June 23, 2013

Gobbens et al. performed a study to assess the predictive validity of the eight individual self-reported components of the physical frailty subscale of the Tilburg Frailty Indicator (TFI) [1] for activities of daily living (ADL) and instrumental activities of daily living (IADL) disability.

This longitudinal study was carried out with a sample of Dutch citizens consisting at baseline of 429 people aged 65 years and older. A subset of all respondents participated again two and a half years later (N=356, 83% response rate). Respondents completed a web-based questionnaire comprising the TFI and the Groningen Activity Restriction Scale for measuring disability.

Five components (unintentional weakness, weakness, poor endurance, slowness, and low physical activity) together, referring to the Fried phenotype [2], predicted disability, even after controlling for previous disability and other background characteristics. The other three components of the physical frailty subscale of the TFI (poor balance, poor hearing, and poor vision) together did not predict disability. Low physical activity predicted both total and ADL disability, and slowness both total and IADL disability.

The authors concluded that self-report assessment using the physical subscale of the TFI aids the prediction of future ADL and IADL disability in older persons two and a half years later.


1. Gobbens RJ, van Assen MA, Luijkx KG, Schols JM. The predictive validity of the Tilburg Frailty Indicator: disability, health care utilization, and quality of life in a population at risk. Gerontologist 2012;52:619-31.

2. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146-56.