MEASUREMENT OF FRAILTY IN OLDER ADULTS: DEVELOPMENT AND PSYCHOMETRIC PROPERTIES OF THE COMPREHENSIVE FRAILTY ASSESSMENT INSTRUMENT (CFAI)

Scriptie/masterproef: Doctoral Thesis

Uittreksel

In this dissertation, the development of a new instrument for the detection of frailty in community-dwelling older people is elaborated. The starting point for this research project was that although Belgium is internationally recognized for its care system, yet 6.4% of community-dwelling older people report care shortages. Consequently, the current tools used for detection become questionable.

Prior to the development of the instrument, the literature was screened for useful theoretical and operational models. We used for this purpose the terms frailty and vulnerability. It was found (see Chapter 4), that although both concepts have contributed to the development of science regarding v
Frail and vulnerable older people, neither concepts were found to be useful for our purpose. The only operational definition that came close to our intentions was the Tilburg Frialty Indicator (TFI).

The conceptual model of the TFI was been used for the development of the CFAI. We only adjusted the operationalisation of frialty. Moreover, and this is new, a new domain, environment, was added. Indeed, although in many gerontological research projects the individual is moved away from the environment, with the CFAI we go the other way by introducing environmental indicators. In literature, the importance of housing and living conditions of the aged is stressed. Moreover, recently there is the phenomenon of 'aging in place', where older people stay as long as possible in their own homes, in their own environment.

The CFAI was validated on data from the Belgian Ageing Studies (BAS). From this large dataset of more than 70,000 community-dwelling older people, 33,692 respondents were selected. Only those respondents with no missing values on the CFAI were included. Respondents with suspicious answer patterns (eg agree with everything) were excluded from the dataset.

The CFAI showed itself as a valid and reliable instrument with good fit indices. The CFAI explained more than 63% of the variance in frailty and the CFAI and it subscales did well to scientific requirements.
The scale was validated against a golden standard. For this purpose we used the TFI. The CFAI and TFI correlated well and the convergent and divergent validity was demonstrated.

It can be concluded that with the CFAI a new detection tool has been developed. The CFAI aims to identify frailty in community-dwelling older persons. Often frailty is by invasive tests that usually take place in hospitals. In our opinion, it is impossible, given the aging population, to perform such studies on a large scale, not least for financial and organizational reasons. With the CFAI, a self-administered instrument, a wide screening can be performed. Afterwards and in consultation with the individual, interventions can be discussed and planned. The CFAI also allows to measure the evolution of frailty and / or the effectiveness of the interventions.
Datum Prijs2 jul 2013
TaalEnglish
BegeleiderDominique Verte (Promotor) & Jos Schols (Promotor)

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