The Edmonton Frail Scale scores frailty from 0 to 17 across nine domains, from a clock drawing to a timed walk. It takes a few minutes, and you don’t need geriatric training to give it. See what each band means, how the domain scores shape the care plan, and record the result with the free template. Get the official form from the University of Alberta.
Edmonton Frail Scale result template
FreeEDMONTON FRAIL SCALE Date: [Date] Patient: [Name or ID, age] Setting: [Preoperative clinic, primary care, geriatric clinic, hospital consult, or home visit] Given by: [Name, role] Form and language: [Official bedside EFS under a University of Alberta license; translation if used] Why now: [Planned surgery, cancer treatment decision, new falls or weight loss, annual check-up, or referral] DOMAIN POINTS Cognition, clock drawing: [Points; errors seen] General health: [Points; hospital stays in the past year and self-rated health] Functional independence: [Points; daily tasks that need help] Social support: [Points; who helps when needed] Medication use: [Points; number of regular medicines and any missed doses] Nutrition: [Points; recent weight loss] Mood: [Points; what the person reported] Continence: [Points; type of leakage, or none] Functional performance, timed up and go: [Points; seconds and walking aid, or why it wasn't done] TOTAL EFS total: [0 to 17] Band: [Not frail, vulnerable, mild frailty, moderate frailty, or severe frailty] Earlier totals: [Dates and totals, or first score] DOMAINS DRIVING THE SCORE Contributing domains: [Each domain that scored, most concerning first] Checked further: [Delirium, memory testing, depression screen, standing blood pressure, weight trend, labs] CARE PLAN BY DOMAIN Falls and mobility: [Fall risk assessment, physical therapy, walking aid, home safety, or not needed] Medicines review: [Medicines stopped, reduced, or changed; pharmacist review; blister pack] Nutrition: [Dietitian, supplements, dental or swallowing review, next weight check] Social support: [Home care, caregiver support, social worker, community programs] Mood and memory: [Screening done, treatment, referral, or follow-up] Continence: [Causes looked for, treatment, products, or referral] Goals of care: [What matters most to the person, decisions it informed, named decision-maker] Before surgery or treatment: [Prehabilitation, geriatric co-management, delirium prevention, timing, or not applicable] FOLLOW-UP Rescore EFS: [Date or trigger] Shared with: [Patient, family, surgeon, family doctor, home care team] Clinician: [Name, credentials]
Use it for
Use the official form from your license. The two tasks need a little set-up, so have it in place before you start.
Avoid: Working from a copy found online. Unofficial copies differ in wording and scoring, and the license covers the official form only.
Ask the nine questions as written on the form, then watch the clock drawing and time the walk. Most people finish in 5 to 10 minutes.
Avoid: Skipping the clock or the walk to save time. They are scored items, and leaving them out changes the total.
Add the points from all 11 items for a total from 0 to 17, then find the band.
Avoid: Recording only the band. “Mild frailty” alone can’t show what to fix or whether the person is getting better.
Each domain that scored points to its own next step. This is what sets the EFS apart from a single frailty grade.
Avoid: Treating the total as the finding. Two people who both score 9 can need completely different plans.
Before surgery, the score helps the person and the team weigh the risks and prepare. In primary care, it turns a sense that someone is slowing down into a plan.
Avoid: Using the score as the only reason to refuse surgery. It informs a shared decision; it doesn’t make it.
Each one follows the recording template. Use them to judge how much to write.
Surgical prehabilitation clinic, scored by a nurse 5 weeks before a planned laparoscopic sigmoid colectomy
Cognition 1: numbers crowded on one side of the clock. General health 2: admitted in August with the bleed that led to the diagnosis, and rates her health as fair. Functional independence 1: her son drives her and does the banking. Social support 0. Medication use 2: 8 regular medicines, and she misses evening doses. Nutrition 1: 5 kg lost since spring. Mood 1: often sad since the diagnosis. Continence 0. Functional performance 1: timed up and go 14 seconds, no aid.
EFS 9, mild frailty. First score.
79-year-old woman with sigmoid adenocarcinoma and iron-deficiency anemia from the tumor, living alone in an apartment. Driving it: medication use, nutrition, general health, and mood. Checked further: no delirium; Montreal Cognitive Assessment 25 of 30; Geriatric Depression Scale 4 of 15, with low mood tied to the diagnosis. Her medicines include amitriptyline 25 mg at night for sleep.
Four weeks of prehabilitation, agreed with the surgeon, with no change to the surgery date: supervised exercise twice a week and a daily walk. Dietitian referral and protein supplements twice a day; IV iron for the anemia. Pharmacist review: amitriptyline tapered and stopped, blister pack started. Referral to the cancer center’s counselor. Delirium prevention flagged for the ward, with her son to bring her glasses and hearing aids. Her goal is cure and getting back home. Geriatric co-management after surgery. Rescore the EFS the week before surgery.
Outpatient geriatric clinic, new referral for falls and weight loss, scored at intake by the clinic nurse
Cognition 1: numbers bunched toward the bottom of the clock. General health 2: admitted in May after a fall with a wrist fracture, and rates his health as fair. Functional independence 2: his wife does the cooking, shopping, laundry, and money, and he no longer drives. Social support 1: help is there only sometimes, as his wife has her own health problems and their daughter lives two hours away. Medication use 2: 12 regular medicines, and he mixes up his pills. Nutrition 1: 6 kg lost in a year. Mood 1: often feels sad. Continence 1: urge leakage most days. Functional performance 1: timed up and go 18 seconds with a cane.
