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neurology geriatrics palliative-care

FAST Scale for Alzheimer Dementia

Functional Assessment Staging Test (FAST). Stages functional decline in Alzheimer disease from normal ageing (Stage 1) to severe dementia (Stage 7). Used in palliative care to determine hospice eligibility.

Score interpretation

FAST 1–3: Normal to early decline. Cognitive screening; memory clinic referral; carer education. Consider driving assessment if applicable.
Mild-Moderate Dementia

→ FAST 4–5: Mild-moderate Alzheimer dementia. Cholinesterase inhibitor (donepezil, rivastigmine); memantine if moderate. Formal carer assessment; lasting power of attorney; advance care planning.

Moderately Severe Dementia

→ FAST 6: Moderately severe dementia. Personal care assistance required. Review all medications; consider antipsychotics only for severe behavioural disturbance (caution). Family support; safety assessment at home.

Severe Dementia — End Stage

→ FAST 7a–7f: Severe/end-stage Alzheimer dementia. Hospice/palliative care referral appropriate (Stage 7c+ typically meets hospice criteria). Focus on comfort; oral care; pressure care; dysphagia management; avoid unnecessary hospitalisations.

Interpretation bands for the FAST 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.