The Tilburg Frailty Indicator (TFI): New Evidence for Its Validity
Received 21 December 2019
Accepted for publication 31 January 2020
Published 21 February 2020 Volume 2020:15 Pages 265—274
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Richard Walker
Robbert JJ Gobbens, 1–3 Petra Boersma, 1 Izabella Uchmanowicz, 4 Livia Maria Santiago 5
1Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands; 2Zonnehuisgroep Amstelland, Amstelveen, the Netherlands; 3Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; 4Division of Nursing in Internal Medicine Procedures, Department of Clinical Nursing, The Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland; 5Faculty of Medicine, Department of Speech and Language Pathology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Correspondence: Robbert JJ Gobbens
Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, De Boelelaan 1109, 1081 HV, Amsterdam, the Netherlands
Tel +31 6 21115578
Objective: The Tilburg Frailty Indicator (TFI) is a self-report user-friendly questionnaire for assessing multidimensional frailty among community-dwelling older people. The main aim of this study is to re-evaluate the validity of the TFI, both cross-sectionally and longitudinally, focusing on the predictive value of the total TFI and its physical, psychological, and social domains for adverse outcomes disability, indicators of healthcare utilization, and falls.
Methods: The validity of the TFI was determined in a sample of 180 Dutch community-dwelling older people aged 70 years and older. The participants completed questionnaires including the TFI, the Groningen Activity Restriction Scale (GARS) for assessing disability, and questions with regard to health care utilization and falls in 2016 and again one year later.
Results: The physical and psychological domains of the TFI were significantly correlated as expected with adverse outcomes disability, many indicators of healthcare utilization, and falls. Regression analyses showed that physical frailty was mostly responsible for the effect of frailty on the adverse outcomes. The cross-sectional and longitudinal predictive validity of total frailty with respect to disability and receiving personal care was excellent, evidenced by Areas Under the Curves (AUCs) > 0.8. In most cases, using the cut-off point 5 for total frailty ensured the best values for sensitivity and specificity.
Conclusion: The present study provided new, additional evidence for the validity of the TFI for assessing frailty in Dutch community-dwelling older people aiming to prevent or delay adverse outcomes, including disability.
Keywords: older people, frailty, disability, validity, Tilburg Frailty Indicator
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