SN

Question

Score

No, not limited at all

Normal; no complaints; no evidence of disease

100

Able to carry on normal activity; minor signs or symptoms of disease

90

Yes, limited a little

Normal activity with effort; some signs or symptoms of disease

80

Cares for self; unable to carry on normal activity or to do active work.

70

Requires occasional assistance but is able to care for most of own needs.

60

Requires considerable assistance and frequent medical care

50

Yes, limited a lot

Disabled; requires special care and assistance

40

Severely disabled; hospitalization indicated although death not imminent

30

Very sick; hospitalization necessary; active supportive treatment necessary

20

Moribund, fatal processes progressing rapidly

10

Dead

0