Pictorial Fit‑Frail Scale


The Pictorial Fit-Frail Scale (PFFS) uses simple visual images to assess a person’s level of fitness-frailty. The assessment can be completed by a patient (self-assessment), a care partner (proxy-assessment), or a healthcare provider (clinical assessment). It is quick to administer, taking less than 2 minutes when assessed by a clinican and less than 5 minutes for self and proxy assessment. The PFFS evaluates a person's ability in 14 different domains. Within each domain, 3 to 6 levels of ability are represented with images and the assessor picks the image that best represents the usual state of the person being assessed. Images make the scale accessible across literacy levels, languages, and cultures. The PFFS visually shows change from one level to another and can facilitate discussion with the patient, and within the care team and their family.  The PFFS is comprehensive and captures the multidimensionality of frailty.

Download a preview of the scale [PDF - 9MB]

Permission for Use

To guard against copyright infringement or unlicensed commercial use, we ask all potential users to complete a Permission for Use Agreement. Agreements are reviewed by the Industry Liaison Office at Dalhousie University to determine whether a license agreement is required. Requests for non-commercial educational, clinical and research use, as well as for reprint usually do not require a license agreement.

Request access to the PFFS