How the Duke Activity Status Index (DASI) Works
The DASI is a 12-item, self-administered questionnaire developed by Hlatky and colleagues (American Journal of Cardiology, 1989) to estimate a person's functional capacity — how much physical exertion they can typically tolerate — without an exercise stress test. Each activity, from self-care to strenuous sports, carries a weight roughly proportional to its metabolic cost. Answering "Yes" adds that weight to your total DASI score, which ranges from 0 to a maximum of 58.2. The score is then converted into an estimated peak oxygen uptake (VO2 peak) and peak METs, giving a quick, validated proxy for cardiorespiratory fitness.
How the score is calculated
Every "Yes" answer contributes its item weight to the running total: self-care (2.75), walking indoors (1.75), walking a block or two (2.75), climbing stairs or a hill (5.50), running a short distance (8.00), light housework (2.70), moderate housework (3.50), heavy housework (8.00), yard work (4.50), sexual relations (5.25), moderate recreational sport such as golf or doubles tennis (6.00), and strenuous sport such as swimming or basketball (7.50). Summing every weight gives the maximum possible score of 58.2. From that total, estimated peak oxygen uptake is VO2peak = 0.43 × DASI + 9.6 (in mL/kg/min), and peak METs = VO2peak ÷ 3.5, since 1 MET is defined as roughly 3.5 mL of oxygen per kilogram of body weight per minute.
Interpreting your functional capacity
Clinicians commonly group estimated peak METs into bands: below 4 METs suggests poor functional capacity (difficulty with everyday exertion such as climbing two flights of stairs), 4 to just under 7 METs is moderate, 7 to just under 10 METs is good, and 10 METs or higher is excellent. The 4-MET mark is widely referenced in perioperative risk guidance because it approximates the exertion of climbing stairs or walking briskly, activities used as an informal bedside gauge of cardiovascular reserve before non-cardiac surgery.
Limitations and when to seek clinical testing
The DASI is a screening estimate based on self-reported ability, not a measured physiological test — it can overestimate or underestimate true fitness, particularly in people with joint, neurological, or lifestyle limitations unrelated to cardiovascular fitness. It does not diagnose heart or lung disease and should not be used to make treatment decisions on its own. If you have symptoms such as chest pain, unexplained shortness of breath, or your result concerns you, or if a clinician has asked for a formal risk assessment before a procedure, discuss it with a physician who may recommend an exercise stress test or cardiopulmonary exercise testing for an objective measurement.