The psychometric properties of three self-report screening instruments for identifying frail older people in the community

Metzelthin, Silke F.; Ramon Daniëls; van Rossum, Erik; de Witte, Luc; van den Heuvel, Wim J. A.; Kempen, Gertrudis I. J. M.; Daniëls, Ramon
January 2010
BMC Public Health;2010, Vol. 10 Issue 1, p176
Academic Journal
journal article
Background: Frailty is highly prevalent in older people. Its serious adverse consequences, such as disability, are considered to be a public health problem. Therefore, disability prevention in community-dwelling frail older people is considered to be a priority for research and clinical practice in geriatric care. With regard to disability prevention, valid screening instruments are needed to identify frail older people in time. The aim of this study was to evaluate and compare the psychometric properties of three screening instruments: the Groningen Frailty Indicator (GFI), the Tilburg Frailty Indicator (TFI) and the Sherbrooke Postal Questionnaire (SPQ). For validation purposes the Groningen Activity Restriction Scale (GARS) was added.Methods: A questionnaire was sent to 687 community-dwelling older people (> or = 70 years). Agreement between instruments, internal consistency, and construct validity of instruments were evaluated and compared.Results: The response rate was 77%. Prevalence estimates of frailty ranged from 40% to 59%. The highest agreement was found between the GFI and the TFI (Cohen's kappa = 0.74). Cronbach's alpha for the GFI, the TFI and the SPQ was 0.73, 0.79 and 0.26, respectively. Scores on the three instruments correlated significantly with each other (GFI - TFI, r = 0.87; GFI - SPQ, r = 0.47; TFI - SPQ, r = 0.42) and with the GARS (GFI - GARS, r = 0.57; TFI - GARS, r = 0.61; SPQ - GARS, r = 0.46). The GFI and the TFI scores were, as expected, significantly related to age, sex, education and income.Conclusions: The GFI and the TFI showed high internal consistency and construct validity in contrast to the SPQ. Based on these findings it is not yet possible to conclude whether the GFI or the TFI should be preferred; data on the predictive values of both instruments are needed. The SPQ seems less appropriate for postal screening of frailty among community-dwelling older people.


Related Articles

  • Critical reflections on the blind sides of frailty in later life. De Donder, Liesbeth; Smetcoren, An-Sofie; Schols, Jos M.G.A.; van der Vorst, Anne; Dierckx, Eva // Journal of Aging Studies;Jun2019, Vol. 49, p66 

    Since the 1970's, frailty emerged as a major theme and has become one of the most researched topics in aging studies. However, throughout the years, the concept 'frailty' became susceptible to different interpretations and has been approached by different synonyms, which resulted in a confusing...

  • Frailty and Mortality Among Chinese at Advanced Ages. Danan Gu; Dupre, Matthew E.; Sautter, Jessica; Haiyan Zhu; Yuzhi Liu; Zeng Yi // Journals of Gerontology Series B: Psychological Sciences & Socia;Mar2009, Vol. 64B Issue 2, p279 

    Objectives. This study investigates the factors associated with frailty and the association of frailty with mortality in a national sample of adults aged 65-109 in China. Methods. Using the 2002 wave of the Chinese Longitudinal Healthy Longevity Survey, we construct a frailty index (FI) based on...

  • Resources as a Protective Factor for Negative Outcomes of Frailty in Elderly People. Ament, Bart H.L.; de Vugt, Marjolein E.; Koomen, Floortje M.K.; Jansen, Maria W.J.; Verhey, Frans R.J.; Kempen, Gertrudis I.J.M. // Gerontology;2012, Vol. 58 Issue 5, p391 

    Background: Although frailty is often conceptualized in terms of deficits, the level of frailty can be perceived as a complex interplay between deficits and resources. Objective: We studied whether resources such as educational level, financial situation, and living-alone status moderate the...

  • Health Status of Elderly: Evidence from India and Japan. Ramachandran, Rathi; R., Radhika // Indian Journal of Gerontology;2013, Vol. 27 Issue 2, p233 

    Health status is an important indicator of the quality of life of the elderly. Ageing increases the proportion of elderly with increased morbidities and functional disability. Addressing this issue has major implications for the government as well for the elderly in areas of socio economic and...

  • Frailty syndrome and all-cause mortality in demented patients: the Italian Longitudinal Study on Aging. Solfrizzi, Vincenzo; Scafato, Emanuele; Frisardi, Vincenza; Sancarlo, Daniele; Seripa, Davide; Logroscino, Giancarlo; Baldereschi, Marzia; Crepaldi, Gaetano; Carlo, Antonio; Galluzzo, Lucia; Gandin, Claudia; Inzitari, Domenico; Maggi, Stefania; Pilotto, Alberto; Panza, Francesco // Age;Apr2012, Vol. 34 Issue 2, p507 

    Cognition has already been considered as a component of frailty, and it has been demonstrated that it is associated with adverse health outcomes. We estimated the prevalence of frailty syndrome in an Italian older population and its predictive role on all-cause mortality and disability in...

  • Standard laboratory tests to identify older adults at increased risk of death. Howlett, Susan E.; Rockwood, Michael R. H.; Mitnitski, Arnold; Rockwood, Kenneth // BMC Medicine;2014, Vol. 12 Issue 1, p1 

    Background Older adults are at an increased risk of death, but not all people of the same age have the same risk. Many methods identify frail people (that is, those at increased risk) but these often require time-consuming interactions with health care providers. We evaluated whether standard...

  • Exercise--It's Never Too Late: The Strong-for-Life Program. Jette, Alan M.; Lachman, Margie; Giorgetti, Marie M.; Assmann, Susan F.; Harris, Bette Ann; Levenson, Claudia; Wernick, Mara; Krebs, David // American Journal of Public Health;Jan1999, Vol. 89 Issue 1, p66 

    Objectives. This investigation determined whether an in-home resistance training program achieved health benefits in older adults with disabilities. Methods. A randomized controlled trial compared the effects of assigning 215 older persons to either a home-based resistance exercise training...

  • The Lifestyle Interventions and Independence for Elders Study: Design and Methods. Fielding, Roger A.; Rejeski, W. Jack; Blair, Steven; Church, Tim; Espeland, Mark A.; Gill, Thomas M.; Guralnik, Jack M.; Hsu, Fang-Chi; Katula, Jeffrey; King, Abby C.; Kritchevsky, Stephen B.; McDermott, Mary M.; Miller, Michael E.; Nayfield, Susan; Newman, Anne B.; Williamson, Jeff D.; Bonds, Denise; Romashkan, Sergei; Hadley, Evan; Pahor, Marco // Journals of Gerontology Series A: Biological Sciences & Medical ;Nov2011, Vol. 66A Issue 11, p1226 

    Background. As the number of older adults in the United States rises, maintaining functional independence among older Americans has emerged as a major clinical and public health priority. Older people who lose mobility are less likely to remain in the community; demonstrate higher rates of...

  • in brief.  // Nursing Older People;Nov2002, Vol. 14 Issue 8, p4 

    The article presents news related to the field of nursing for older people in Great Britain. The market survey from the company Laing and Buisson suggests that capacity in nursing and residential homes has decreased by around 64,300 places since 1996. In April 2002 there were an estimated...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics