Version May 2024
| Domain | Score |
| Age | |
| 75-85 | 1 |
| >85 | 3 |
| Self-rated health | |
| Good, very good, and excellent | 0 |
| Fair and poor | 1 |
| Activities of daily living (ADLs)/instrumental ADLs (IADLs) | |
| Needs assistance with | |
| Bathing or showering | 1 |
| Shopping | 1 |
| Money management | 1 |
| Transfer | 1 |
| Light housework | 1 |
| Difficulty in special activities | |
| Kneeling, bending, and stooping | 1 |
| Performance of housework (example: scrubbing the floor) | 1 |
| Reaching out and lifting upper extremities above the shoulder | 1 |
| Lifting and carrying 10 pounds | 1 |
| Walking 0.25 miles | 1 |
| Writing or handling and grasping small objects | 1 |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
