Clinical Frailty Scale (CFS)

Choose the description that best fits the patient’s condition about 2 weeks before the current illness (for acutely unwell patients).

1Very fitRobust, active, energetic and motivated people who usually exercise regularly and are among the fittest for their age.2FitNo active disease symptoms but less fit than category 1. Often active or exercising occasionally, e.g. seasonally.3Managing wellMedical problems are well controlled, even if occasionally symptomatic. Often not regularly active beyond routine walking.4Living with very mild frailtyEarly transition from complete independence. Not dependent on others for daily help, but symptoms often limit activities; a common complaint is being “slowed up” or tired during the day.5Living with mild frailtyMore evident slowing; need help with higher-order activities such as finances, transport and heavy housework. Shopping, walking outside alone, meal preparation and medications become progressively harder.6Living with moderate frailtyNeed help with all outside activities and with keeping house. Inside, often have problems with stairs, need help with bathing and may need minimal assistance (cueing, standby) with dressing.7Living with severe frailtyCompletely dependent for personal care, from whatever cause (physical or cognitive). Even so, they seem stable and not at high risk of dying within about 6 months.8Living with very severe frailtyCompletely dependent and approaching the end of life. Typically could not recover even from a minor illness.9Terminally illLife expectancy under 6 months in people who are not otherwise living with severe frailty. Many terminally ill people can still be active until very close to death.

How to score

Score the patient’s state about 2 weeks before the onset of acute illness, not their state on admission.
In people with dementia, frailty usually matches dementia severity: mild — 5, moderate — 6, severe — 7.
Choose the category from the history and observation, ideally with input from family or carers.
A CFS of 5 or more usually indicates frailty and is linked to worse outcomes after admission and procedures.

Frequently asked questions

From which CFS level is someone frail?

Usually from 5 (mild frailty). Level 4 is a transitional state, and levels 1–3 are not frail.

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This calculator is for education and does not replace a doctor’s assessment. Always interpret the result together with the history and examination.

Clinical Frailty Scale (CFS)

How to score

Limitations

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Frequently asked questions

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