The Tilburg Frailty Indicator: Psychometric Properties

Gobbens, Robbert; Assen, Marcel A.L.M. van; Luijkx, Katrien; Wijnen-Sponselee, M.Th.; Schols, Jos M. G. A.

doi:10.1016/j.jamda.2009.11.003

Cited by 823 publications

(989 citation statements)

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“…38 Examples of self-reported questionnaires assessing frailty are: the FRAIL scale, 39 the Groningen Frailty Indicator 40 and the Tilburg Frailty Indicator (TFI) 41 .…”

Section: Frailty Definitions and Measuresmentioning

confidence: 99%

“…44 In recent years, a number of prevention programs have been launched that promote screening tests enabling quick identification of patients who are frail or at risk of frailty such as the FRAIL scale 39 and the TFI. 41 Consistent prevention activity programs have become a priority for many health care facilities and teams. In accordance with the guidelines, screening for frailty should include all patients older than 70 years who have one or more of the following symptoms: significant weight loss in the preceding year, fatigability, overall weakness, and a decrease in physical activity interfering with normal activity.…”

Section: Care For Frail Patientsmentioning

confidence: 99%

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Hypertension and Frailty Syndrome in Old Age: Current Perspectives

Uchmanowicz

Chudiak

Jankowska‐Polańska

et al. 2017

Cardiac Failure Review

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Hypertension is considered the most common disorder in the general population. It is both a health and a financial problem worldwide.The Writing Group of the American Society of Hypertension defines hypertension as a cardiovascular syndrome resulting from a number of interconnected factors. 1 Therefore, a comprehensive evaluation is required, involving both the cardiovascular system and other risk factors. In the global population, the prevalence of hypertension is 26.4 %, which is expected to increase to one-third of the population by 2025. 2 The elderly comprise a special group of hypertensive patients because of ageing-related processes. In accordance with data from the Framingham study, 58.9 % of people aged ≥65 and 70 % of those aged ≥80 years are hypertensive. 3 Most patients in the group have isolated systolic hypertension, with normal diastolic blood pressure (DBP) valuesbelow 90 mmHg. In the elderly population, systolic blood pressure (SBP) is a more significant risk factor for cardiovascular complications than DBP. Chronic high SBP leads to left ventricular hypertrophy, as decreased elasticity of large blood vessels -particularly the aortaputs extra strain on the heart. 4 The ageing process involves a number of changes contributing to the development of hypertension. Besides decreased blood vessel elasticity, these include increased collagen content in the extracellular matrix, decreased numbers of elastic fibres, increased vessel wall thickness, and decreased vessel lumen.In the elderly, the lower number of elastic fibres in the vessel wall contributes to increased SBP. AbstractHypertension is both a health problem and a financial one globally. It affects nearly 30 % of the general population. Elderly people, aged ≥65 years, are a special group of hypertensive patients. In this group, the overall prevalence of the disease reaches 60 %, rising to 70 % in those aged ≥80 years. In the elderly population, isolated systolic hypertension is quite common. High systolic blood pressure is associated with an increased risk of cardiovascular disease, cerebrovascular disease, peripheral artery disease, cognitive impairment and kidney disease. Considering the physiological changes resulting from ageing alongside multiple comorbidities, treatment of hypertension in elderly patients poses a significant challenge to treatment teams. Progressive disability with regard to the activities of daily life, more frequent hospitalisations and low quality of life are often seen in elderly patients. There is discussion in the literature regarding frailty syndrome associated with old age. Frailty is understood to involve decreased resistance to stressors, depleted adaptive and physiological reserves of a number of organs, endocrine dysregulation and immune dysfunction. The primary dilemma concerning frailty is whether it should only be defined on the basis of physical factors, or whether psychological and social factors should also be included. Proper nutrition and motor rehabilitation should be prioritised in care for frail pa...

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“…38 Examples of self-reported questionnaires assessing frailty are: the FRAIL scale, 39 the Groningen Frailty Indicator 40 and the Tilburg Frailty Indicator (TFI) 41 .…”

Section: Frailty Definitions and Measuresmentioning

confidence: 99%

Section: Care For Frail Patientsmentioning

confidence: 99%

Hypertension and Frailty Syndrome in Old Age: Current Perspectives

Uchmanowicz

Chudiak

Jankowska‐Polańska

et al. 2017

Cardiac Failure Review

View full text Add to dashboard Cite

show abstract

“…There is evidence for a broader biopsychosocial (175,193,194) approach to frailty, with some association with adverse events, such as long length of stay and readmission to hospital. However, how to measure these psychosocial elements, and the degree of effect these elements have on outcomes is not clear, particularly in the acute context.…”

Section: Predictor Variablesmentioning

confidence: 99%

Frailty Assessment in Acute Care

2015

The Gerontologist

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IntroductionFor some people, ageing is associated with the experience of increased co-morbidity, functional impairment, poor resilience and heightened vulnerability to external stressors, resulting in reduced lifespan as well as health-span. This frailty phenomenon poses challenges to health care systems in the form of increased patient complexity and resource utilisation. The acute care setting, characterised by time-pressure and high patient turn-over, is under strain and struggles to recognise and subsequently reliably intervene, to prevent, reverse or halt the decline of this vulnerable cohort. MethodsThis mixed-methods study probes existing evidence and 'real-world' processes with a systematic review of frailty assessments developed or validated in the acute care setting and a survey of contemporaneous clinical practice in London Acute Medical Units. Content validation and understanding of contextual factors for ideal frailty assessment in acute care is explored using Delphi consensus and Focus Group methodology respectively. The resultant model is developed on existing retrospective national Hospital Episode Statistics data, and prospectively tested on observational data in a local Acute Medical Unit setting. ResultsExisting frailty scores are preponderantly biophysical in nature, and have poor predictive power for adverse outcomes in the acute care setting. In clinical practice, single-dimension assessment tools predominate. Frailty syndromes and previous high resource utilisation in the form of a simple, clinically relevant tool useful to the multidisciplinary team gain consensus as optimal assessment for the setting. Retrospective testing of the frailty model displays moderate predictive powers for adverse events (inpatient mortality, emergency readmission and institutionalisation) and prospective testing provides concurrent (Frailty Index, Age, Co-Morbidity) and comparative predictive validity (Frailty Index, Co-Morbidity, 2 admission National Early Warning Score) with existing risk stratification models in this setting. ConclusionsA risk prediction model based on frailty syndromes and previous high resource utilisation is a valid, feasible and useful for the acute care setting.

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“…In actuality, this represents a co-morbidity index. Other frailty scales such as the Tilburg Frailty Indicator (14,15) and the Groningen Frailty Index (16,17) include both physical and psychosocial elements. Recently, a number of studies have suggested that the presence of a cognitive deficit leads to worse outcomes in persons with a physical frailty deficit (18)(19)(20).…”

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confidence: 99%