Pictorial Fit‑Frail Scale© (PFFS)


The Pictorial Fit-Frail Scale© (PFFS) was designed to use simple visual images to assess a person’s level of fitness-frailty. The assessment can be completed by the patient (self-assessment), the caregiver (proxy-assessment), or the healthcare provider (clinical assessment). It can be completed quickly (<2 minutes for clinical assessment; <5 minutes for self and proxy assessment).

The scale is comprised of 14 domains, represented by 3 to 6 images that correspond to levels of ability. The assessor picks the image that best represents the usual state of the patient.

Images make the scale accessible across literacy levels, language, 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©