Sarcopenia Assessment Tool
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Assessment
Sarcopenia Risk Assessment
Gender
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Male
Female
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Age
1. How difficult is it for you to lift a weight of about 4.5 kg?
0 – None
1 – Some
2 – A lot or unable
2. How hard is it for you to walk across the room?
0 – None
1 – Some
2 – A lot or unable
3. How difficult is it for you to get up/rise from a chair or bed?
0 – None
1 – Some
2 – A lot or unable
4. How difficult is it for you to go up a floor or climb 10 stairs?
0 – None
1 – Some
2 – A lot or unable
5. How many times have you fallen in the last year?
0 – None
1 – 1–3 falls
2 – 4 or more falls
6. Measure how long it takes you to get up and sit down from a chair 5 times without using your hands (seconds)
7. Measure how long it takes you to walk 4 meters at a normal pace (seconds)
Your Result
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