Predicting Mobility and Functional Recovery After Hip Fracture With Handgrip Strength, Calf Circumference, and the SARC-F Questionnaire

OBJECTIVES: More longitudinal studies of the implications of sarcopenia are needed in patients with hip fractures. This study compared 2 sarcopenia-related measurements and 1 questionnaire-based screening tool and examined their association with rehabilitation outcomes after hip fracture. DESIGN: A prospective cohort study with 1-year follow-up was performed between 2021 and 2023. SETTING AND PARTICIPANTS: Four hundred thirty older adults (≥70 years) with hip fractures participated in a single university hospital. METHODS: The associations of handgrip strength, calf circumference, and the SARC-F (Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls) questionnaire were examined with early postoperative mobilization (the Cumulated Ambulation Score), walking mobility (the New Mobility Score, up to 4 months), and functional outcome [the Barthel Index (BI) up to 12 months]. The analyses were adjusted for age and sex, American Society of Anesthesiologists score, and cognitive and nutritional status. RESULTS: Only SARC-F was consistently associated with impaired early mobilization (odds ratio [OR], 1.99; 95% CI, 1.14-3.45 for day 1; OR, 4.90; 95% CI, 2.84-8.44 for day 2; OR, 7.56; 95% CI, 3.61-15.81 for day 3). Similarly, only the SARC-F-based sarcopenia group was associated with inferior walking ability from 1 month to 4 months after fracture and a greater functional decline in BI at 4 months compared with those without sarcopenia [mean New Mobility Score change (CI) 2.0 (1.7-2.4) vs 0.6 (0.3-0.9); mean BI change -17.5 (-20.9 to -14.2) vs -11.2 (-13.9 to -8.6)]. No significant improvement in BI was observed in either group between 4 and 12 months. Handgrip strength or calf circumference was not consistently associated with the studied outcomes. CONCLUSIONS AND IMPLICATIONS: SARC-F was consistent in predicting short- and long-term functional outcomes. It may be a practical screening tool to identify patients at risk of poor recovery after hip fracture.