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geriatrics general-medicine

Clinical Frailty Scale (CFS)

Clinically assesses frailty in adults >=65 years on a 9-point scale from very fit to terminally ill. Predicts adverse outcomes and guides goals of care.

Score interpretation

Not Frail (CFS 1–3) 1–3

Very fit, fit or managing well (CFS version 2.0).

→ Standard care; preventive health advice; healthy ageing promotion; pre-habilitation if major surgery planned.

Living with Very Mild Frailty (CFS 4) 4

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.

Mild to Moderate Frailty (CFS 5–6) 5–6

CFS 5: needs help with higher-order IADLs; CFS 6: needs help with all outside activities and keeping house.

→ Comprehensive geriatric assessment; falls prevention; medication review; community support; rehab input.

Severe to Very Severe Frailty (CFS 7–8) 7–8

Completely dependent for personal care; at CFS 8 approaching end of life and typically could not recover even from a minor illness.

→ Goals of care discussion; advance care planning; palliative input if appropriate; assess ceiling of treatment; avoid burdensome interventions.

Terminally Ill (CFS 9) 9

Approaching the end of life: life expectancy < 6 months, not otherwise living with severe frailty.

→ Palliative and end-of-life care; advance care planning; avoid burdensome interventions.

Interpretation bands for the Clinical Frailty Scale. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.