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Kasa AS, Drury P, Chang HCR, Lee SC, Traynor V. Cross-Cultural Adaptation, Validity, and Reliability Testing of the Tilburg Frailty Indicator (TFI) Amharic Version for Screening Frailty in Community-Dwelling Ethiopian Older People. Clin Interv Aging 2023; 18:1115-1127. [PMID: 37522070 PMCID: PMC10377638 DOI: 10.2147/cia.s416942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Frailty is a global health problem, including in African countries. Despite this, no reliable or valid frailty instruments incorporate any African language, and no research exists to cross-culturally adapt and test the validity and reliability of instruments commonly used in other countries for use within African countries. The Tilburg Frailty Indicator (TFI) is a reliable and validated instrument with the potential to be relevant for older populations living in Africa. This study aimed to develop the TFI Amharic (TFI-AM) version for use within Ethiopia. METHODS This study employed psychometric testing and the evaluation of a translated and adapted instrument. The original English language version of the TFI was translated and culturally adapted into Amharic using the World Health Organization process of translation and adaptation of an instrument. A convenience sample of ninety-six community-dwelling older people 60 years and over was recruited. Cronbach's alpha was used for the analysis of the internal consistency of the TFI Amharic (TFI-AM) version using IBM SPSS 26.0 (IBM Corp., Armonk, NY, USA). Face and content validities of the TFI-AM were determined. RESULTS The TFI-AM total mean score was 5.76 (±2.89). The internal consistency of the TFI-AM was very good with an overall Cronbach alpha value of 0.82. The physical domain showed the highest reliability with a 0.75 Cronbach's alpha value while the social domain was the lowest with a 0.68 Cronbach's alpha value. The Cronbach's alpha reliability coefficients of the instrument ranged from 0.68 to 0.75. The item content validity index value ranged from 0.83 to 1.0 and the total content validity index average for the instrument was 0.91. CONCLUSION The TFI-AM is reliable, valid, and reproducible for the assessment of frailty among community-dwelling older populations in Ethiopia. TFI-AM proved an easy-to-administer, applicable and fast instrument for assessing frailty in community-dwelling older populations.
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Affiliation(s)
- Ayele Semachew Kasa
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), New South Wales, Australia
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Peta Drury
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), New South Wales, Australia
| | - Hui-Chen Rita Chang
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), New South Wales, Australia
- School of Nursing and Midwifery, Western Sydney University, Parramatta South Campus, Parramatta, New South Wales, Australia
| | - Shu-Chun Lee
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Victoria Traynor
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), New South Wales, Australia
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Balasch-Bernat M, Sentandreu-Mañó T, Tomás JM, Cebrià I Iranzo MA, Tortosa-Chuliá MA, Arnal-Gómez A, Cezón-Serrano N. Deepening the understanding of the structural validity of the Tilburg Frailty Indicator. Aging Clin Exp Res 2023; 35:1263-1271. [PMID: 37085651 DOI: 10.1007/s40520-023-02407-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/02/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Psychometric properties of the Tilburg Frailty Indicator (TFI) have shown low internal consistency for psychological and social domains, and evidence for its structure validity is controversial. Moreover, research on TFI is frequently limited to community dwellings. AIMS To evaluate structural validity, reliability, and convergent and divergent validity of the Spanish version of the Tilburg Frailty Indicator (TFI) in both community-dwelling and institutionalized older people. MATERIALS AND METHODS A cross-sectional study was conducted on Spanish older adults (n = 457) recruited from both community settings (n = 322) and nursing homes (n = 135). Participants completed the TFI and other frailty instruments: Fried's Frailty Phenotype, Edmonton Frailty Scale, FRAIL Scale, and Kihon Checklist (KCL). Confirmatory Factor Analysis (CFA), and reliability and validity coefficients were estimated. RESULTS AND DISCUSSION Some items from physical and social domains showed low factor loadings (< 0.40). The three-factor CFA model showed better fit indices after depurating these items. Reliability estimates were good (CRI ≥ 0.70) for physical and psychological domains in the institutionalized sample, while in the community dwellings, only physical domain reliability was adequate. Convergent and divergent validity of physical and psychological domains was good, except for some alternative psychological measures highly correlating with the TFI physical component (KCL-depressive mood and Edmonton mood). However, the social domain showed low correlations with some social indicators. CONCLUSION The findings of this study clarify some of the controversial validation results of the TFI structure and provide evidence to improve its use in psychometric terms. CLINICAL TRIAL REGISTRATION NUMBER NCT03832608.
