Have you lost more than 5% of your body weight in the past 6 months?
Must be unintentional weight loss.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Rapid frailty screening in primary care or busy outpatient clinics.
Epidemiological surveys and population health screening.
Telephone-based assessment where physical tests (like grip strength or TUG) are impossible.
Simplicity and Speed
The FRAIL scale is entirely questionnaire-based. It requires no equipment, no physical performance measurement, and takes less than 1 minute, making it ideal for population-level screening.
Section 2
Formula & Logic
Scoring
5 items, each scoring 0 (No) or 1 (Yes).
Total score: 0–5
0: Robust
1–2: Pre-frail
3–5: Frail
The FRAIL Acronym
F - Fatigue
Are you fatigued? (Most or all of the time in past month)
R - Resistance
Cannot walk up 1 flight of stairs without resting?
A - Ambulation
Cannot walk 1 block without resting?
I - Illnesses
Do you have > 5 illnesses? (From a list of 11 specific conditions)
L - Loss of weight
Have you lost > 5% of your body weight in past 6 months?
Section 3
Pearls/Pitfalls
Phenotype Proxy
The FRAIL scale conceptually maps to the Fried Frailty Phenotype (Fatigue = Exhaustion, Resistance/Ambulation = Slow Gait/Weakness, Loss of weight = Unintentional weight loss) but substitutes objective physical measures with self-reported functional limitations.
Section 4
Next Steps
Management
Section 5
Evidence Appraisal
Primary Reference
A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans.
Morley JE et al. • J Nutr Health Aging.. 2012;16(7):601-8. Validated the scale's ability to predict mortality and functional decline.
Section 6
Origins
John Morley
Developed by John Morley and the International Academy on Nutrition and Aging (IANA) to overcome the barriers to frailty screening in primary care. It sought to democratise frailty assessment by removing the need for hand dynamometers or measured walking tracks.
