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Frailty screening and assessment tools

Frailty screening tools are used to identify people who may be frail.

They are typically short, easy-to-administer questionnaires that assess a person’s physical function, nutritional status, cognition, mental health, and health supports.

Frailty assessment tools are used to provide a more detailed assessment of frailty.

Clinical Frailty Scale

This is an easy-to-use screening tool based on clinical judgement where frailty is determined by comparing a patient to nine possible options as noted in the below image. Those who have a Clinical Frail Scale of 5, 6, 7 or 8 are classified as “frail”. Further information on this tool can be found at the Dalhousie University website.

Frailty Index (FI)

The frailty index (FI) is an assessment tool which provides a granular quantification of frailty which can discriminate risk across the health spectrum from the fittest people with no deficits to those who are most frail.  

It is calculated by dividing the number of health deficits that a person has by the total number of potential deficits captured by the tool, which typically takes into account a variety of factors, including physical function, cognitive function, and nutritional status. The FI can range from 0 to 1, with a higher score indicating a higher level of frailty. Those with a score of >0.25 are considered frail.

Fried Phenotype

This approach to frailty conceptualises it as a clinical syndrome with a distinct phenotype. Someone would be classified as frail if they have deficits in three or more of the following characteristics: weight loss in prior year; grip strength; self-reported exhaustion; gait speed; and, estimated kilocalories per week.