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Affiliation(s)
- Mercè Balasch-Bernat
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010, Valencia, Spain
- Physiotherapy in Motion. Multi-Speciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010, Valencia, Spain
| | - Trinidad Sentandreu-Mañó
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010, Valencia, Spain.
- Advanced Research Methods Applied to Quality of Life Promotion (ARMAQoL), University of Valencia, 46010, Valencia, Spain.
| | - José M Tomás
- Advanced Research Methods Applied to Quality of Life Promotion (ARMAQoL), University of Valencia, 46010, Valencia, Spain
- Department of Methodology for the Behavioral Sciences, University of Valencia, 46010, Valencia, Spain
| | - Maria A Cebrià I Iranzo
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010, Valencia, Spain
- Physiotherapy in Motion. Multi-Speciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010, Valencia, Spain
- Physical Medicine and Rehabilitation Service, La Fe Hospital in Valencia, La Fe Health Research Institute (IISLAFE), 46026, Valencia, Spain
| | - Maria A Tortosa-Chuliá
- Department of Applied Economics, University of Valencia, 46022, Valencia, Spain
- Public Economic Evaluation Research Group (EVALPUB), Department of Applied Economics, Faculty of Economics, University of Valencia, 46022, Valencia, Spain
| | - Anna Arnal-Gómez
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010, Valencia, Spain
- Physiotherapy in Motion. Multi-Speciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010, Valencia, Spain
| | - Natalia Cezón-Serrano
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010, Valencia, Spain
- Physiotherapy in Motion. Multi-Speciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010, Valencia, Spain
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Fan JY, Xie W, Zhang WY, Liu YT, Wang Q, Zhao HM, Kong LL, Li J. To validate the integral conceptual model of frailty among community-dwelling older adults in China: a cross-sectional study. BMC Geriatr 2023; 23:242. [PMID: 37085758 PMCID: PMC10120217 DOI: 10.1186/s12877-023-03960-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 04/07/2023] [Indexed: 04/23/2023] Open
Abstract
PURPOSE The integral conceptual model of frailty (ICFM) integrates physical, psychological, social aspects of individuals and stresses that frailty is a dynamic state evolving over time. This study aimed to validate the ICMF among community-dwelling older adults in China. METHODS The study recruited 341 older community-dwelling adults by convenient sampling method between June 1 and August 30, 2019 in Hubei province, China. The data was collected by questionnaire-based survey. Frailty was assessed by the Chinese version of the Tilburg Frailty Index. Participants were assessed for life-course determinants, disease and adverse health outcomes. Hierarchical regression analyses, Bootstrap method and the structural equation model were conducted in data analysis. RESULTS Both linear and logistic hierarchical regression models were statistically significant. Life-course determinants, disease, and three domains of frailty together explained 35.6% to 50.6% of the variance of disability and all domains of quality of life. The mediation effect of frailty between disease and all adverse outcomes was significant, excluding hospitalization. The structural equation model guided by the ICMF fits the data well. CONCLUSIONS The ICMF is valid among community-dwelling older adults in China. Therefore, the multidimensional concept of frailty should be widely used in Chinese communities.
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Affiliation(s)
- Jun-Yao Fan
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wen Xie
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China
| | - Wen-Ya Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China
| | - Yue-Ting Liu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China
| | - Quan Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China
| | - Hui-Min Zhao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China
| | - Ling-Lin Kong
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China
| | - Jie Li
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, China.
