How is the Frailty Score Measured in the UK?

In the UK, the frailty score is used by doctors and healthcare professionals to assess how well someone is coping with the effects of ageing or long term health conditions. It helps identify older adults who may need extra support to stay safe and independent, whether at home or in a care setting.

The score is based on physical ability, general health and how easily a person can man age day to day tasks. It plays an important role in planning care and making sure the right help is in place at the right time.

In this guide, we will explain how the frailty score is measured, what it means and how it can help you or a loved one get the support you need.

What is frailty?

Frailty is a condition that affects many older adults as they age. It describes a gradual decline in strength, balance and overall resilience, making it harder to cope with everyday tasks or recover from illness or injury.

Someone who is frail may feel more tired than usual, lose weight without trying, or become less steady on their feet. Frailty is not just a natural part of ageing, it is a health condition that can be managed with the right support and care.

Symptoms of frailty include:

• Frequent feelings of exhaustion
• Muscle weakness or a loss of strength
• Noticeably slower movements
• Trouble with balance and stability
• Incontinence
• Social isolation: avoiding going out in public or seeing loved ones
• Depression
• Needing help with activities of daily living, such as feeding and dressing
• Losing weight without trying (10 pounds or more in a year)

How is frailty diagnosed?

Your GP or healthcare specialist will use one or several methods to determine whether you have frailty indicators. They’ll complete a physical assessment using frailty scales or scoring systems to give them an insight into your health and how severe the risk of frailty is.

There are several scales and scoring systems used around the world to measure frailty, and there is no general consensus as to which is the best. Some scales use a criterion that focuses on mental function, support network, incontinence and other factors, while others assess your BMI to check for muscle loss.

Your doctor will walk you through the tests they recommend depending on your specific situation.

Electronic Frailty Index (eFI)

The NHS is the first healthcare system in the world to systematically identify older people (aged 65 years and older) living with frailty using a population-based stratification approach: the electronic Frailty Index.

The eFI utilises routine health record data to automatically calculate a score, identifying whether you’re likely to be fit or living with mild, moderate or severe frailty. Early identification can lead to quicker targeted support, helping you manage symptoms and live independently for as long as possible.

Once the eFI has detected the potential for frailty, confirmation is needed. A doctor can refer you to a Clinical Frailty Scale, PRISMA 7, Gait Speed Test or Timed Up and Go test.

Clinical Frailty Scale (CFS)

The Clinical Frailty Scale is a simple and accessible tool that many doctors use to quickly assess patients living with frailty. There are nine scores to easily identify what stage of frailty you’re experiencing. Having a frailty score lets all healthcare providers know your current situation without having to repeat assessments and checks every time.

1.    Very fit

A score of 1 is given to people who are active, energetic and motivated. They often exercise regularly and are very fit for their age. If they fall ill, there usually won’t be many repercussions as they’ll be able to recover well.

2.    Well

If you have no active disease symptoms but are slightly less fit than score 1, you may be given a score of 2. These people often exercise occasionally or are active seasonally.

3.    Managing well

Someone considered ‘managing well’ might have medical problems that are well-controlled. You may not do any regular activity other than walking.

4.    Vulnerable

People with a score of 4 are considered ‘vulnerable’, which means their symptoms may limit activities. While they might find themselves slowing down or getting tired throughout the day, they’re not dependent on others for daily help.

5.    Mildly frail

A score of 5 means having more evident slowing, meaning you require more help with your activities of daily living, such as bathing, cooking and gardening. Mild frailty might impair your ability to go out on your own, prepare your meals and complete housework.

6.    Moderately frail

If you need help with all outside activities and with keeping the house running, you may get a score of 6 and be considered ‘moderately frail’. You might have difficulty with taking the stairs, bathing yourself and dressing.

7.    Severely frail

A person who’s considered ‘severely frail’ is completely dependent on personal care. These people often seem stable without a high risk of dying within six months.

8.    Very severely frail

Similar to a score of 7, ‘very severely frail’ people are completely dependent on others and nearing the end of their lives. Typically, these people find it difficult to recover from a minor illness.

9.    Terminally ill

A score of nine means that you’re approaching the end of your life. People who fall under this score are typically given a life expectancy of less than six months. You may not otherwise be evidently frail.

PRISMA 7 Questionnaire

PRISMA 7 is a questionnaire with seven questions used to identify frailty, as well as some similar disabilities. A score of more than three may indicate frailty, while a score of one or two indicates a person is pre-frail.

To determine your risk of frailty, the PRISMA 7 questions look at your:

• Age
• Gender
• Limiting health problems
• Ability to live independently
• Support system
• Mobility

Gait Speed Test

A gait speed test, also known as a walking speed test, records how quickly you can comfortably cover a certain distance. This will usually be measured in m/s and usually ranges from 2.4 to 6 metres, depending on your activity level and doctor’s orders.

Your gait speed gives healthcare professionals a good insight into your functional mobility and general health status. Gait speed is sometimes considered a ‘vital sign’, which means it predicts the likelihood of several common outcomes, such as hospitalisation, fall risk and cognitive decline.

Timed Up and Go Test

The timed up and go test measures how quickly you can stand up from a chair, walk three metres, turn, walk back to the chair and sit down. An older adult who takes longer than 12 seconds to complete this test is considered at higher risk of falling due to an increased frailty score.

Living with frailty: what’s next?

If you or a loved one has received a positive frailty score, you may be wondering what’s next. Living with frailty often requires people to adapt their lifestyles, finding new ways to manage everyday tasks. They may need to lean on loved ones more often or look for other types of care.

It’s important to note that frailty can be managed and even reversed in some cases. Maintaining a nutritious diet and active lifestyle sometimes helps manage frailty symptoms, while not focusing on these things might quicken its progression.

If you’re struggling, a live-in carer can encourage you to live well to manage your symptoms. They’ll also be able to assist with light housework, assistance with daily living and companionship, preventing social isolation and boosting quality of life.

There are several benefits to live-in care for frailty, including:

• Help moving around the house to reduce your fall risk
• Nutritious meal planning and preparation
• Encouragement to stay active and independent wherever possible
• Continuous monitoring of symptoms
• Personalised, tailored care that can change from day to day
• Emotional support for you and your loved ones

If you’re wondering how you can support a frail family member, a live-in carer will provide a stable support system to help you all navigate this life change.

How Country Cousins can help

At Country Cousins, we know just how challenging frailty can be on our clients and their loved ones. We offer round-the-clock support to ensure you remain comfortable and confident in your own home, matching one of our friendly carers to your personal situation and needs.

Our 24-hour live-in care services include:

• Cooking, meal preparation and planning
• Assistance with showering, bathing, shaving and oral hygiene
• Transportation to and from appointments and social events
• Help moving from room to room, monitoring for fall risk
• Encouragement to continue activities and hobbies you enjoy
• Companionship and emotional support

Talk to our team today

As the UK’s longest-serving introductory live-in care agency, we have been providing compassionate live-in care to those who need it since 1959 – all from the comfort of their own homes.

Give us a call today on 01293 224 706. Our experienced team is on hand to help from Monday to Friday, 8 am to 6 pm. Alternatively, contact us through our online enquiry form.