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

Annemiek Bielderman, Cees van der Schans, M.R. van Lieshout, Mathieu de Greef, F. Boersma, Wim Krijnen, N. Steverink

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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, Hs = .84, r = -.62; Psychosocial Functioning: Cronbach's α = 0.80, Hs = .35, r = -.48). The subscale Health Problems showed less strong internal consistency but acceptable scalability and criterion validity (Cronbach's α = .57, Hs = .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.
Original languageEnglish
Number of pages9
JournalBMC geriatrics
Volume22
Issue number13
DOIs
Publication statusPublished - 2013

Keywords

  • older people
  • frailty

Cite this

@article{cb4b26be28174361997481c09df2c31b,
title = "Multidimensional structure of the Groningen Frailty Indicator in community-dwelling older people.",
abstract = "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, Hs = .84, r = -.62; Psychosocial Functioning: Cronbach's α = 0.80, Hs = .35, r = -.48). The subscale Health Problems showed less strong internal consistency but acceptable scalability and criterion validity (Cronbach's α = .57, Hs = .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.",
keywords = "kwetsbare ouderen, oudere volwassenen, older people, frailty",
author = "Annemiek Bielderman and {van der Schans}, Cees and {van Lieshout}, M.R. and {de Greef}, Mathieu and F. Boersma and Wim Krijnen and N. Steverink",
year = "2013",
doi = "10.1186/1471-2318-13-86",
language = "English",
volume = "22",
journal = "BMC geriatrics",
issn = "1471-2318",
publisher = "BioMed Central",
number = "13",

}

Multidimensional structure of the Groningen Frailty Indicator in community-dwelling older people. / Bielderman, Annemiek; van der Schans, Cees; van Lieshout, M.R. ; de Greef, Mathieu; Boersma, F.; Krijnen, Wim; Steverink, N. .

In: BMC geriatrics, Vol. 22, No. 13, 2013.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Multidimensional structure of the Groningen Frailty Indicator in community-dwelling older people.

AU - Bielderman, Annemiek

AU - van der Schans, Cees

AU - van Lieshout, M.R.

AU - de Greef, Mathieu

AU - Boersma, F.

AU - Krijnen, Wim

AU - Steverink, N.

PY - 2013

Y1 - 2013

N2 - 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, Hs = .84, r = -.62; Psychosocial Functioning: Cronbach's α = 0.80, Hs = .35, r = -.48). The subscale Health Problems showed less strong internal consistency but acceptable scalability and criterion validity (Cronbach's α = .57, Hs = .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.

AB - 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, Hs = .84, r = -.62; Psychosocial Functioning: Cronbach's α = 0.80, Hs = .35, r = -.48). The subscale Health Problems showed less strong internal consistency but acceptable scalability and criterion validity (Cronbach's α = .57, Hs = .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.

KW - kwetsbare ouderen

KW - oudere volwassenen

KW - older people

KW - frailty

U2 - 10.1186/1471-2318-13-86

DO - 10.1186/1471-2318-13-86

M3 - Article

VL - 22

JO - BMC geriatrics

JF - BMC geriatrics

SN - 1471-2318

IS - 13

ER -