Clinical Frailty Scale (CFS)
The Clinical Frailty Scale (CFS) is a judgement-based frailty tool that assesses the person's illnesses, function and cognition (thinking and understanding) to generate a frailty score ranging from 1 (very fit) to 9 (terminally ill).
- Recognition of frailty should be part of a holistic assessment.
- The CFS can be undertaken by any appropriately trained healthcare professional with training and support. A free 15 minute eLearning resource from Ottawa Hospital is available here.
- The CFS is only validated for people aged ≥ 65. It should not be used in younger people, people with stable long-term disabilities (for example, cerebral palsy), learning disability or autism and an individualised assessment is recommended.
- Be mindful of your prejudices. Just because a person is old doesn’t mean they are frail.
- Complete the screening based on how the person’s function was two weeks prior to deterioration. This requires understanding their global function and cognition which means talking to the patient, their family members and their carers as appropriate.
The degree of frailty generally corresponds to the degree of dementia. Common symptoms in mild dementia include forgetting the details of a recent event, though still remembering the event itself, repeating the same question/story and social withdrawal.
In moderate dementia, recent memory is very impaired, even though they seemingly can remember their past life events well. They can do personal care with prompting.
In severe dementia, they cannot do personal care without help.
In very severe dementia they are often bedfast. Many are virtually mute.
Copied with permission from Dalhousie University.
Rockwood, K and Theou, O. Using the Clinical Frailty Scale in Allocating Scarce Health Care Resources. Canadian Geriatrics Journal, Volume 23, Issue 3, pages 254-259, September 2020.