Reliability and validity of the Tilburg Frailty Indicator (TFI) among Chinese community-dwelling older people

•The Chinese TFI had good internal consistency and test-retest reliability.•The TFI items and domains had convergent validity with alternative measures.•The divergent validity of the TFI was good except for the psychological frailty.•The Chinese TFI had excellent criterion validity with phenotype an...

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Published in:Archives of gerontology and geriatrics 2017-11, Vol.73, p.21-28
Main Authors: Dong, Lijuan, Liu, Na, Tian, Xiaoyu, Qiao, Xiaoxia, Gobbens, Robbert J.J., Kane, Robert L., Wang, Cuili
Format: Article
Language:English
Subjects:
Aged
Aging - physiology
Aging - psychology
Asian Continental Ancestry Group
China
Chinese
Disabled Persons
Female
Frail Elderly - psychology
Frail Elderly - statistics & numerical data
Frailty
Geriatric Assessment - methods
Health Status
Humans
Independent Living - psychology
Male
Mass Screening - methods
Older people
Psychometrics - methods
Psychometrics - statistics & numerical data
Quality of Life - psychology
Reliability
Reproducibility of Results
Sensitivity and Specificity
Surveys and Questionnaires
Tilburg frailty indicator
Translating
Translations
Validity
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Summary:•The Chinese TFI had good internal consistency and test-retest reliability.•The TFI items and domains had convergent validity with alternative measures.•The divergent validity of the TFI was good except for the psychological frailty.•The Chinese TFI had excellent criterion validity with phenotype and frailty index.•The predictive validity of adverse outcomes and healthcare use were acceptable. To translate the Tilburg Frailty Indicator (TFI) into Chinese and assess its reliability and validity. A sample of 917 community-dwelling older people, aged ≥60 years, in a Chinese city was included between August 2015 and March 2016. Construct validity was assessed using alternative measures corresponding to the TFI items, including self-rated health status (SRH), unintentional weight loss, walking speed, timed-up-and-go tests (TUGT), making telephone calls, grip strength, exhaustion, Short Portable Mental Status Questionnaire (SPMSQ), Geriatric Depression scale (GDS-15), emotional role, Adaptability Partnership Growth Affection and Resolve scale (APGAR) and Social Support Rating Scale (SSRS). Fried's phenotype and frailty index were measured to evaluate criterion validity. Adverse health outcomes (ADL and IADL disability, healthcare utilization, GDS-15, SSRS) were used to assess predictive (concurrent) validity. The internal consistency reliability was good (Cronbach's α=0.71). The test-retest reliability was strong (r=0.88). Kappa coefficients showed agreements between the TFI items and corresponding alternative measures. Alternative measures correlated as expected with the three domains of TFI, with an exclusion that alternative psychological measures had similar correlations with psychological and physical domains of the TFI. The Chinese TFI had excellent criterion validity with the AUCs regarding physical phenotype and frailty index of 0.87 and 0.86, respectively. The predictive (concurrent) validities of the adverse health outcomes and healthcare utilization were acceptable (AUCs: 0.65–0.83). The Chinese TFI has good validity and reliability as an integral instrument to measure frailty of older people living in the community in China.
ISSN:0167-4943
1872-6976
DOI:10.1016/j.archger.2017.07.001