Component	Question	Scoring
Strength	How much difficulty do you have in lifting and carrying 10 lb?	None - 0 Some - 1 A lot or unable - 2
Assistance in walking	How much difficulty do you have walking across a room?	None - 0 Some - 1 A lot, use aids, or unable - 2
Rise from a chair	How much difficulty do you have transferring from a chair or bed?	None - 0 Some - 1 A lot or unable without help - 2
Climb stairs	How much difficulty do you have climbing a flight of 10 stairs?	None - 0 Some - 1 A lot or unable - 2
Falls	How many times have you fallen in the past year?	None - 0 1-3 falls - 1 ≥4 falls - 2