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Leininger S, Davis Micco RN. The Future of Assessing Frailty in the Patient With Advanced Heart Failure: A Review of Current Literature. Crit Care Nurs Q 2022; 45:359-375. [PMID: 35980798 DOI: 10.1097/cnq.0000000000000428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Frailty is becoming an important component of health care outcomes in patients with a diagnosis of heart failure. A literature search was completed to determine whether a best practice guideline existed to assess frailty in patients who were considering ventricular assist device placement. The literature search revealed that best practice guidelines did not exist. A second comprehensive literature search was completed specifically for frailty including the definition, criteria, assessment, and outcomes. The studies revealed that there were challenges with defining frailty, the age of frailty, assessments tools, and study designs. Cardiologists are primarily interested in screening for frailty, but other physician specialty practices are interested in a frailty screening tool as well. This article discusses the inconsistent research studies and the need for a valid and reliable tool to assess for frailty. It is important that nurse leaders and those working with heart failure patients determine the best practice guidelines for assessing frailty.
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Zamora-Sánchez JJ, Urpí-Fernández AM, Sastre-Rus M, Lumillo-Gutiérrez I, Gea-Caballero V, Jodar-Fernández L, Julián-Rochina I, Zabaleta-Del-Olmo E. The Tilburg Frailty Indicator: A psychometric systematic review. Ageing Res Rev 2022; 76:101588. [PMID: 35150901 DOI: 10.1016/j.arr.2022.101588] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/11/2022] [Accepted: 02/07/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The Tilburg Frailty Indicator (TFI) is one of the most prominent multidimensional frailty assessment instruments. This review aimed to critically appraise and summarise its measurement properties. METHODS Reports were eligible if they included results of studies aimed at developing the TFI or evaluating its measurement properties. We performed a literature search in MEDLINE, CINAHL, and PsycINFO databases from their inception until December 8, 2021. We also searched grey literature databases. We assessed the methodological quality of the included studies using the "COSMIN Risk of Bias". The measurement properties were evaluated using specific criteria. We graded the quality of the evidence using a GRADE approach. RESULTS Sixty-three studies were included. We found moderate sufficient evidence for TFI content validity, although it is still insufficient for the comprehensiveness of its items. TFI construct validity was based on sufficient evidence from two studies of its structural validity as well as multiple hypothesis-testing for construct validity studies with inconsistent results. We did not find any studies that assessed cross-cultural validity. Only one of TFI's three dimensions showed sufficient evidence for the internal consistency of its scores, and results in test-retest reliability were inconsistent. The TFI showed high sufficient concurrent validity with the comprehensive geriatric assessment. We identified several studies assessing its predictive validity for adverse frailty-related outcomes, although most of the evidence from these studies was insufficient. We did not find any studies that assessed the responsiveness of TFI scores. CONCLUSIONS The TFI had evidence gaps in several relevant measurement properties. Further research is needed to strengthen its usefulness as a clinical decision-making tool.
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Affiliation(s)
- Juan-José Zamora-Sánchez
- Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain; School of Nursing, Universitat de Barcelona, Barcelona, Spain.
| | | | - Meritxell Sastre-Rus
- Escola Universitària d'Infermeria Gimbernat, Universitat Autònoma de Barcelona, Sant Cugat del Vallès, Barcelona, Spain.
| | - Iris Lumillo-Gutiérrez
- School of Nursing, Universitat de Barcelona, Barcelona, Spain; Chronic Disease Management Team, Baix Llobregat Centre Primary Care Service, Costa de Ponent Primary Care Directorate, Gerència Territorial Metropolitana Sud, Institut Català de la Salut, Cornellà de Llobregat, Spain.
| | - Vicente Gea-Caballero
- Deanery, Faculty of Health Sciences, Valencian International University, Valencia, Spain; Nursing School "La Fe", University of Valencia, Valencia, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.
| | - Lina Jodar-Fernández
- Montbaig Primary Care Centre, Delta Primary Care Service, Costa de Ponent Primary Care Directorate, Gerència Territorial Metropolitana Sud, Institut Català de la Salut, Viladecans, Spain.
| | - Iván Julián-Rochina
- Nursing Department, Universitat de València, Valencia, Spain; Frailty and Cognitive Impairment Group (FROG), Universitat de València, Valencia, Spain.
