The Tilburg Frailty Indicator: A psychometric systematic review

Zamora-Sánchez, Juan-José; Urpí-Fernández, Ana-María; Sastre-Rus, Meritxell; Lumillo-Gutiérrez, Iris; Gea-Caballero, Vicente; Jódar-Fernández, Lina; Julián-Rochina, Iván; Zabaleta‐del‐Olmo, Edurne

doi:10.1016/j.arr.2022.101588

Cited by 7 publications

(14 citation statements)

References 75 publications

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“…This was also true for the Turkish validation [18] not included in this systematic review. Therefore, the adequacy of the factor structure of the TFI needs more attention, which is in line with the conclusions of the aforementioned review [22].…”

Section: Discussionsupporting

confidence: 73%

“…In addition, the Turkish CFA also had some limitations, as no information about the estimation method or the correlations among factors was provided. On the other hand, a recent systematic psychometric review [ 22 ] of this measurement instrument concludes that, despite the large number of validation studies available, it is necessary to continue accumulating evidence on metric properties such as the structural validity of this tool.…”

Section: Introductionmentioning

confidence: 99%

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Deepening the understanding of the structural validity of the Tilburg Frailty Indicator

et al. 2023

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Background Psychometric properties of the Tilburg Frailty Indicator (TFI) have shown low internal consistency for psychological and social domains, and evidence for its structure validity is controversial. Moreover, research on TFI is frequently limited to community dwellings. Aims To evaluate structural validity, reliability, and convergent and divergent validity of the Spanish version of the Tilburg Frailty Indicator (TFI) in both community-dwelling and institutionalized older people. Materials and methods A cross-sectional study was conducted on Spanish older adults (n = 457) recruited from both community settings (n = 322) and nursing homes (n = 135). Participants completed the TFI and other frailty instruments: Fried’s Frailty Phenotype, Edmonton Frailty Scale, FRAIL Scale, and Kihon Checklist (KCL). Confirmatory Factor Analysis (CFA), and reliability and validity coefficients were estimated. Results and discussion Some items from physical and social domains showed low factor loadings (< 0.40). The three-factor CFA model showed better fit indices after depurating these items. Reliability estimates were good (CRI ≥ 0.70) for physical and psychological domains in the institutionalized sample, while in the community dwellings, only physical domain reliability was adequate. Convergent and divergent validity of physical and psychological domains was good, except for some alternative psychological measures highly correlating with the TFI physical component (KCL-depressive mood and Edmonton mood). However, the social domain showed low correlations with some social indicators. Conclusion The findings of this study clarify some of the controversial validation results of the TFI structure and provide evidence to improve its use in psychometric terms. Clinical trial registration number NCT03832608.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Deepening the understanding of the structural validity of the Tilburg Frailty Indicator

et al. 2023

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“…Apart from the 12 items of the health assessment questionnaire for older adults, there are other tools that evaluate frailty from a comprehensive perspective: the Groningen Frailty Indicator, 22,23 Edmonton Frail Scale, 24,25 and Tilburg Frailty Indicator [26][27][28] in Europe; and the KCL 13,14 and Kaigo Yobo Checklist (KYCL) 29 in Japan. Yakabe et al reported that when using all 15 items in the health assessment questionnaire for old-old adults, the AUC for frailty discrimination of this questionnaire was calculated as 0.85 when they used the KCL as the gold standard for determining frailty.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Criterion validity of the health assessment questionnaire for the national screening program for older adults in Japan: The SONIC study

