Groningen Frailty Indicator–Chinese (GFI-C) for pre-frailty and frailty assessment among older people living in communities: psychometric properties and diagnostic accuracy

Abstract

Background The early identification of pre-frailty and frailty among older people is a global priority because of the increasing incidence of frailty and associated adverse health outcomes. This study aimed to validate the Groningen Frailty Indicator-Chinese (GFI-C), a widely used screening instrument, and determine the optimal cut-off value in Chinese communities to facilitate pre-frailty and frailty screening. Methods This methodological study employed a cross-sectional and correlational design to examine the psychometric properties of GFI-C, namely, internal consistency, stability, and concurrent and construct validities. The appropriate cut-off values for pre-frailty and frailty screening in the receiver-operating characteristic (ROC) curve were determined through sensitivity and specificity analysis. Results A total of 350 community older people had been assessed and interviewed by a nurse. The GFI-C showed satisfactory internal consistency (Cronbach’s α = 0.87) and two-week test-retest reliability (intra-class correlation coefficient = 0.87). Concurrent validity (r = 0.76, p < 0.001) showed a moderate correlation with Fried’s frailty phenotype. The known-groups method, hypothesis testing and confirmatory factory analysis (three-factor model; χ2/df = 2.87, TLI = 0.92, CFI = 0.93, GFI = 0.92, RMR = 0.014; RMSEA = 0.073) were suitable for the establishment of construct validity. Based on the ROC and Youden’s index, the optimal cut-off GFI-C values were 2 (sensitivity, 71.5%; specificity, 84.7%) for pre-frailty and 3 for frailty (sensitivity, 88.2%; specificity, 79.6%). Conclusions The result indicated that GFI-C is a reliable and valid instrument for pre-frailty and frailty screening among older Chinese people in communities. For optimal diagnostic accuracy, the cut-off values of 3 for frailty and 2 for pre-frailty are recommended.

Measuring depression in Primary Health Care in Spain: Psychometric properties and diagnostic accuracy of HSCL-5 and HSCL-10

“…The total score was expected to be significantly higher among women ( 40 , 41 ). Independent sample t -test was performed, a significant result ( p < 0.05) was considered satisfactory ( 42 ). Confirmatory factor analysis (CFA) was conducted to assess the structural validity.…”

“…Sensitivity and specificity were assessed as measures of internal validity; positive and negative predictive values were also calculated. Both the sensitivity and specificity of a screening test should be greater than 0.70 ( 42 ). For these calculations, cutoffs those proposed by Strand et al were followed: 1.85 for the HSCL-10 and 2.00 for the HSCL-5 ( 22 ).…”

Sensitivity and specificity of conventional and new face validation in determining the incomprehensible items by older people: Empirical evidence of testing 106 quality‐of‐life items

“…The AMT was used for checking the cognitive status of our older participants. It was widely used to screen impaired cognitive function of older people in Hong Kong and the best cutoff value was 7 19–21 . When applying AMT in older people in community and nursing homes, the psychometric properties were established satisfactorily and a sensitivity of 92.3% and specificity of 87.1% was attained 20 …”

“…All participants involved in our study met the following inclusion criteria: (1) they were able to articulate their experiences in Cantonese; (2) cognitively competent (AMT ≥ 7); 21 (3) did not have any psychiatric illness; (4) lived in the RCH for more than 6 months 27 . The approach of maximum variation in sample selection was purposefully adopted 19 .…”

“…22 However, about 15 to 20 samples are generally accepted for instrument development 13,15 and such a suggestion has been tested in several recent studies. [23][24][25][26] All participants involved in our study met the following inclusion criteria: (1) they were able to articulate their experiences in Cantonese; (2) cognitively competent (AMT ≥ 7); 21 (3) did not have any psychiatric illness; (4) lived in the RCH for more than 6 months. 27 The approach of maximum variation in sample selection was purposefully adopted.…”