Clinical Frailty Scale - Geriatric Medicine Research

The Clinical Frailty Scale (CFS) was introduced in the second clinical examination of the Canadian Study of Health and Aging (CSHA) as a way to summarize ... About Admissions Academics CampusLife Libraries Research&Innovation Alumni News&Events SearchDal.ca GeriatricMedicineResearch Home OurTeam OurWork OurTools Resources Opportunities Contact Home GeriatricMedicineResearch OurTools ClinicalFrailtyScale ClinicalFrailtyScale OurTools TheFrailtyIndexComprehensiveGeriatricAssessmentClinicalFrailtyScaleCFSGuidance&TrainingCFSClassificationTreeCFSTranslations PictorialFit-FrailScaleHierarchicalAssessmentofBalanceandMobilityPermissionforUse TheClinicalFrailtyScale(CFS)wasintroducedinthesecondclinicalexaminationoftheCanadianStudyofHealthandAging(CSHA)asawaytosummarizetheoverallleveloffitnessorfrailtyofanolderadultaftertheyhadbeenevaluatedbyanexperiencedclinician(Rockwoodetal.,2005). Althoughintroducedasameansofsummarizingamultidimensionalassessmentinanepidemiologicalsetting,theCFSquicklyevolvedforclinicaluse,andhasbeenwidelytakenupasajudgement-basedtooltoscreenforfrailtyandtobroadlystratifydegreesoffitnessandfrailty.Itisnotaquestionnaire,butawaytosummarizeinformationfromaclinicalencounterwithanolderperson,inacontextinwhichitisusefultoscreenforandroughlyquantifyanindividual’soverallhealthstatus. ThehighestgradeoftheCFS(level7)aspublishedin2005,incorporatedbothseverefrailtyandterminalillness.Later,itbecameevidentthatweneededtodistinguishbetweenidentifiablegroupswhowereotherwiselumpedtogetherintheoriginalscale–severelyfrail,veryseverelyfrailandterminallyill-asclinicallydistinctgroupswhorequireddistinctivecareplans.Therefore,in2007theCFSwasexpandedfroma7-pointscaletothepresent9-pointscale,andithasbeenusedextensivelyinthatformat.Wepublishedonthepredictivevalidityofthe9-pointCFSin2020(Puloketal.,2020).  In2020theCFSwasfurtherrevised(version2.0)withminorclarifyingeditstotheleveldescriptionsandtheircorrespondinglabels.Mostnotably,CFSlevel2changedfrom"Well"to"Fit",level4from"Vulnerable"to"LivingwithVeryMildFrailty",andlevels5-8wererestatedas"Livingwith..."mild,moderate,severe,andveryseverefrailty,respectively(Rockwood&Theou,2020).  Pleaserefertothe CFSGuidanceandTraining sectionofthiswebsiteformoreinformationandresourcesaboutusingtheClinicalFrailtyScale.FornoviceCFSraters,wedevelopedaclassificationtreetoassistwithCFSscoring.  References RockwoodK,SongX,MacKnightC,BergmanH,HoganDB,McDowellI,MitnitskiA.Aglobalclinicalmeasureoffitnessandfrailtyinelderlypeople.CMAJ.2005;173(5):489-495. PulokMH,TheouO,vanderValkAM,RockwoodK.Theroleofillnessacuityontheassociationbetweenfrailtyandmortalityinemergencydepartmentpatientsreferredtointernalmedicine.AgeAgeing.2020;49(6):1071-1079.  RockwoodK,TheouO.UsingtheClinicalFrailtyScaleinAllocatingScarceHealthCareResources.CanGeriatrJ.2020:23(3):210-215. PermissionforUse Toguardagainstcopyrightinfringementorunlicensedcommercialuse,weaskallpotentialuserstocompletea PermissionforUseAgreement. AgreementsarereviewedbytheIndustryLiaisonOfficeatDalhousieUniversitytodeterminewhetheralicenseagreementisrequired.Requestsfornon-commercialeducational,clinicalandresearchuse,aswellasforreprintusuallydonotrequirealicenseagreement. Asaresultofitsworldwideuptake,theClinicalFrailtyScaleisnowavailableinanumberoflanguages(seeCFSTranslations).