Psychometric properties of the Tilburg Frailty Indicator in older Spanish people

Vrotsou, Kalliopi; Machón, Mónica; Rivas‐Ruiz, Francisco; Carrasco, Estefanía; Contreras-Fernández, Eugenio; Mateo-Abad, Maider; Güell, Carolina; Vergara, Itziar

doi:10.1016/j.archger.2018.05.024

Cited by 22 publications

(54 citation statements)

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“…Validated in six countries, it is multidimensional and can be applied in the community, in the hospital setting and in LTCIOA and does not include variables that are considered frailty outcomes, such as disability, falls and hospitalization. However, Vrotsou et al [90] recommend additional studies in different social contexts, as the different social realities in Europe and the rest of the world do not seem to have been contemplated in designing and validating the scale and therefore its applicability at different stages of frailty should be reconsidered.…”

Section: Discussionmentioning

confidence: 99%

Instruments for the detection of frailty syndrome in older adults: A systematic review

et al. 2019

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Frailty is a dynamic process in which there is a reduction in the physical, psychological and/or social function associated with aging. The aim of this study was to identify instruments for the detection of frailty in older adults, characterizing their components, application scenarios, ability to identify pre-frailty and clinimetric properties evaluated. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), under registration number CRD42017039318. A total of 14 electronic sources were searched to identify studies that investigated instruments for the detection of frailty or that presented the construction and/or clinimetric evaluation of the instrument, according to criteria established by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). 96 studies were included in the qualitative synthesis: 51 instruments for the detection of frailty were identified, with predominantly physical domains; 40 were constructed and/or validated for use in the older adult community population, 28 only highlighted the distinction between frail and non-frail individuals and 23 presented three or more levels of frailty. The FRAGIRE, FRAIL Scale, Edmonton Frail Scale and IVCF-20 instruments were the most frequently analyzed in relation to clinimetric properties. It was concluded that: (I) there is a large number of instruments for measuring the same construct, which makes it difficult for researchers and clinicians to choose the most appropriate; (II) the FRAGIRE and CFAI stand out due to their multidimensional aspects, including an environmental assessment; however, (III) the need for standardization of the scales was identified, since the use of different instruments in clinical trials may prevent the comparability of the results in systematic reviews and; (IV) considering the different instruments identified in this review, the choice of researchers/clinicians should be guided by the issues related to the translation and validation for their location and the suitability for their context.

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Section: Discussionmentioning

confidence: 99%

Instruments for the detection of frailty syndrome in older adults: A systematic review

et al. 2019

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“…The TFI was considered because it appeared to be potentially relevant for the screening of frailty in primary care [52] and because its method of data collection is easy to use in primary care. Besides, it is also worth mentioning that this group has translated and culturally adapted the TFI for use in Spain [44]. The GFST was included, even though it was not validated at the time, because it was based on clinical judgement and this was a relevant approach for primary care settings in our opinion.…”

Section: Discussionmentioning

confidence: 99%

“…Scores ≥5 indicate frailty [28]. An assessment of the psychometric properties of the Spanish TFI adaptation is described elsewhere [44].…”

Section: Methodsmentioning

confidence: 99%

Description of frail older people profiles according to four screening tools applied in primary care settings: a cross sectional analysis

et al. 2019

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BackgroundRegarding the health care of older populations, WHO recommends shifting from disease-driven attention models towards a personalized, integrated and continuous care aimed to the maintenance and enhancement of functional capacities. Impairments in the construct of functional intrinsic capacity have been understood as the condition of frailty or vulnerability. No consensus has been yet reached regarding which tools are the most suitable for screening this kind of patients in primary care settings. Tools based on the measurement of functional performance such as Timed up and go test (TUG), Short Physical Performance battery (SPPB), self-completed questionnaires like Tilburg Frailty Indicator (TFI) and clinical judgement, as the Gerontopole Frailty Scale (GFS) may be adequate. The objective of this work is to describe and compare characteristics of community-dwelling individuals identified as vulnerable or frail by four tools applied in primary care settings.MethodsCross sectional analysis developed in primary care services in two regions of Spain.Community-dwelling independent individuals aged 70 or more willing to participate were recruited and data was collected via face-to-face interviews. Frailty was assessed by TUG, SPPB, TFI and GFST. Also socio-demographic characteristics, lifestyle habits and health status data (comorbidities, polypharmacy, self-perceived health), were collected. Multiple correspondence analysis (MCA) and cluster analysis were used to identify groups of individuals with similar characteristics.ResultsEight hundred sixty-five individuals were recruited, 53% women, with a mean age of 78 years. Four clusters of participants emerge. Cluster 1 (N = 263) contained patients categorized as robust by most of the studied tools, whereas clusters 2 (N = 199), 3 (N = 183) and 4 (N = 220) grouped patients classified as frail or vulnerable by at least one of the tools. Significant differences were found between clusters.ConclusionsThe assessed tools identify different profiles of patients according to their theoretical construct of frailty. There is a group of patients that are identified by TUG and SPPB but not by GFS or TFI. These tools may be useful in primary care settings for the implementation of a function- driven clinical care of older patients.

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“…14 The correlations between the TFI and GFI, SPQ and phenotype of frailty were 0.76, 0.42, and 0.49, respectively. 14,36 The predictive validity was established using regression analyses and AUC. The prediction period ranged from 6 months 49 to 5 years.…”

Section: Validity Of the Tfi Criterion Validitymentioning

confidence: 91%

“…10, 14,52 Eight studies also present the Cronbach's alpha for physical, psychological and social frailty, ranging from 0.57 to 0.79, 7,9 0.37 to 0.63, 1,50 and 0.25 to 0.59, 13,50 respectively. The lowest and highest values of the KR-20, with regard to physical, psychological, and social frailty, were 0.64 14 and 0.75, 10 0.48 10 and 0.58, 14 and 0.22 14 and 0.49, 10 respectively. Six studies examined the internal consistency reliability of the TFI using corrected item-total correlations.…”

Section: Reliability Of the Tfimentioning

confidence: 99%

Assessing Frailty with the Tilburg Frailty Indicator (TFI): A Review of Reliability and Validity

Gobbens¹,

Uchmanowicz²

2021

CIA

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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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Psychometric properties of the Tilburg Frailty Indicator in older Spanish people

Cited by 22 publications

References 30 publications

Instruments for the detection of frailty syndrome in older adults: A systematic review

Instruments for the detection of frailty syndrome in older adults: A systematic review

Description of frail older people profiles according to four screening tools applied in primary care settings: a cross sectional analysis

Assessing Frailty with the Tilburg Frailty Indicator (TFI): A Review of Reliability and Validity

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