Clinical Frailty Scale (CFS)
9-level clinical tool for assessing frailty in older adults. Based on clinical judgement integrating mobility, energy, physical activity, and function. Score 1 = very fit; score 9 = terminally ill. Widely used for clinical decision-making.
Score interpretation
Very fit, fit or managing well (CFS version 2.0).
→ Standard care; preventive health advice; healthy ageing promotion; pre-habilitation if major surgery planned.
Not dependent on others for daily help, but symptoms often limit activities (previously 'vulnerable').
→ Identify and address modifiable factors (exercise, nutrition, social engagement); optimise long-term conditions; falls and functional review.
CFS 5: needs help with higher-order IADLs; CFS 6: needs help with all outside activities and keeping house.
→ Comprehensive geriatric assessment (CGA); physiotherapy, OT; medication review; falls assessment; nutritional review; social care input; advance care planning discussion; careful consideration of major interventional treatments.
Completely dependent for personal care; at CFS 8 approaching end of life and typically could not recover even from a minor illness.
→ Comprehensive geriatric assessment; MDT with palliative care involvement; goals of care discussion; advance care planning and DNACPR consideration; senior clinical decision-making involvement.
Approaching the end of life: life expectancy < 6 months, not otherwise living with severe frailty.
→ Palliative and end-of-life care; symptom management; advance care planning; family meeting.
Interpretation bands for the Clinical Frailty Scale. Apply clinical judgement and local guidance.
References
- Rockwood K et al. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005;173(5):489–495.
- Rockwood K, Theou O. Using the Clinical Frailty Scale in allocating scarce health care resources. Can Geriatr J. 2020;23(3):210–215.
Related
Curated clinical cross-links plus same-class fallbacks.
- Gaviscon Advance (Alginate Preparation) · Alginate / Antacid Combination
- Sodium alginate with calcium carbonate and sodium bicarbonate · Reflux suppressant (alginate raft + antacid)
- Alginic Acid · Antacid / Alginate (GORD Treatment)
- Sodium hyaluronate · Ocular lubricant (hyaluronic acid)
- Medical-Grade Honey (Manuka) · Topical Wound Care Agent
- Silicone Gel / Sheeting (Scar Management) · Medical Device / Topical Scar Treatment
- Falls Assessment in Older Adults · NICE CG161 2013
- Delirium Outside ICU · NICE CG103
- Comprehensive Geriatric Assessment (CGA) · BGS / NICE
- Delirium Assessment and Management · NICE CG103 2010
- Frailty Recognition and Management · BGS Frailty Framework / NHS NHSE
- Polypharmacy and Medicines Optimisation · STOPP/START v2 2014 / NICE NG5
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.