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The Predictive Validity of the Tilburg Frailty Indicator: Disability, Health Care Utilization, and Quality of Life in a Population at Risk
Open accessAbstract
PURPOSE: To assess the predictive validity of frailty and its domains (physical, psychological, and social), as measured by the Tilburg Frailty Indicator (TFI), for the adverse outcomes disability, health care utilization, and quality of life. DESIGN AND METHODS: The predictive validity of the TFI was tested in a representative sample of 484 community-dwelling persons aged 75 years and older in 2008 (response rate 42%). A subset of all respondents participated 1 year later (N = 336, 69%) and again 2 years later (N = 266, 55%). We used the TFI, the Groningen Activity Restriction Scale assessing disability, seven indicators of health care utilization, and a brief version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF). The WHOQOL-BREF was assessed in 2008 and 2010; all others were assessed in 2008, 2009, and 2010. RESULTS: The predictive validity of the TFI assessed in 2008 for disability, health care utilization, and quality of life was corroborated by (a) medium to very large associations of frailty with adverse outcomes 1 or 2 years later; (b) mostly good to excellent area under the curve of total frailty; and (c) an increase in predictive accuracy of most adverse outcomes, even after controlling for that same adverse outcome in 2008, and life-course determinants and multimorbidity. Physical frailty was mostly responsible for the predictive validity of the TFI. IMPLICATIONS: This study showed that the TFI is a valid instrument to predict disability, many indicators of health care utilization, and quality of life of older people, 1 and 2 years later.
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“The Groningen Frailty Indicator (102) and the Tilburg Frailty Indicator (103) are simple and similar (104) questionnaire based approaches to detecting people with frailty.”
From Frailty in elderly people (2013) · cites this paper as [104]
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Frailty in Older Adults: Evidence for a Phenotype
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The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons
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“Several other multi-dimensional instruments are currently available for measuring frailty in older persons, such as the Edmonton Frail Scale (Rolfson, Majumdar, Tsuyuki, Tahir, & Rockwood, 2006), the Frailty Index (Jones et al., 2004), and the Groningen Frailty Indicator (Schuurmans, Steverink,…”
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Clegg, A., Young, J., Iliffe, S., Rikkert, M. O., & Rockwood, K. (2013) · The Lancet · doi:10.1016/s0140-6736(12)62167-9 · Cited by 9,503
Frailty: implications for clinical practice and public health
Hoogendijk, E. O., Afilalo, J., Ensrud, K. E., Kowal, P. R., Onder, G., & Fried, L. P. (2019) · The Lancet · doi:10.1016/s0140-6736(19)31786-6 · Cited by 3,472
Cognitive frailty: Rational and definition from an (I.A.N.A./I.A.G.G.) International Consensus Group
Kelaiditi, E., Cesari, M., Canevelli, M., van Kan, G. A., Ousset, P., Guyonnet, S., Ritz, P., Duveau, F., Soto, M., Provencher, V., et al. (2013) · The journal of nutrition health & aging · doi:10.1007/s12603-013-0367-2 · Cited by 1,156
Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis
Vermeiren, S., Vella-Azzopardi, R., Beckwée, D., Habbig, A.-K., Scafoglieri, A., Jansen, B., Bautmans, I., Bautmans, I., Verté, D., Beyer, I., et al. (2016) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2016.09.010 · Cited by 1,068
Social frailty in older adults: a scoping review
Bunt, S., Steverink, N., Olthof, J., van der Schans, C. P., & Hobbelen, H. J. S. M. (2017) · European Journal of Ageing · doi:10.1007/s10433-017-0414-7 · Cited by 526
Metadata
- Authors
- Gobbens, R. J. J., van Assen, M. A. L. M., Luijkx, K. G., & Schols, J. M. G. A.
- Affiliations
- Tilburg University (NL)
- Corresponding author
- Gobbens, R. J. J.
- Venue
- The Gerontologist
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-01-04
- Volume
- 52
- Issue
- 5
- Pages
- 619-631
- ISSN
- 0016-9013 (ISSN-L)
- 1758-5341
- OpenAlex
- W2158875429
- Cited by
- 289
- References
- 48
- Citations by year
- 2026: 12 · 2025: 10 · 2024: 18 · 2023: 15 · 2022: 24 · 2021: 17 · 2020: 25 · 2019: 32 · 2018: 20 · 2017: 34 · 2016: 23 · 2015: 24 · 2014: 20 · 2013: 11 · 2012: 4
- FWCI
- 9.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Gerontologist (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Research portal (Tilburg University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- Tilburg Frailty Indicator, frailty, predictive validity, disability, health care utilization, quality of life, older adults, physical frailty, psychological frailty, social frailty, community-dwelling older adults, multimorbidity
- MeSH terms
- Aged, Aged, 80 and over, Disability Evaluation, Female, Persons with Disabilities, Health Services, Humans, Male, Netherlands, Predictive Value of Tests, Primary Health Care, Psychometrics, Quality of Life, Surveys and Questionnaires, Regression Analysis, Risk, Socioeconomic Factors, World Health Organization, Reproducibility of Results, Geriatric Assessment, Frail Elderly, Vulnerable Populations
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