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

Article English OPEN
van Rossum Erik ; Daniëls Ramon ; Metzelthin Silke F ; de Witte Luc ; van den Heuvel Wim JA ; Kempen Gertrudis IJM (2010)
  • Publisher: BMC
  • Journal: BMC Public Health, volume 10, pages 176-176 (issn: 1471-2458, eissn: 1471-2458)
  • Related identifiers: pmc: PMC2868816, doi: 10.1186/1471-2458-10-176
  • Subject: Research article | RA1-1270 | Public aspects of medicine | Public Health, Environmental and Occupational Health

<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>A questionnaire was sent to 687 community-dwelling older people (≥ 70 years). Agreement between instruments, internal consistency, and construct validity of instruments were evaluated and compared.</p> <p>Results</p> <p>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.</p> <p>Conclusions</p> <p>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.</p>
  • References (37)
    37 references, page 1 of 4

    1. Slaets JP: Vulnerability in the elderly: frailty. Med Clin North Am 2006, 90(4):593-601.

    2. Levers MJ, Estabrooks CA, Ross Kerr JC: Factors contributing to frailty: literature review. J Adv Nurs 2006, 56(3):282-291.

    3. Markle-Reid M, Browne G: Conceptualizations of frailty in relation to older adults. J Adv Nurs 2003, 44(1):58-68.

    4. Pel Littel RE, Schuurmans MJ, Emmelot Vonk MH, Verhaar HJ: Frailty: defining and measuring of a concept. J Nutr Health Aging 2009, 13(4):390-394.

    5. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G: Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004, 59(3):255-263.

    6. Daniels R, Metzelthin S, Van Rossum E, De Witte L, Heuvel W Van den: Interventions to prevent disability in frail community-dwelling older persons: an overview. European Journal of Ageing 2010, 7(1):137-155.

    7. De Lepeleire J, Degryse J, Illiffe S, Mann E, Buntinx F: Family physicians need easy instruments for frailty. Age Ageing 2008, 37(4):484. author reply 484-485

    8. Hebert R, Bravo G, Korner-Bitensky N, Voyer L: Predictive validity of a postal questionnaire for screening community-dwelling elderly individuals at risk of functional decline. Age Ageing 1996, 25(2):159-167.

    9. Daniels R, Van Rossum HIJ, De Witte LP, Heuvel WJA Van den: Frailty in Older Age: Concepts and Relevance for Occupational and Physical Therapy. Physical & Occupational Therapy In Geriatrics 2008, 27(2):81-95.

    10. Bergman H, Beland F, Karunanthan S, Hummel S, Hogan D, Wolfson C: Developing a working framework for understanding frailty. (English translation of article published in). Gerontologie et Societe 2004, 109:15-29.

  • Metrics
    No metrics available
Share - Bookmark