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Composite Autonomic Severity Scale (CASS)
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Supplemental: Parkinson's Disease (PD)
Short Description of Instrument

The Composite Autonomic Scoring Scale (CASS) is a 10-point scoring system of autonomic function. The scale rates adrenergic deficits by one of four grades, and sudomotor and cardiovagal deficits each by one of three grades.

Each score is normalized for the compounding effects of age and sex. The score ranges from 0 (no deficit) to 10 (maximal deficit).
Patients with a score of 3 or less have only mild autonomic failure, patients scoring 7–10 have severe autonomic failure and patients scoring 0–2 have moderate autonomic failure.
Cohen J, Low P, Fealey R, et al. Somatic and autonomic function in progressive autonomic failure and multiple systems atrophy. Ann Neurol 1987; 22: 692-699.
Low PA. Composite autonomic scores scale for laboratory quantification of generalized autonomic failure. Mayo Clin Proc 1993; 68: 748-752.
Low PA. Laboratory evaluation of autonomic dysfunction, In: Low PA, ed. Clinical autonomic disorders: evaluation and management. 2nd ed. Philadelphia: Lippincott-Raven, 1997: 179-208.


Document last updated April 2020