It’s no secret that Alzheimer’s disease, the most common form of dementia, can take a significant toll on the person living with dementia and their loved ones.

As any form of dementia progresses, it’s important to have a reliable way to assess and track its impact on cognitive and functional abilities. That’s where the FAST (Functional Assessment Staging) scale comes in handy.

Key Takeaways:

  • Functional Assessment: The FAST scale evaluates activities of daily living decline in people with Alzheimer’s.
  • Staged Progression: The FAST scale breaks down Alzheimer’s progression into seven detailed stages.
  • Helps with Care Planning: The FAST scale helps tailor care planning based on a person’s Alzheimer’s stage.
  • The Tool Has Limitations: The FAST scale is subjective based on the practitioner, time of day the assessment is completed, personal reporting of caregivers, and cultural and environmental factors.

Developed by Dr. Barry Reisberg, this innovative tool provides healthcare professionals, caregivers, and family members with valuable insights into the progression of Alzheimer’s disease and cognitive decline.

Let’s take a deep dive into the FAST scale for dementia for assessing cognition.

An Overview of the FAST Scale for Dementia

A Brief History

Dr. Barry Reisberg, a renowned dementia expert, developed the FAST dementia scale as a means to measure the functional decline in people with Alzheimer’s. This 7-stage system has become an invaluable tool for healthcare professionals, helping them make informed decisions about care planning and treatment options.

The Scale’s Purpose

The FAST scale’s primary goal is to evaluate and track the progression of Alzheimer’s disease, providing a clearer picture of a person’s current cognitive and functional abilities. By offering a better understanding of the disease’s stages, the FAST scale empowers caregivers and family members to provide appropriate care and support.

How to Interpret Fast Scale: The 7 FAST Scale Stages

The FAST scale breaks down Alzheimer’s progression into seven stages, ranging from normal adult cognitive function to severe Alzheimer’s disease. Each stage represents a decline in cognitive and functional abilities.

Keep in mind, every person moves through the stages of dementia differently and may or may not exhibit deficits in the stages represented by the FAST scale. Not every person with dementia will experience every stage.

A closer look at the FAST scale stages and how to interpret FAST scale:

StageStage NameDeficits
1Normal AgingNo deficits, no cognitive or functional decline detected.
2Possible mild cognitive impairmentSubjective functional defecit
3Mild cognitive impairmentNeeds help to select clothing
4Mild dementiaIndependent Activities of Daily Living (IADL’s) become affected such as bill paying, cooking, cleaning, traveling
5Moderate dementiaNeeds help selecting clothes
6a
6b
6c
6d
6e
Moderately severe dementiaNeeds help putting on clothes
Needs help bathing
Needs help toileting
Incontinent of bladder
Incontinent of bowel
7a
7b
7c
7d
7e
7f
Severe dementiaSpeaks 5-6 words during the day
Speaks only one word clearly
Can no longer walk
Can no longer sit up
Can no longer smile
Can no longer hold up head

Credit: Medical Care Corporation Functional Assessment Staging Test

Benefits of measuring cognitive decline with the FAST Scale

Using the FAST scale comes with several advantages:

  • Improved understanding: The FAST scale for dementia helps identify the person’s current stage of Alzheimer’s or other dementia, allowing for better communication and support. A FAST score can help loved ones and caregivers understand the current stage of dementia their loved one is experiencing.
  • Tailored care: The scale’s detailed information enables healthcare professionals and caregivers to develop personalized care plans and adapt treatment options.
  • Monitoring progression: The FAST scale allows for tracking the disease’s progression, helping adjust care strategies accordingly.

Limitations of the FAST Scale

Despite its many benefits, the FAST scale isn’t without limitations:

  • Specificity: The scale primarily targets Alzheimer’s disease, making it less applicable to other forms of dementia.
  • The FAST scale is subjective: It’s based on subjective observations, potentially leading to inconsistent evaluations. A FAST score could change based on the time of day, mood, and interactions with the practitioner.
  • Focuses on functional abilities: Does not encompass all the cognitive, behavioral, and psychological symptoms that may be present in individuals with Alzheimer’s disease.
  • The journey of Alzheimer’s progression is different for everyone: No two people experience the progression of Alzheimer’s alike. One person may stay in a stage for an extended period, while another may quickly move through the same or several stages.

Comparing the FAST Scale with Other Assessment Tools

There are other dementia assessment tools available, such as the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). While these tests also evaluate cognitive function in people living with dementia, they differ in focus and methodology.

Let’s compare them with the FAST scale:

  • MMSE: The MMSE is a widely used cognitive screening tool that assesses memory, attention, language, and other cognitive abilities. However, it does not provide detailed information about functional decline or activities of daily living.
  • MoCA: The MoCA is another cognitive assessment tool that evaluates various cognitive domains, including memory, executive function, and visuospatial abilities. While it is more sensitive to mild cognitive impairment, it does not specifically assess functional decline like the FAST scale.

As a social worker in skilled nursing facilities, I used the MMSE routinely for residents who exhibited cognitive deficits. What I liked about the MMSE is that it is easy to administer and score. However, as stated above, it didn’t address a person’s ability to perform activities of daily living.

Amie Clark, BSW

Practical Tips for Using the FAST Scale

To make the most of the FAST scale, consider these practical suggestions:

  • Administering the scale: Healthcare professionals should familiarize themselves with the scale’s stages and sub-stages to ensure accurate assessment.
  • Interpreting results: Keep in mind the scale’s limitations, and use the results in conjunction with other assessment tools for a comprehensive understanding of the person’s condition.
  • Integrating the scale into care: Utilize the FAST scale’s information to adapt care plans, treatment decisions, and communication strategies to better support the person living with dementia and their family.

FAST Scale is a Useful Clinical Tool

Navigating the complex world of Alzheimer’s and other related dementias can be challenging. Still, the FAST scale is just one tool that offers a valuable roadmap to understanding and tracking a person’s progression.

By learning about the FAST scale scoring, benefits, and limitations, healthcare professionals, caregivers, and family members can better support their loved ones living with Alzheimer’s.

Knowledge is power, and using tools like the FAST scale can help make the journey a little smoother for everyone.

FAST Scale Frequently Asked Questions

What is the FAST scale used for?

The FAST scale is used to assess and track the progression of Alzheimer’s disease, providing valuable insights into a person’s cognitive and functional abilities.

Can the FAST scale be used for other types of dementia?

While the FAST scale primarily targets Alzheimer’s disease, it may still provide some valuable information for other forms of dementia. However, its applicability may be limited, and other assessment tools might be more suitable for specific types of dementia.

Who can administer the FAST scale?

Healthcare professionals, such as doctors, nurses, and dementia care specialists, are typically responsible for administering the FAST scale.

Is the FAST scale a diagnostic tool?

No, the FAST scale is not a diagnostic tool. It is used to evaluate the progression of Alzheimer’s disease in individuals who have already been diagnosed.

Author Profile

An expert in senior care, Amie has professional and personal experience in senior housing, caregiving, end-of-life care, and more from her 24 years of working with older adults.