The Functional Assessment Staging Tool (FAST), developed by Barry Reisberg, stages dementia by what a person can still do rather than by memory test scores. It runs from stage 1 (normal function) to stage 7f (unable to hold the head up), with stages 6 and 7 divided into sub-stages.
In Alzheimer's disease, function is usually lost in a predictable order, which is what makes FAST useful for describing progression, planning care and, at stage 7, supporting hospice and palliative care decisions.
Zdrovia: https://www.zdrovia.ca/resources/fast-dementia-scale/
Dementia Staging
FAST Scale (Functional Assessment Staging Tool)
Choose the highest consecutive stage the person has reached. Stages describe function, not memory test scores, and in Alzheimer's disease they usually progress in order.
FAST stage
Score every item to see the result
These results are estimates based on published clinical data and are for informational purposes only. They do not constitute medical advice, a diagnosis, or a treatment recommendation. Consult a licensed aesthetic practitioner before beginning any treatment. Individual results vary.
Zdrovia's smart blocks drop validated scales into the visit note, keep every item score, and graph the total across visits so the trend is visible at a glance. See how smart blocks work →
FAST stages
| Stage | Function | Clinical stage |
|---|---|---|
| 1 | No difficulty | Normal adult |
| 2 | Subjective forgetfulness, word-finding | Normal aged forgetfulness |
| 3 | Decline noticed in demanding work or travel | Mild cognitive impairment |
| 4 | Needs help with complex tasks: finances, meal planning | Mild dementia |
| 5 | Needs help choosing clothing | Moderate dementia |
| 6a–6e | Help dressing (a), bathing (b), toileting (c); urinary (d) then faecal (e) incontinence | Moderately severe dementia |
| 7a–7f | Speech limited to a few words (a), one word (b); unable to walk (c), sit up (d), smile (e), hold head up (f) | Severe dementia |
Score it straight into the chart
Zdrovia's smart blocks drop validated scales into the visit note, keep every item score, and graph the total across visits so the trend is visible at a glance.
How to stage with FAST
Assign the highest consecutive stage the person has reached. Because losses usually happen in order, someone who is incontinent but still dresses independently doesn't fit the expected pattern, which suggests the incontinence has another cause or that the dementia isn't Alzheimer's type. Ask carers about the person's usual function, not a bad day.
FAST and hospice eligibility
Stage 7a or beyond is one of the criteria commonly cited in hospice eligibility guidance for dementia, usually alongside a recent complication such as aspiration pneumonia, infection or significant weight loss. Eligibility rules depend on the program and jurisdiction, so treat FAST as one part of that assessment.
Cognitive screen: MoCA score interpretation →
Pain in dementia: PAINAD scale →
References
Other clinical assessment references