Assessing Frailty with the Tilburg Frailty Indicator (TFI): A Review of Reliability and Validity

• Main Authors: Gobbens RJ, Uchmanowicz I
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-05-01
• Series: Clinical Interventions in Aging
• Subjects: older people; frailty; tilburg frailty indicator; reliability; validity
• Online Access: https://www.dovepress.com/assessing-frailty-with-the-tilburg-frailty-indicator-tfi-a-review-of-r-peer-reviewed-fulltext-article-CIA

Robbert J Gobbens,1– 3 Izabella Uchmanowicz4 1Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands; 2Zonnehuisgroep Amstelland, Amstelveen, the Netherlands; 3Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; 4Division of Nursing in Internal Medicine Procedures, Department of Clinical Nursing, The Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, PolandCorrespondence: Robbert J GobbensFaculty of Health, Sports and Social Work, Inholland University of Applied Sciences, De Boelelaan 1109, Amsterdam, 1081 HV, The NetherlandsTel [phone]Email [e-mail]: The Tilburg Frailty Instrument (TFI) is an instrument for assessing frailty in community-dwelling older people. Since its development, many studies have been carried out examining the psychometric properties. The aim of this study was to provide a review of the main findings with regard to the reliability and validity of the TFI.Methods: We conducted a literature search in the PubMed and CINAHL databases on May 30, 2020. An inclusion criterion was the use of the entire TFI, part B, referring to the 15 components. No restrictions were placed on language or year of publication.Results: In total, 27 studies reported about the psychometric properties of the TFI. By far, most of the studies (n = 25) were focused on community-dwelling older people. Many studies showed that the internal consistency and test–retest reliability are good, which also applies for the criterion and construct validity. In many studies, adverse outcomes of interest were disability, increased health-care utilization, lower quality of life, and mortality. Regarding disability, studies predominantly show results that are excellent, with an area under the curve (AUC) > 0.80. In addition, the TFI showed good associations with lower quality of life and the findings concerning mortality were at least acceptable. However, the association of the TFI with some indicators of health-care utilization can be indicated as poor (eg, visits to a general practitioner, hospitalization).Conclusion: Since population aging is occurring all over the world, it is important that the TFI is available and well known that it is a user-friendly instrument for assessing frailty and its psychometric properties being qualified as good. The findings of this assessment can support health-care professionals in selecting interventions to reduce frailty and delay its adverse outcomes, such as disability and lower quality of life.Keywords: older people, frailty, Tilburg Frailty Indicator, reliability, validity