1. Very fit – people who are robust, active, energetic and motivated. They commonly exercise regularly and are among the fittest for their age
2. Well – people who have no active disease symptoms but are less fit than category 1. Typically, they exercise or are very active occasionally, such as seasonally
3. Managing well – people whose medical problems are well controlled but are not regularly active beyond routine walking
4. Vulnerable – while not dependent on others for daily help, often symptoms limit activities. A common complaint is being ‘slowed up’ and/or being tired during the day
5. Mildly frail – these eople often have more evident slowing and need help with high-order IADLs. Typically, mild frailty progressively impairs shopping and walking outside alone, meal preparation and housework
6. Moderately frail – People need help with all outside activities, housework and cooking. They often need help with stairs and bathing, and might need minimal assistance with dressing
7. Severely frail – people completely dependent for personal care. However, they seem stable and not at high risk of dying (within approximately 6 months)
8. Very severely frail – people completely dependent and approaching the end of life. Typically, they could not recover even from a minor illness
9. Terminally ill – people approaching the end of life. This category applies to people with a life expectancy of more than 6 months, who are not otherwise evidently frail
IADL = instrumental activity of daily living (such as finances, transport, heavy housework or medications)
Scoring frailty in people with dementia
The degree of frailty corresponds to the degree of dementia. Common symptoms in mild dementia include forgetting the details of a recent event, though still remembering the event itself, repeating the same question/story and social withdrawal.
In moderate dementia, recent memory is very impaired, even though they seemingly can remember their past life events well. They can do personal care with prompting.
In severe dementia, they cannot do personal care without help.