| | - Edurne Zabaleta-Del-Olmo
- Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain; Nursing Department, Faculty of Nursing, Universitat de Girona, Girona, Spain; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
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van Assen MALM, Helmink JHM, Gobbens RJJ. Associations between lifestyle factors and multidimensional frailty: a cross-sectional study among community-dwelling older people. BMC Geriatr 2022; 22:7. [PMID: 34979945 PMCID: PMC8722011 DOI: 10.1186/s12877-021-02704-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 11/24/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Multidimensional frailty, including physical, psychological, and social components, is associated to disability, lower quality of life, increased healthcare utilization, and mortality. In order to prevent or delay frailty, more knowledge of its determinants is necessary; one of these determinants is lifestyle. The aim of this study is to determine the association between lifestyle factors smoking, alcohol use, nutrition, physical activity, and multidimensional frailty. METHODS This cross-sectional study was conducted in two samples comprising in total 45,336 Dutch community-dwelling individuals aged 65 years or older. These samples completed a questionnaire including questions about smoking, alcohol use, physical activity, sociodemographic factors (both samples), and nutrition (one sample). Multidimensional frailty was assessed with the Tilburg Frailty Indicator (TFI). RESULTS Higher alcohol consumption, physical activity, healthy nutrition, and less smoking were associated with less total, physical, psychological and social frailty after controlling for effects of other lifestyle factors and sociodemographic characteristics of the participants (age, gender, marital status, education, income). Effects of physical activity on total and physical frailty were up to considerable, whereas the effects of other lifestyle factors on frailty were small. CONCLUSIONS The four lifestyle factors were not only associated with physical frailty but also with psychological and social frailty. The different associations of frailty domains with lifestyle factors emphasize the importance of assessing frailty broadly and thus to pay attention to the multidimensional nature of this concept. The findings offer healthcare professionals starting points for interventions with the purpose to prevent or delay the onset of frailty, so community-dwelling older people have the possibility to aging in place accompanied by a good quality of life.
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Affiliation(s)
- Marcel A L M van Assen
- Faculty of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands.,Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
| | | | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, De Boelelaan 1109, 1081, HV, Amsterdam, the Netherlands. .,Zonnehuisgroep Amstelland, Amstelveen, the Netherlands. .,Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
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Ozsoy G, Ates Bulut E, Gurpinar B, Ilcin N, Isik AT. Determination of an optimal frailty cut-off score of Tilburg Frailty Indicator and frailty associated factors in community-dwelling Turkish older adults. Ann Geriatr Med Res 2021; 25:294-300. [PMID: 34773934 PMCID: PMC8749031 DOI: 10.4235/agmr.21.0086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/06/2021] [Indexed: 11/01/2022] Open
Abstract
Background Frailty is a multidimensional and dynamic state that has adverse physical, psychological, and social outcomes. The Tilburg Frailty Indicator (TFI) has the most robust evidence of reliability and validity for assessing frailty. However, the characteristics of TFI have not been investigated in detail. This study aimed to set a cut-off score for frailty and evaluate frailty-associated factors in community-dwelling older adults. Methods This cross-sectional study assessed frailty according to both the TFI and Fried criteria. The Geriatric Depression Scale, basic and instrumental activities of daily living, and Hospital Anxiety and Depression Scale-Anxiety subscale were also implemented. Results This study included 166 older adults. The area under the receiver operating characteristic curve was 0.735 (95% confidence interval [CI]: 0.648-0.823). A TFI cut-off point of 8, showed a sensitivity of 60% and specificity of 72.5% for the prediction of frailty (p<0.05). Frailty according to the TFI was more associated with the physical and psychological parameters, while frailty according to the Fried score was more closely related to the physical parameters (p<0.05). Conclusion The results of this study suggested an optimal TFI cut-off score of 8 as a frailty instrument in community-dwelling older adults. Additionally, the TFI included physical, psychological, and social aspects, thereby providing a multidimensional evaluation of frailty.
