Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
University of Rijeka, Faculty of Medicine, Department of Social Medicine and Epidemiology, Rijeka, Croatia.
J Am Med Dir Assoc. 2020 Jun;21(6):772-779.e6. doi: 10.1016/j.jamda.2020.03.019. Epub 2020 May 6.
To assess the internal consistency, convergent and divergent validity, and concurrent validity of the Tilburg Frailty Indicator (TFI) within community-dwelling older people in Spain, Greece, Croatia, the Netherlands, and the United Kingdom.
Cross-sectional study.
Primary care and community settings.
In total, 2250 community-dwelling older people (60.3% women; mean age = 79.7 years; standard deviation = 5.7).
We assessed the reliability and validity of the full TFI as well as its physical, psychological, and social domains. Baseline data of the Urban Health Centers Europe project were used. The internal consistency was assessed with the Cronbach alpha. The convergent and divergent validity were assessed using Pearson correlation coefficients between the domains and alternative measures: the 12-item short-form, Groningen activity restriction scale, 5-item mental well-being scale of the 36-Item Short Form Survey, and the De Jong Gierveld loneliness scale. The concurrent validity was assessed by the area under the receiver operating characteristic curve with physically frail (Survey of Health, Ageing and Retirement in Europe-Frailty Instrument), loss of independence (Groningen activity restriction scale), limited function (Global Activity Limitation Index), poor mental health (5-item mental well-being scale of the 36-Item Short Form Survey), and feeling lonely (De Jong Gierveld loneliness scale) as criteria.
The internal consistency of the full TFI was satisfactory with the Cronbach alpha ≥0.70 in the total population and in each country. The internal consistency of the psychological and social domains was not satisfactory. The convergent and divergent validity of the physical, psychological, and social domains was supported by all the alternative measures in the total population and in each country. The concurrent validity of the full TFI and the physical, psychological, and social domains was supported with most area under the receiver operating characteristic curve ≥0.70 in the total population and in each country.
The TFI is a reliable and valid instrument to assess frailty in community-dwelling older people in Spain, Greece, Croatia, the Netherlands, and the United Kingdom.
评估蒂尔堡虚弱指数（TFI）在西班牙、希腊、克罗地亚、荷兰和英国的社区居住老年人中的内部一致性、收敛和发散有效性以及同时有效性。
横断面研究。
初级保健和社区环境。
共有 2250 名社区居住的老年人（60.3%为女性；平均年龄为 79.7 岁；标准差为 5.7）。
我们评估了完整的 TFI 的可靠性和有效性，以及其身体、心理和社会领域。使用欧洲城市卫生中心项目的基线数据。内部一致性用 Cronbach alpha 评估。收敛和发散有效性用各领域与替代措施之间的皮尔逊相关系数评估：12 项简短式健康调查、格罗宁根活动限制量表、36 项简短式健康调查的 5 项心理健康量表和 Jong Gierveld 孤独量表。同时有效性通过接收者操作特征曲线下面积评估，使用身体虚弱（欧洲调查健康、老龄化和退休-虚弱工具）、丧失独立性（格罗宁根活动限制量表）、功能受限（全球活动限制指数）、心理健康差（36 项简短式健康调查的 5 项心理健康量表）和孤独感（Jong Gierveld 孤独量表）作为标准。
TFI 的内部一致性在总人口和每个国家中用 Cronbach alpha ≥0.70 评估均令人满意。心理和社会领域的内部一致性则不够满意。在总人口和每个国家中，所有替代措施均支持身体、心理和社会领域的收敛和发散有效性。在总人口和每个国家中，大多数情况下，接收者操作特征曲线下面积≥0.70 支持 TFI 及其身体、心理和社会领域的同时有效性。
TFI 是评估西班牙、希腊、克罗地亚、荷兰和英国社区居住老年人虚弱状况的可靠且有效的工具。