Hori

Ishizaki

Masui

et al. 2023

Geriatrics Gerontology Int

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Aim In our previous study, we proposed that the total score of the 12 frailty‐related items in the health assessment questionnaire for the national screening program for older adults could be used as an indicator of frailty. We aim to examine the criterion validity of the 12 frailty‐related items for frailty. Methods The data used in this study were from older Japanese individuals aged 78–81 years (n = 461) who participated in the in‐venue (2019) and mailed questionnaire (2020) surveys of the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study. A receiver operator characteristic (ROC) curve analysis was used to evaluate the criterion validity of the 12 frailty‐related items for frailty defined based on the Japanese version of the Cardiovascular Health Study criteria. A multivariable logistic regression model was used to examine the independent association of the 12 frailty‐related items with frailty. Results The area under the ROC curve of the scores of the 12 frailty‐related items for frailty was 0.79 (95% confidence interval [CI] = 0.73–0.85, P < 0.001). The cut‐off value for frailty was 3 and 4 points, and the sensitivity and specificity were 55.9% and 85.8%, respectively. The multivariable logistic regression model showed that four or more scores of the 12 frailty‐related items were significantly associated with frailty (adjusted odds ratio = 7.75, 95% CI = 4.10–14.65, P < 0.001). Conclusions The results of this study suggest that the 12 frailty‐related items in the health assessment questionnaire for older adults may be useful for assessing frailty in community‐dwelling older adults in a simplified manner. Geriatr Gerontol Int 2023; 23: 437–443.

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“…Although there are several validated frailty measurement tools [ 20 ], most of them have focused on the physical aspects of frailty. In addition to this questionnaire, only some comprehensively assessed the physical, psychological, and social aspects of frailty, such as the Groningen Frailty Indicator [ 21 , 22 , 23 ] from Germany, the Edmonton Frail Scale [ 24 , 25 ] from Canada, the Tilburg Frailty Indicator [ 26 , 27 , 28 ] from The Netherlands, and the Kihon Checklist [ 29 , 30 ] and Kaigo Yobo Checklist [ 31 ] from Japan. These comprehensive frailty assessment instruments were reported to examine convergent validity and/or concurrent validity and to compare their predictive validity: a comparison of predictive validity for disability between the Groningen Frailty Indicator and the Tilburg Frailty Indicator [ 32 ]; a comparison of predictive value for identifying frailty between the Groningen Frailty Indicator and the Tilburg Frailty Indicator [ 33 ]; an examination of the convergent validity between the electronic frailty index and the Edmonton Frail Scale [ 34 ]; a comparison of diagnostic test accuracy for identifying frailty among the Groningen Frailty Indicator, the Edmonton Frail Scale, and the Kihon Checklist [ 35 ]; a comparison of predictive value for frailty between the Kihon Checklist and the Kaigo Yobo Checklist [ 36 ]; an examination of convergent validity between the Kihon Checklist (Portuguese version) and the Edmonton Frail Scale [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Construct Validity of a New Health Assessment Questionnaire for the National Screening Program of Older Adults in Japan: The SONIC Study

Ishizaki

Masui

Nakagawa

et al. 2022

IJERPH

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The Japanese government has implemented a new screening program to promote measures to avoid worsening lifestyle-related diseases and frailty among the older population. In this effort, the government formulated a new health assessment questionnaire for the screening program of old-old adults aged ≥75 years. The questionnaire comprises 15 items, of which 12 address frailty, two address general health status, and one addresses smoking habits. This study examined the construct validity of this questionnaire, using the explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). The data used in this study were drawn from a mail-in survey conducted in 2020 as part of the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study. A total of 1576 respondents (range, 78–99 years of age) were included in the study. Although the EFA did not show an interpretable factor structure of the questionnaire with 15 items, the CFA using only 12 frailty-related items showed the goodness of fit for a higher-order factor “frailty”, and the five frailty-related sub-factors model was acceptable. These results suggest that the total score of the 12 frailty-related items in the questionnaire can be used as an indicator of the degree of “frailty”.

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The Tilburg Frailty Indicator: A psychometric systematic review

Cited by 7 publications

References 75 publications

Deepening the understanding of the structural validity of the Tilburg Frailty Indicator

Deepening the understanding of the structural validity of the Tilburg Frailty Indicator

Criterion validity of the health assessment questionnaire for the national screening program for older adults in Japan: The SONIC study

Construct Validity of a New Health Assessment Questionnaire for the National Screening Program of Older Adults in Japan: The SONIC Study

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