CGA-FI

Administration time: 30 minutes
Relies on medical history and self-report; cognitive and physical performance tests are optional
Multidimensional assessment

INSTRUCTIONS

MM/DD/YYY

CGA-FI

Final Score: 0.00

* Items marked with a star (*) must be completely assessed.

RESET ALL

Score : 0

Medical History* (21 items)

Reset

Check any items that the patient has in his/her medical history.

Anemia

Anxiety disorder

Arthritis

Atrial fibrillation/flutter

Cancer within 5 years

Chronic kidney disease

Chronic lung disease

Coronary artery disease

Dementia

Depression

Diabetes

Fall within the past year

Heart failure

Hypertension

Incontinence

Liver disease

Osteoporosis

Peripheral vascular disease

Sensory impairment

Stroke/TIA

Use of >= 5 prescription drugs

Functional Status* (22 items)

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Does the patient need help from another person to perform the following activities (Check all that apply)?

Activities of Daily Living

Feeding

Dressing/undressing

Grooming

Walking (or use of a walker)

Getting in and out of bed

Toileting

Bathing or shower

Instrumental Activities of Daily Living

Using telephone

Using transportation

Shopping

Preparing own meals

Housework

Taking own medications

Managing money

Nagi & Rosow-Breslau Activities

Pulling or pushing a large object

Stooping, crouching or kneeling

Lifting or carrying 10 lbs

Reaching arms above shoulder

Writing or handling small objects

Walking up/dn a flight of stairs

Walking half a mile

Heavy work around house

Performance Tests (4 items)

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Cognitive Function

5 Repeated Chair Stands

Gait Speed

Dominant Handgrip Strength (Select the biological sex)

Nutritional Status (3 items)

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Weight loss > 10 lbs in past year

Body mass index < 21 kg/m²

Serum albumin < 3.5 g/L

Number of positive items: Number of items assessed: CGA-FI (range: 0.0-1.0):

* Items marked with a star (*) must be completely assessed.

HEALTH DASHBOARD

Frailty Index :

Patient's frailty status is ROBUST

To maintain independence, physical fitness, and overall health, the following general approaches can be considered:

Staying physically active and engaging in regular exercise
Following a balanced, high-quality diet
Optimizing chronic health conditions
Receiving age-appropriate preventive care (e.g. vaccinations, cancer screening)
Staying socially engaged and connected

Patient's frailty status is PRE-FRAILTY

To prevent frailty and maintain independence, the following general approaches can be considered:

Staying physically active and engaging in regular exercise
Following a balanced, high-quality diet with adequate protein intake (1.0-1.2 g/kg/day) unless contraindicated (e.g., chronic kidney disease)
Optimizing chronic health conditions
Receiving age-appropriate preventive care (e.g. vaccinations, cancer screening)
Staying socially engaged and connected

Patient's frailty status is MILD FRAILTY

To preserve independence, optimize function, and prevent further decline, the following general approaches can be considered:

Staying physically active and engaging in regular exercise
Following a balanced, high-quality diet with adequate protein intake (1.0-1.2 g/kg/day) unless contraindicated (e.g., chronic kidney disease)
Receiving age-appropriate preventive care (e.g. vaccinations, cancer screening)
Staying socially engaged and connected
See domain specific advice below prioritized by level of vulnerability

Patient's frailty status is MODERATE FRAILTY

To prevent or slow further health decline and support quality of life, the following general approaches can be considered:

Staying physically active and engaging in regular exercise
Following a balanced, high-quality diet with adequate protein intake (1.0-1.2 g/kg/day) unless contraindicated (e.g., chronic kidney disease)
Receiving vaccinations
Individualizing cancer screening based on time to benefit vs. life expectancy
Staying socially engaged and connected
See domain specific advice below prioritized by level of vulnerability

Patient's frailty status is SEVERE FRAILTY

To maintain quality of life and manage symptoms, the following general approaches can be considered:

