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Edmonton Frail Scale (EFS)
EFS: A multidimensional frailty tool assessing 9 domains. Combines patient self-report with objective tests (CDT, TUG).
Rate all 11 items
Clock Drawing Test (CDT)
Cognition
How many times have you been admitted to hospital in the last year?
General Health Status
In general, how would you describe your health?
General Health Status
How many of the following activities do you require help with? (Meal prep, shopping, transport, phone, housekeeping, laundry, meds, finances)
Functional Independence
When you need help, can you count on someone willing and able to meet your needs?
Social Support
Do you use 5 or more different prescription medications on a regular basis?
Medication Use
At times, do you forget to take your prescription medications?
Medication Use
Have you recently lost weight such that your clothing has become looser?
Nutrition
Do you often feel sad or depressed?
Mood
Do you have a problem with losing control of urine when you don't want to?
Continence
Timed Up and Go (TUG) Test: Time to rise from chair, walk 3m, return and sit.
Functional Performance
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Comprehensive frailty assessment in primary care or geriatric outpatient clinics.
Preoperative risk stratification before elective or urgent surgery.
Identifying multidimensional drivers of frailty to guide targeted interventions.
Multidimensional Approach
While the Fried Phenotype focuses almost entirely on physical frailty, the EFS captures cognitive, social, pharmacological, and psychological domains, providing a more holistic picture of a patient's vulnerability.
Section 2
Formula & Logic
Scoring
11 items across 9 domains.
Total score: 0–17
0–4: Not frail
5–6: Vulnerable
7–8: Mild frailty
9–10: Moderate frailty
11–17: Severe frailty
The EFS does not just output a score; it outputs a profile. A patient scoring 9 primarily due to social isolation and depression requires a completely different intervention plan than a patient scoring 9 due to severe physical and cognitive impairment.
Section 4
Next Steps
Management
Section 5
Evidence Appraisal
Primary Reference
Validity and reliability of the Edmonton Frail Scale.
Rolfson DB et al. • Age Ageing.. 2006;35(5):526-9. Validation demonstrating strong correlation with comprehensive geriatric assessment and low inter-rater variability.
Section 6
Origins
Darryl Rolfson
Developed by Darryl Rolfson and colleagues at the University of Alberta in Edmonton. The tool was specifically designed to be performed by non-geriatricians in under 5 minutes, yet still capture the multidimensional nature of frailty better than purely physical scales.
