Abstract
Background
The Tilburg frailty indicator (TFI) is a self-report measurement instrument which integrates the physical, psychological and social domains to assess frailty in older adults. The aim of this study was the adaptation of the TFI to a German version and testing of the psychometric properties.
Material and methods
This study surveyed 210 individuals aged 64–91 years living at home. The mean age of participants was M = 75.3±5.7 years with 62 % females. The internal consistency was tested with Cronbach’s alpha. The test-retest reliability was calculated after 20 weeks. The German TFI was validated using alternative measures for assessment of the quality of life, e.g. Eurohis-QoL-8 and short form health survey (SF-12), the patient health questionnaire (PHQ), the geriatric anxiety inventory short form (GAI-SF), the social support scale (F-Soz-U-K-14) and the resilience scale (RS-11).
Results
The internal consistency was acceptable with a value for Cronbach’s alpha of 0.67. The test-retest reliability was good after 5 months α = 0.87 (physical domain r = 0.85, psychological domain r = 0.75 and social domain r = 0.84). The inter-item correlations ranged between − 0.06 and 0.57. Correlations with alternative frailty measures showed good convergent and divergent validity.
Conclusion
This study showed acceptable psychometric properties of the German adaptation of the TFI which was found to be age and frailty sensitive. The results of the validity of the TFI support the three domains integrated in the frailty score. Further application and testing of the German TFI in primary care and clinical settings are suggested to consolidate the findings.
Zusammenfassung
Hintergrund
Der Tilburg Frailty Indicator (TFI) ist ein Selbstbeurteilungsinstrument, das die physischen, psychischen und sozialen Bereiche für das Assessment von Gebrechlichkeit bei älteren Erwachsenen integriert. Ziele dieser Studie sind die Anpassung des TFI auf eine deutsche Version und ein Test der psychometrischen Eigenschaften.
Methoden
Befragt wurden 210 selbstständig lebende Personen im Alter von 64 bis 91 Jahren. Das durchschnittliche Alter der Teilnehmer war M(SD) = 75,3 (5,7) Jahren, der Frauenanteil bei 62 %. Die interne Konsistenz wurde anhand von Cronbach’s α getestet. Die Retest-Reliabilität wurde nach 20 Wochen berechnet. Validiert wurde die deutsche Version des TFI mit alternativen Instrumenten zum Assessment von Lebensqualität (EUROHIS-QoL-8, SF-12), Depression und Angst (PHQ, GAI-SF), sozialer Unterstützung (F-Soz-U-K-14) und Resilienz (RS-11).
Ergebnisse
Die interne Konsistenz war mit Cronbach’s α = 0,67 akzeptabel. Die Retest-Reliabilität nach 5 Monaten erwies sich als gut α = 0,87 (r = 0,85, r= 0,75, r= 0,84 für den physischen, psychischen bzw. sozialen Bereich). Die Inter-Item-Korrelationen lagen zwischen − 0,06 und 0,57. Korrelationen mit alternativen Maßen der Gebrechlichkeit ergaben eine gute konvergente und divergente Validität.
Schlussfolgerungen
Die Studie wies akzeptable psychometrische Eigenschaften der deutschen Adaptation des TFI nach. Der TFI war sensitiv bezüglich Alter und Gebrechlichkeit, und die Ergebnisse der Validitätstestung stützen die 3 in den TFI integrierten Bereiche. Empfohlen wird eine weitere Anwendung und Erprobung der deutschen Version des TFI in der medizinischen Grundversorgung und in klinischen Studien, um die Ergebnisse zu konsolidieren.
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Acknowledgment
This research study was funded by the Federal Ministry of Education and Research Germany with the funding number (01ET100 2B).
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S. Freitag, S. Schmidt and R.J.J. Gobbens declare that there are no conflicts of interest.
All persons recruited in this study signed an informed consent and data were treated anonymously. Ethical approval was given by the medical chamber of Hamburg, the ethics committee of the University of Greifswald and in accordance with national law and the Helsinki Declaration of 1975 (in its current revised form).
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Freitag, S., Schmidt, S. & Gobbens, R. Tilburg frailty indicator. Z Gerontol Geriat 49, 86–93 (2016). https://doi.org/10.1007/s00391-015-0889-9
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DOI: https://doi.org/10.1007/s00391-015-0889-9