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)
- Normal adult: No difficulty either subjectively or objectively.
- Normal older adult: Complains of forgetting location of objects. Subjective work difficulties.
- Early dementia: Decreased job functioning evident to co-workers. Difficulty in traveling to new locations. Decreased organizational capacity.
- Mild dementia: Decreased ability to perform complex task, (e.g., planning dinner for guests, handling personal finances, such as forgetting to pay bills, etc.)
- 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).
- Moderately severe dementia: Occasionally or more frequently over the past weeks, for the following:
- Improperly putting on clothes without assistance or cueing
- Unable to bathe properly (not able to choose proper water temp)
- Inability to handle mechanics of toileting (e.g., forget to flush the toilet, does not wipe properly or properly dispose of toilet tissue)
- Urinary incontinence
- Fecal incontinence
- Severe dementia:
- 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.
- Speech ability is limited to the use of a single intelligible word in an average day or in the course of an intensive interview
- Ambulatory ability is lost (cannot walk without personal assistance)
- Cannot sit up without assistance (e.g., the individual will fall over if there are not lateral rests [arms] on the chair.)
- Loss of ability to smile.
- Loss of ability to hold up head independently.
- Reisberg B. Functional assessment staging (FAST). Psychopharmacol Bull. 1988;24(4):653-9. [Medline]
- 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.