Please note: **The CFS has not been widely validated in younger populations (below 65 years of age), or in those with learning disability. It may not perform as well in people with stable long term disability such as cerebral palsy, whose outcomes might be very different compared to older people with progressive disability. We would advise that the scale is not used in these groups. However, the guidance on holistic assessment to determine the likely risks and benefits of critical care support, and seeking critical care advice where there is uncertainty, is still relevant.**

How to use the Clinical Frailty Scale

Frailty is a state of increased risk. On average, frailty increases with age. People are frail when they have more things wrong with them compared to others of the same age. That might not seem like a big deal, but it's actually a challenge for how we deliver health care.

The Clinical Frailty Scale (CFS) was developed in Halifax, Nova Scotia in 2005 and is now used in more than 20 countries. It’s employed both in routine clinical care and in research. The key idea behind the CFS is that as people age they are more likely to have things wrong with them. Those things they have wrong with them begin to impact on their ability to do the high order functions which define their overall health.

For those interested in administering the CFS for clinical or research purposes, please see this two-page CFS training guide entitled “Using the Clinical Frailty Scale to Rapidly Assay Grades of Fitness and Frailty”, along with accompanying cover letter.

In addition, the AIMS Research Group at the Ottawa Hospital has developed a CFS Training Module that is freely accessible online that is useful in learning to administer the CFS. It seeks to provide learners with a comprehensive understanding of frailty and how to accurately determine a person's CFS score based on their specific circumstances.