Items | Possible answers (score) | |
---|---|---|
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 |