FUNCTIONAL ASSESSMENT STAGING (FAST)
(Check highest consecutive level of disability.)
1. G No difficulty, either subjectively or objectively.
2. G Complains of forgetting location of objects. Subjective work difficulties.
3. G Decreased job functioning evident to co-workers. Difficulty in traveling to new locations. Decreased
4. G Decreased ability to perform complex tasks, e.g., planning dinner for guests, handling personal
finances (such as forgetting to pay bills), difficulty marketing, etc.*
5. G Requires assistance in choosing proper clothing to wear for the day, season, or occasion, e.g.
patient may wear the same clothing repeatedly, unless supervised.*
6. G (a) Improperly putting on clothes without assistance or cuing (e.g., may put street clothes on over night
clothes, or put shoes on wrong feet, or have difficulty buttoning clothing) occasionally or more frequently over
the past weeks.*
G (b) Unable to bathe properly (e.g., difficulty adjusting bath-water temperature) occasionally or more frequently
over the past weeks.*
G (c) Inability to handle mechanics of toileting (e.g., forgets to flush the toilet, does not wipe properly or properly
dispose of toilet tissue) occasionally or more frequently over the past weeks.*
G (d) Urinary incontinence (occasionally or more frequently over the past weeks).*
G (e) Fecal incontinence (occasionally or more frequently over the past weeks).*
7. G (a) Ability to speak limited to approximately a half a dozen intelligible different words or fewer, in the course of
an average day or in the course of an intensive interview.
G (b) Speech ability limited to the use of a single intelligible word in an average day or in the course of an
intensive interview (the person may repeat the word over and over).
G (c) Ambulatory ability lost (cannot walk without personal assistance).
G (d) Cannot sit up without assistance (e.g., the individual will fall over if there are no lateral rests [arms] on
G (e) Loss of ability to smile.
G (f) Loss of ability to hold up head independently.
* Scored primarily on the basis of information obtained from a knowledgeable informant and/or caregiver.
Reisberg, B., Functional assessment staging (FAST). Psychopharmacology Bulletin, 1988;24:653-659.
©1984 by Barry Reisberg, M.D. All rights reserved.
FUNCTIONAL ASSESSMENT STAGING (FAST)
The FAST Stage is the highest consecutive level of disability. For clinical purposes, in addition to staging the level of
disability, additional, non-ordinal (nonconsecutive) deficits should be noted, since these additional deficits are of clear clinical
For the purpose of therapeutic trials, the FAST can be used to sensitively encompass the full range in functional
disability in CNS aging and dementia. For these purposes the FAST Disability Score should be obtained as follows:
(1) Each FAST substage should be converted into a numerical stage. Specifically, the following scoring should be
applied: 6a=6.0; 6b=6.2; 6c=6.4; 6d = 6.6; 6e = 6.8; 7a = 7.0; 7b=7.2; 7c=7.4; 7d=7.6; 7e=7.8; 7f=8.0.
(2) The consecutive level of disability (FAST stage) is scored and given a numerical value.
(3) The non-consecutive FAST deficits are scored. A non-consecutive full stage deficit is scored as 1.0. A non-
consecutive sub - stage deficit is scored as 0.2.
(4) The FAST Disability Score =( The FAST Stage Score) + (Each Non-Consecutive FAST disability scored as
For example, if a patient is at FAST Stage 6a, then the patient’s FAST stage score = 6.0. By definition, this patient
cannot handle a job, manage their personal finances, independently pick out their clothing properly, or put on their clothing
properly without assistance. If, in addition, this patient is incontinent of urine and cannot walk without assistance, then
nonconsecutive deficits “6d” and “7c” are scored. The FAST Disability Score for this patient is 6.0 + 0.2+0.2 = 6.4.