A |
Has food intake declined over the past 3 months due to loss of appetite, digestive problems, chewing or swallowing difficulties? |
0 : severe decrease in food intake |
1 : moderate decrease in food intake |
2 : no decrease in food intake |
B |
Weight loss during the last 3 months |
0 : weight loss > 3 kg |
1 : does not know |
2 : weight loss between 1 and 3 kgs |
3 : no weight loss |
C |
Mobility |
0 : bed or chair bound |
1 : able to get out of bed/chair but does not go out |
2 : goes out |
E |
Neuropsychological problems |
0 : severe dementia or depression |
1 : mild dementia or depression |
2 : no psychological problems |
F |
Body Mass Index (BMI (weight in kg)/(height in m2) |
0 : BMI < 19 |
1 : BMI = 19 to BMI < 21 |
2 : BMI = 21 to BMI < 23 |
3 : BMI = 23 and > 23 |
H |
Takes more than 3 medications per day |
0 : yes |
1 : no |
P |
In comparison with other people of the same age, how does the patient consider his/her health status? |
0 : not as good |
0.5 : does not know |
1 : as good |
2 : better |
|
Age |
0 : >85 |
1 : 80–85 |
2 : <80 |
|
Total Score |
0–17 |