Unifying Concepts

Functional Assessment Scale Tool (FAST)

The FAST scale is a functional scale designed to evaluate patients at the more moderate-severe stages of dementia when the MMSE no longer can reflect changes in a meaningful clinical way.

Functional Assessment Scale (FAST) 

  1. Normal adult: No difficulty either subjectively or objectively.
  2. Normal older adult: Complains of forgetting location of objects. Subjective work difficulties.
  3. Early dementia: Decreased job functioning evident to co-workers. Difficulty in traveling to new locations. Decreased organizational capacity.
  4. Mild dementia: Decreased ability to perform complex task, (e.g., planning dinner for guests, handling personal finances, such as forgetting to pay bills, etc.)
  5. Moderate dementia: Requires assistance in choosing proper clothing to wear for the day, season or occasion, (e.g. pt may wear the same clothing repeatedly, unless supervised).
  6. Moderately severe dementia: Occasionally or more frequently over the past weeks,  for the following:
    1. Improperly putting on clothes without assistance or cueing
    2. Unable to bathe properly (not able to choose proper water temp)
    3. Inability to handle mechanics of toileting (e.g., forget to flush the toilet, does not wipe properly or properly dispose of toilet tissue)
    4. Urinary incontinence
    5. Fecal incontinence
  7. Severe dementia:
    1. Ability to speak limited to approximately </= 6 intelligible different words in the course of an average day or in the course of an intensive interview.
    2. Speech ability is limited to the use of a single intelligible word in an average day or in the course of an intensive interview
    3. Ambulatory ability is lost (cannot walk without personal assistance)
    4. Cannot sit up without assistance (e.g., the individual will fall over if there are not lateral rests [arms] on the chair.)
    5. Loss of ability to smile.
    6. Loss of ability to hold up head independently. 


  1. Reisberg B. Functional assessment staging (FAST). Psychopharmacol Bull. 1988;24(4):653-9. [Medline]
  2. Na HR, Kim SY, Chang YH, Park MH, Cho ST, Han IW, Kim TY, Hwang SA. Functional assessment staging (FAST) in Korean patients with Alzheimer’s disease. J Alzheimers Dis. 2010;22(1):151-8. [Medline]


Created Jul 22, 2015.

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