Polypharmacy guidance: Appropriate prescribing making medicines safe, effective and sustainable 2026-2029
A range of tools for assessing frailty are available and following a review of these, the Clinical Frailty Score (Rockwood) is recommended.
Clinical Frailty Score (Rockwood):
- Is a simple, accessible, ordinal scale which stratifies frailty and each level has a pictorial description, and is based on the clinical judgment of the practitioner
- It stratifies the person into nine levels from fit, to living with mild, moderate or severe frailty or terminally ill
- It is validated in older adults over the age of 65 years but not in younger people with stable long-term disabilities
- It has been shown to indicate adverse outcomes in older people in hospital
- A level of 5 or more is seen as frail
Rockwood clinical frailty scale
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Clinical Frailty Scale ©2005–2020 Rockwood, Version 2.0 (EN). All rights reserved. For permission: www.geriatricmedicineresearch.ca Rockwood K et al. A global clinical measure of fitness and frailty in elderly people.94
Scoring frailty in people with dementia:
The degree of frailty generally 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.
In very severe dementia they are often bedfast. Many are virtually mute.