Staying physically active and engaging in exercise as tolerated
Following a balanced, high-quality diet with adequate protein intake (1.0-1.2 g/kg/day) unless contraindicated (e.g., chronic kidney disease)
Receiving vaccinations
Stopping cancer screening
Staying socially engaged and connected
See domain specific advice below prioritized by level of vulnerability

Patient's frailty status is ADVANCED FRAILTY

To focus on comfort and dignity, the following general approaches can be considered:

Individualized treatments based on the goals of care
Stopping cancer screening
Palliative care and hospice for symptom management and end-of-life care

Domain	Factors Contributing to Frailty	Consider the following if appropriate
Medical	0 comorbidities Fall within the past year Sensory impairment Use of >= 5 prescription drugs	Identify and stabilize medical conditions contributing to patient's frailty Reduce potentially inappropriate medications Prioritize management of conditions that most affect patient's function Stop treatment of unclear benefits and/or harms Refer to audiology or optometrist/ophthalmologist as appropriate
Mobility	No mobility deficits reported Gait speed: X.X to X.X m/sec	Encourage aerobic exercise, resistance exercise, and balance training Assess and reduce home hazards Reduce fall-risk-increasing medications Refer to physical therapist
Muscle Strength	No muscle strength deficits reported	Encourage muscle strengthening Increase protein intake unless contraindicated (chronic kidney disease) Refer to physical therapist
Disability	ADL Disability IADL Disability No disability reported	Refer to occupational therapist for evaluation and use adaptive equipment as needed Engage and support caregivers
Cognition	No cognitive assessment reported	Consider pharmacologic/nonpharmacologic treatments to promote brain health Reduce anticholinergics, benzodiazepines, sedatives, and sleep aids Refer to cognitive neurology, geriatrics, or geriatric psychiatry Assess home safety, financial decision-making, and driving abilities Assess caregiver burden Discuss future care needs (care setting)
Nutrition	No nutritional deficits reported	Ensure adequate calories and nutrients from diet and/or oral nutritional supplement Refer to nutritionist or dietician for nutritional counseling Refer to speech-language pathologist (for swallowing) or dentist (for poor dentition)

One-year Risk of Adverse Outcomes Based on Frailty Index

Based on community-dwelling Medicare population in the US, 1 year risk of new ADL disability is ______, falls is _____, hospitalizations is _____, and mortality is ______.

Frailty Index	Mortality	ADL	Falls	Hospitalizations
<0.15	0.6%	2.8%	22.3%	13.3%
0.15-0.25	2.7%	8.8%	35.2%	26.1%
0.25-0.35	4.5%	20.9%	46.0%	34.9%
0.35-0.45	5.4%	35.1%	55.2%	37.0%
≥0.45	19.7%	44.1%	60.3%	46.7%

Frailty Index Crosswalk

Caution: The equipercentile linking method used to create this crosswalk assumes that different tools measure a similar construct (vulnerability). Because the equipercentile linking relies on the population distribution of frailty scores, frailty status may be misclassified at the individual patient level. Therefore, the crosswalk should be used as an approximation. It should not replace clinical judgment; it is intended to supplement, not substitute, professional expertise and clinical assessment.

Health Domains	Normal	Low Risk	Moderate Risk	High Risk	Insufficient Data
1. Medical
2. Mobility
3. Muscle Strength
4. ADL disability
5. IADL disability
6. Cognition
7. Nutrition

CGA-FI

CGA-FI

HEALTH DASHBOARD

Patient's frailty status is ROBUST

Patient's frailty status is PRE-FRAILTY

Patient's frailty status is MILD FRAILTY

Patient's frailty status is MODERATE FRAILTY

Patient's frailty status is SEVERE FRAILTY

Patient's frailty status is ADVANCED FRAILTY

One-year Risk of Adverse Outcomes Based on Frailty Index

Frailty Index Crosswalk

Key references

Alternative tools to CGA-FI

Frailty Phenotype

Groningen Frailty Indicator

Tilburg Frailty Indicator

Edmonton Frail Scale