The scale is used as a way to summarize the overall level of fitness or frailty of an older adult after they had been evaluated by an experienced clinician.
1. Very fit
- Robust, active, energetic, and motivated: these people commonly exercise regularly.
- No active disease symptoms but are less fit than category 1. Exercise occasionally. Some may complain of memory symptoms, but do not have objective deficits.
3. Managing well
- Medical problems are well controlled, but they are not regularly active beyond routine walking. With exercise, they become classed in categories 1 or 2.
- While not dependent on others for daily help, often symptoms limit their activities. Common complaints: being "slowed up" or tired during the day. Many rate themselves as no better than "fair." Memory problems, if present, can begin to impact on function (e.g., having to look up familiar recipes, misplacing documents).
5. Mildly frail
- More evident slowing, need help with ADLs (Activities of Daily Living: eating, bathing, dressing, toileting, mobility, grooming) and IADLs (Instrumental Activities of Daily Living: finances, transportation, heavy housework, medications). Shopping and walking outside alone, meal preparation, and housework are progressively impaired. Often, they have several illnesses and several medications. This category includes people with mild dementia.
6. Moderately frail
- Help needed with all outside activities and with keeping house. Problems with stairs and may need minimal help bathing and dressing. Recent memory will be very impaired even though past life events can remembered.
7. Severely frail
- Complete dependency for personal care, from whatever cause (physical or cognitive). Stable and not at high risk of dying (i.e., within about 6 months).
8. Very severely frail
- Complete dependency, approaching the end of life. No recovery from even a minor illness.
9. Terminally ill
- Approaching the end of life. Life expectancy is six months or less.
Adapted from Rockwood K et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173(5): 489-495. Internet. Available at https://www.cmaj.ca/content/173/5/489. Accessed on July 10, 2016.