This tool was developed to identify older people with frailty who, it was felt, would benefit most from integrated service delivery (ISD).


The PRISMA group (Programme of Research to Integrate Services for the Maintenance of Autonomy) from Canada devised the PRISMA-7 tool alongside an ISD model that co-ordinated healthcare between organisations, commissioners and services. The model promotes single entry points for services, individualised care plans and a single assessment tool (PRISMA-7) for being eligible for ISD.

The PRISMA-7 is based on an individual’s functional autonomy as well as age and gender. It is recommended by both NICE and the British Geriatric Society (BGS) as an option for identifying frailty.  It is simple and quick to use as it asks seven “yes” or “no” questions which can be self-completed.

  1. Are you older than 85 years?
  2. Are you male?
  3. In general do you have any health problems that require you to limit your activities?
  4. Do you need someone to help you on a regular basis?
  5. In general do you have any health problems that require you to stay at home?
  6. In case of need can you count on someone close to you?
  7. Do you regularly use a stick, walker or wheelchair to get about?

A cut off score of 3 or more indicates frailty and the need for further clinical review.  The questions can be asked in person or via a postal questionnaire.  As such it can be used for both opportunistic and population-based approaches to identifying frailty.  It is recommended across all settings, including if the person is unwell and unable to perform physical assessments such as the gait speed test.

Further details of the PRISMA-7 questionnaire and associated Integrated Service delivery model can be found below:

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The BGS recommendation is contained within their ‘Fit for Frailty’ document.

The NICE recommendation is contained with NG56 Multimorbidity: clinical assessment and management.