We strongly encourage all parties to obtain a license, use the official version of the Edmonton Frail Scale and ensure that they are trained to administer and score it correctly.
After you obtain a license, you will have access to the official version of the Edmonton Frail Scale, the toolkit, a training video, and soon, an online training course. Over the years, several unofficial versions of the EFS have been constructed and posted online. Unfortunately, this has resulted in some confusion about how to administer and score each of the EFS items, and how to assign a grade of frailty based on the final score. The official version of the Edmonton Frail Scale, the proposed scoring and interpretation, and the training materials found herein were developed between 2018 and 2019 based on careful consultation with knowledge-users and comparison of the distribution of EFS scores in a community-based sample with comparable cut-points in other frailty measures such as the Frailty Index. Use of the current version ensures standardization so that it can be used as a common data element or common outcome measure in systematic comparisons.
The Edmonton Frail Scale is designed to be intuitive for use by non-expert clinicians and researchers. There are three types of items in the EFS – performance-based items, self-report, and consensus.
Performance-based items: These include the Clock-Drawing Test (CDT) and the Timed Up and Go (TUG). The CDT is easy to administer but requires some training to interpret. Correct interpretation of a completed CDT is important because it influences whether input from other sources is encouraged for consensus-based items. To be performed correctly and safely, the TUG requires minor training as well. However, interpretation is relatively easy.
Self-report: If the CDT score is 0 (normal), then all the remaining reported items in the EFS are completed as self-report only. Generally, these items will be easy to score. At times, unique questions arise, and we hope that the training materials can be consulted for clarification.
Consensus: If the CDT is not normal (1 or 2), there are still 3 items that need to be scored based only on self-report alone. This leaves 6 items that can be score based on the best information available. Here, an accompanying person and the person administering the test may compare their own understanding of facts, and the item is score by consensus. This is further explained in the training.
