective single-centre cohort, 1-year follow-up
Population: 430 adults aged 70 or over with hip fracture
Primary outcome: Early mobilisation, walking ability and Barthel Index
Effect: SARC-F positive: day-3 impaired mobilisation OR 7.56 (95% CI 3.61 to 15.81); Barthel change −17.5 vs −11.2 at 4 months

This prospective cohort at a Finnish university hospital followed 430 adults aged 70 or over with hip fracture for a year, comparing grip strength, calf circumference and the SARC-F questionnaire (strength, assistance walking, rising from a chair, climbing stairs and falls) as predictors of recovery.

Only SARC-F was consistently associated with outcomes. A positive screen was associated with impaired mobilisation on days 1 to 3 after surgery (OR 1.99 on day 1, rising to 7.56 by day 3), poorer walking from one to four months and greater loss of daily function at four months (Barthel Index change −17.5 vs −11.2). Neither group recovered further function between four and twelve months. Grip strength and calf circumference were not consistently associated with outcomes.

SARC-F takes a minute and needs no equipment, which makes it practical on a busy orthopaedic ward or in settings without dynamometers. Answers are usually about the weeks before the fracture and may come from family when the patient is confused. It identifies who needs more rehabilitation; it does not by itself show that extra rehabilitation changes the outcome.

Complete SARC-F on admission for older adults with hip fracture, asking about function before the fall.
Ask a family member or carer when the patient cannot answer reliably.
Flag a positive screen for early, intensive physiotherapy and nutritional review.
Plan rehabilitation goals within the first four months, when most recovery occurred.

Why it matters

A free bedside questionnaire outperformed physical measurements at spotting patients heading for a poor recovery.

The statistics, in plain English

The odds ratios for early mobilisation are large but have wide intervals (day 3: 3.61 to 15.81), so the exact size is uncertain. Results were adjusted for age, fitness, cognition and nutrition, but this is a single-centre cohort and associations do not show cause.