NICE guidance on assessing frailty in people with multimorbidity includes the use of self-reported health status and self-reported physical activity as two of the options.
Self-reported health status
This can be obtained through simply asking:
“How would you rate your health status on a scale from 0 to 10”
with scores of 6 or less indicating frailty. This approach is considered appropriate in primary care, community care and hospital outpatient settings.
Self-reported physical activity
Self-reported physical activity can be obtained using the Physical Activity Scale for the Elderly (PASE). This approach is considered to be an option for assessing frailty in hospital outpatient settings. The PASE is a relatively short to administer (5-10 minutes) survey designed specifically to assess physical activity in persons age 65 years and older. The PASE score combines information on leisure, household and occupational activity. Whilst the questionnaire can be administered by mail or interview, the NICE recommendation covers only the interview based approach. Frailty is indicated by a score of 56 or less for men and 59 or less for women.
The questions are outlined below. Most have two parts.
Part 1 asks about the frequency of activity over the past 7 days and has four levels: Never; Seldom (1-2 days); Sometimes (3-4 days); Often (5-7 days).
Part 2 (assuming there has been some activity) then asks how many hours per day of activity. Again there are four levels: Less than 1 hour; 1 but less than 2 hours; 2 – 4 hours; and more than 4 hours.
Total PASE scores are computed by multiplying activity weights by activity frequencies.
Leisure Time activity questions
Over the past 7 days, how often did you…
- take a walk outside your home or yard for any reason?
- engage in light sport or recreational activities?
- engage in moderate sport and recreational activities?
- engage in strenuous sport and recreational activities?
- do any exercises specifically to increase muscle strength and endurance?
Household activity questions
Over the past 7 days…
- have you done any light housework
- have you done any heavy housework or chores
- did you engage in any of the following activities?
- Home repairs
- Lawn work or yard care
- Outdoor gardening
- Caring for another person
Work-related activity questions
- During the past 7 days did you work for pay or as a volunteer?
- How many hours per week did you work for pay and or as a volunteer?
- Which of the following categories best describes the amount of physical activity required on your job and or volunteer work?
- Mainly sitting with some slight arm movement
- Sitting or standing with some walking
- Walking with some handling of materials generally weighing less than 50 pounds (c. 23kg)
- Walking and heavy manual work often requiring handling of materials weighting over 50 pounds (c. 23kg)
Detail methodology of how to obtain and calculate PASE score can be found in the following references:
- Washburn RA, Smith KW, Jette AM, Janney CA. The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol 1993;46(2):153-62
- Washburn RA, McAuley E, Katula J, Mihalko SL, Boileau RA. The physical activity scale for the elderly (PASE): evidence for validity. J Clin Epidemiol 1999;52(7):643-51
The scale is copyright. Licenses for use are available from New England Research Institute (Neriscience) website.