Multidimensional structure of the Groningen Frailty Indicator in community-dwelling older people

BMC Geriatrics

Nardi Steverink³  Wim P Krijnen⁵  Froukje Boersma⁴  Mathieu HG de Greef¹  Marie-Rose J van Lieshout²  Cees P van der Schans⁵  Annemiek Bielderman⁵ 

[1] Institute of Human Movement Sciences, University of Groningen, PO Box 1969, 9700 AD, Groningen, The Netherlands;Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands;Department of Sociology, University of Groningen, PO Box 1969, 9700 AD, Groningen, The Netherlands;Department of General Practice, Elderly Care Section University of Groningen, University Medical Center Groningen, PO Box 1969, 9700 AD, Groningen, The Netherlands;Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences, PO Box 3109, 9701 DC, Groningen, The Netherlands

关键词: Measurement;    Screening;    Older adults;    Frailty;   

Others  :  857471
DOI  :  10.1186/1471-2318-13-86

 received in 2013-04-25, accepted in 2013-08-15,  发布年份 2013

【 摘 要 】

Background

Due to the rapidly increasing number of older people worldwide, the prevalence of frailty among older adults is expected to escalate in coming decades. It is crucial to recognize early onset symptoms to initiate specific preventive care. Therefore, early detection of frailty with appropriate screening instruments is needed. The aim of this study was to evaluate the underlying dimensionality of the Groningen Frailty Indicator (GFI), a widely used self-report screening instrument for identifying frail older adults. In addition, criterion validity of GFI subscales was examined and composition of GFI scores was evaluated.

Methods

A cross-sectional study design was used to evaluate the structural validity, internal consistency and criterion validity of the GFI questionnaire in older adults aged 65 years and older. All subjects completed the GFI questionnaire (n = 1508). To assess criterion validity, a smaller sample of 119 older adults completed additional questionnaires: De Jong Gierveld Loneliness Scale, Hospital Anxiety Depression Scale, RAND-36 physical functioning, and perceived general health item of the EuroQol-5D. Exploratory factor analysis and Mokken scale analysis were used to evaluate the structural validity of the GFI. A Venn diagram was constructed to show the composition of GFI subscale scores for frail subjects.

Results

The factor structure of the GFI supported a three-dimensional structure of the scale. The subscales Daily Activities and Psychosocial Functioning showed good internal consistency, scalability, and criterion validity (Daily Activities: Cronbach’s α = 0.81, H_s = .84, r = −.62; Psychosocial Functioning: Cronbach’s α = 0.80, H_s = .35, r = −.48). The subscale Health Problems showed less strong internal consistency but acceptable scalability and criterion validity (Cronbach’s α = .57, H_s = .35, r = −.48). The present data suggest that 90% of the frail older adults experience problems in the Psychosocial Functioning domain.

Conclusions

The present findings support a three-dimensional factor structure of the GFI, suggesting that a multidimensional assessment of frailty with the GFI is possible. These GFI subscale scores produce a richer assessment of frailty than with a single overall sum GFI score, and likely their use will contribute to more directed and customized care for older adults.

【 授权许可】

   
2013 Bielderman et al.; licensee BioMed Central Ltd.

【 图 表 】

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