FRAIL Scale Calculator — Frailty Screening in Older Adults
Screen for frailty with the 5-item FRAIL scale — Fatigue, Resistance, Ambulation, Illnesses and Loss of weight — score 0–5: robust, pre-frail or frail.
How it works
One point each for: Fatigue (tired all or most of the time in the past 4 weeks); Resistance (difficulty climbing 10 steps alone without resting or aids); Ambulation (difficulty walking several hundred metres alone without aids); Illnesses (5 or more of 11 conditions); Loss of weight (more than 5% in the past year). 0 = robust, 1–2 = pre-frail, 3–5 = frail.
The FRAIL scale (Morley, Malmstrom & Miller, Journal of Nutrition, Health & Aging 2012) is a quick self-report screen recommended by the International Conference of Frailty and Sarcopenia Research. It combines features of the Fried frailty phenotype and the deficit-accumulation frailty index without needing grip strength or gait-speed testing. Frailty predicts falls, disability, hospital admission and death, and a positive screen should prompt a comprehensive geriatric assessment.
Worked example
An older adult who feels tired most of the time (1) and has difficulty climbing 10 steps (1), can walk a few hundred metres, has 2 of the 11 illnesses (0) and no weight loss (0) scores 2 / 5 — pre-frail.
Sources: Morley JE, Malmstrom TK, Miller DK — A simple frailty questionnaire (FRAIL) (J Nutr Health Aging 2012) · Dent E et al. — Physical Frailty: ICFSR International Clinical Practice Guidelines (2019)
Frequently asked questions
What does pre-frail mean?
A score of 1–2 suggests reduced reserve. Exercise (especially resistance training), good protein intake, a medication review and treating conditions like depression or anaemia can stop progression to frailty.
How is the FRAIL scale different from the frailty index?
The frailty index counts many health deficits (often 30 or more) as a proportion, whereas FRAIL is a 5-question screen that takes about a minute and needs no equipment.
Is the FRAIL scale validated?
Yes — it has been validated in several cohorts in the USA, Europe and Asia, predicting disability and mortality, and is translated into many languages.
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Clinical decision tool for education and for use by trained clinicians alongside clinical judgement — not a diagnosis and not a substitute for medical assessment. Formulas and cut-offs come from the cited sources; local protocols may differ.