EFS 12, severe frailty. First score.
84-year-old retired machinist in a two-story house with his wife. Hypertension, type 2 diabetes, kidney disease, an enlarged prostate, and knee arthritis. Driving it: medication use, functional independence, continence, mood, and nutrition. Checked further: a prescribing cascade, with amlodipine causing ankle swelling, furosemide added for the swelling, urgency and leakage after that, then oxybutynin. Standing blood pressure falls 28 mmHg. A1c 6.1% on glyburide. No delirium; Montreal Cognitive Assessment 21 of 30. Geriatric Depression Scale 8 of 15.
Medicines: oxybutynin and glyburide stopped, amlodipine swapped for another agent, and furosemide to stop once the swelling settles; pharmacist blister pack. Falls: physical therapy at home for strength and balance, an occupational therapy home safety visit, and a walker for outdoors. Nutrition: dietitian, monthly weights, and a dental visit for a loose denture. Mood: talked it through; sertraline 25 mg and an adult day program twice a week. Continence: urine test clear, bladder scan after voiding 60 mL, timed toileting. Social support: social worker referral, home care for bathing, and support for his wife as his carer. Goals: he wants to stay at home with his wife and named his daughter as his decision-maker. Rescore the EFS in 3 months, after the medicine changes.
Two people who both score 9 can need different plans. The domains that scored tell you what to do next, so record and act on each one.
They are scored items, not extras. Give both, and when one can’t be done, write down why and score it as the official form directs.
The Reported version is scored to 18, and the Acute Care version is built for inpatients. Say which one you used, and compare totals only within the same version.
A score taken the day before an operation can’t change anything. Give it weeks ahead, so prehabilitation and a medicines review have time to work.
A high score raises the risk of surgery and other treatment, but the decision also needs the illness, the options, and what the person wants.
Vero Scribe records the Edmonton Frail Scale result in your template from the visit, with the patient’s consent, or from your dictation: the domain points, the total and band, the domains driving it, and the plan for each. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
It’s a short frailty test that scores 11 items across nine domains: cognition, by a clock drawing; general health; functional independence; social support; medication use; nutrition; mood; continence; and functional performance, by a timed up and go. The total runs from 0 to 17, and higher means frailer. Dr. Darryl Rolfson and colleagues at the University of Alberta developed it, and its validation was published in Age and Ageing in 2006.
Ask the nine questions, watch the clock drawing, and time the walk, then add the item points for a total from 0 to 17. The official form and its toolkit give the exact wording and the points for each answer. Record each domain’s points as well as the total, because the domains guide the plan.
On the official form, 0 to 5 is not frail, 6 to 7 vulnerable, 8 to 9 mild frailty, 10 to 11 moderate frailty, and 12 to 17 severe frailty. Some studies group the vulnerable band with the frail, so record the total itself, not only “frail” or “not frail.”
The Clinical Frailty Scale is a judgment: a clinician picks one level from 1 to 9 based on what they know of the person’s usual state, with nothing to add up. The Edmonton Frail Scale is a scored test: the person answers questions and does two tasks, and the points add up to a total from 0 to 17 that shows which domains drive the frailty. The EFS developers suggest a quick tool such as the Clinical Frailty Scale for rapid case-finding, and the EFS to confirm frailty, grade it, and find the parts to work on.
You don’t need geriatric training. In the validation study, a non-clinician gave it and still agreed well with specialist geriatricians. Nurses, physicians, pharmacists, and physical and occupational therapists use it in clinics, on wards, and before surgery. The licensed online course teaches how to give and score it, and it takes 5 to 10 minutes per person.
Higher scores predict complications, longer hospital stays, readmission, and loss of independence after surgery. Given a few weeks ahead, the score helps the person and the surgeon weigh the operation, and the domains that scored point to prehabilitation: exercise, nutrition, a medicines review, and plans for delirium prevention and support after discharge.
It’s a later version, developed by Hilmer and colleagues in 2009, that swaps the timed up and go for a question about physical function, so it works for people who can’t do the walk, such as acutely unwell inpatients. It’s scored 0 to 18, so its totals aren’t interchangeable with the bedside EFS.
It’s copyrighted by the University of Alberta and needs a license. The license is free for a single clinician’s routine care, smaller academic studies, and smaller teaching programs once eligibility is checked; larger clinics, health networks, and larger or industry-sponsored studies pay a fee. Request the official form, toolkit, and training from the EFS website, and ask whether your institution already holds a license. The recording template on this page is free to copy or download.
Ten-year probability of a major osteoporotic fracture and of a hip fracture, from 12 inputs, with or without bone density.
Six nursing items that predict a patient’s risk of falling in hospital, scored 0 to 125: the higher the total, the higher the risk.
Stand, walk 3 meters, turn, walk back, and sit: a timed test of mobility and fall risk, with 12 seconds as the usual flag.
Fourteen balance tasks, from sitting to standing on one leg, scored 0 to 56: the higher the total, the better the balance.
A 9-level clinical judgment of frailty in older adults, from very fit to terminally ill, scored on the person’s state before an acute illness.
History, risk assessment, and the plan before surgery, with the frailty score alongside.
Notes for frailty, falls, memory, and goals-of-care visits.
Every tool, by area, with what its scores mean.
Vero records scores, findings, and plans in the templates you choose, so you review instead of type.
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