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Affiliation(s)
- Gulsah Ozsoy
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Selcuk University, Konya, TR
| | - Esra Ates Bulut
- Department of Geriatric Medicine, Adana City Training and Research Hospital, Adana, TR
| | - Baris Gurpinar
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, TR
| | - Nursen Ilcin
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, TR
| | - Ahmet Turan Isik
- Department of Geriatric Medicine, Dokuz Eylul University, Faculty of Medicine, Izmir, TR
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Gobbens RJ, Uchmanowicz I. Assessing Frailty with the Tilburg Frailty Indicator (TFI): A Review of Reliability and Validity. Clin Interv Aging 2021; 16:863-875. [PMID: 34040363 PMCID: PMC8140902 DOI: 10.2147/cia.s298191] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 01/19/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The Tilburg Frailty Instrument (TFI) is an instrument for assessing frailty in community-dwelling older people. Since its development, many studies have been carried out examining the psychometric properties. The aim of this study was to provide a review of the main findings with regard to the reliability and validity of the TFI. Methods We conducted a literature search in the PubMed and CINAHL databases on May 30, 2020. An inclusion criterion was the use of the entire TFI, part B, referring to the 15 components. No restrictions were placed on language or year of publication. Results In total, 27 studies reported about the psychometric properties of the TFI. By far, most of the studies (n = 25) were focused on community-dwelling older people. Many studies showed that the internal consistency and test–retest reliability are good, which also applies for the criterion and construct validity. In many studies, adverse outcomes of interest were disability, increased health-care utilization, lower quality of life, and mortality. Regarding disability, studies predominantly show results that are excellent, with an area under the curve (AUC) >0.80. In addition, the TFI showed good associations with lower quality of life and the findings concerning mortality were at least acceptable. However, the association of the TFI with some indicators of health-care utilization can be indicated as poor (eg, visits to a general practitioner, hospitalization). Conclusion Since population aging is occurring all over the world, it is important that the TFI is available and well known that it is a user-friendly instrument for assessing frailty and its psychometric properties being qualified as good. The findings of this assessment can support health-care professionals in selecting interventions to reduce frailty and delay its adverse outcomes, such as disability and lower quality of life.
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Affiliation(s)
- Robbert J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands.,Zonnehuisgroep Amstelland, Amstelveen, the Netherlands.,Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Izabella Uchmanowicz
- Division of Nursing in Internal Medicine Procedures, Department of Clinical Nursing, The Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
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Mazoochi F, Gobbens RJJ, Lotfi MS, Fadayevatan R. Diagnostic accuracy of the Tilburg Frailty Indicator (TFI) for early frailty detection in elderly people in Iran. Arch Gerontol Geriatr 2020; 91:104187. [PMID: 32777633 DOI: 10.1016/j.archger.2020.104187] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/16/2020] [Accepted: 07/13/2020] [Indexed: 11/20/2022]
Abstract
AIM Screening is one of the most important ways for early frailty detection that contributes to its prevention and timely treatment. The aim of this study was to determine the diagnostic value of the Persian version of the Tilburg Frailty Indicator (P-TFI) in the frailty screening. METHOD This is a diagnostic test accuracy study that uses known group method. It was designed based on a STARD statement and performed on 175 elderly people in the City of Kashan, Iran. The subjects were selected among older people available in health centers affiliated to Kashan University of Medical Sciences using purposive sampling. Data analysis was carried out using SPSS v16. Descriptive statistics were used to describe the characteristics of the research subjects. Independent t-test was used to determine the ability of the P-TFI to discriminate frail and non-frail individuals, and to evaluate the cut-off point and instrument accuracy, the receiver operating characteristic (ROC) curve was used. The best cut-off point was determined among the proposed points using Youden index. At the determined cut-off point, the diagnostic value parameters of the P-TFI (sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, accuracy, and diagnostic odds ratio) were calculated and their range was estimated with 95 % confidence interval. FINDINGS A total of 74.3 % of the sample was male and their mean age was 68.6 ± 54.44 years. The area under the ROC curve was calculated 0.922, indicating high accuracy of the instrument. The sensitivity and specificity of this instrument at the cut-off point of 4.5 were 0.95 and 0.86, respectively. Positive and negative predictive values were calculated 0.68 and 0.98, respectively, and the accuracy of the instrument was reported to be 0.88. CONCLUSION The P-TFI can be used as a sensitive and accurate instrument, which is highly applicable to screen frailty in older people.
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Affiliation(s)
- Faezeh Mazoochi
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Robbert J J Gobbens
- Rotterdam University of Applied Sciences, Museumpark 40, 3015 CX, Rotterdam, the Netherlands; Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands.; Zonnehuisgroep Amstelland, Amstelveen, the Netherlands.; Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Mohammad-Sajjad Lotfi
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Reza Fadayevatan
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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