Cross-Cultural Adaptation and Validation of the FRAIL Scale in Chinese Community-Dwelling Older Adults.

To cross-culturally adapt and test the FRAIL scale in Chinese community-dwelling older adults. Cross-sectional study. The Chinese FRAIL scale was generated by translation and back-translation. An urban sample of 1235 Chinese community-dwelling older adults was enrolled to test its psychometric properties, including convergent validity, criterion validity, known-group divergent validity, internal consistency and test-retest reliability. The Chinese FRAIL scale achieved semantic, idiomatic, and experiential equivalence. The convergent validity was confirmed by statistically significant kappa coefficients (0.209-0.401, P < .001) of each item with its corresponding alternative measurement, including the 7th item of the Center for Epidemiologic Studies-Depression Scale, the Timed Up and Go test, 4-m walking speed, polypharmacy, and the Short-Form Mini Nutritional Assessment. Using the Fried frailty phenotype as an external criterion, the Chinese FRAIL scale showed satisfactory diagnostic accuracy for frailty (area under the curve = 0.91). The optimal cut-point for frailty was 2 (sensitivity: 86.96%, specificity: 85.64%). The Chinese FRAIL scale had fair agreement with the Fried frailty phenotype (kappa = 0.274, P < .001), and classified more participants into frailty (17.2%) than the Fried frailty phenotype (3.9%). More frail individuals were recognized by the Chinese FRAIL scale among older and female participants than their counterparts (P < .001), respectively. It had low internal consistency (Kuder-Richardson formula 20 = 0.485) and good test-retest reliability within a 7- to 15-day interval (intraclass correlation coefficient = 0.708). The Chinese FRAIL scale presents acceptable validity and reliability and can apply to Chinese community-dwelling older adults.

Dong L ，Qiao X ，Tian X ，Liu N ，Jin Y ，Si H ，Wang C ... -  《-》

Assessment of frailty in Saudi community-dwelling older adults: validation of measurements.

Alqahtani BA ，Nasser TA 《-》

Cross-cultural adaptation and validation of the FRAIL-NH scale for Chinese nursing home residents: A methodological and cross-sectional study.

Frailty is a common condition in older adults, and has a particularly high prevalence among nursing home residents. Therefore, it is essential to assess frailty in nursing homes. The FRAIL-NH scale is a brief, quick-to-complete, and user-friendly measurement tool. However, it has not been used in China, and further cross-cultural adaptation and validation need to be undertaken. To cross-culturally adapt and validate the FRAIL-NH scale for Chinese nursing home residents. Methodological and cross-sectional study. Twenty-seven nursing homes in Jinan, China. Older Chinese nursing home residents (n = 353, age ≥60 years, 197 women; 156 men). Interviewers obtained data on frailty, demographics, comorbidity, physical function, nutritional status, and self-rated health. The Chinese FRAIL-NH scale version was generated using the translation-backward translation method. Psychometric properties, including internal consistency, test-retest reliability, convergent validity, criterion validity, and diagnosis accuracy were evaluated. The FRAIL-NH scale showed acceptable internal consistency (Cronbach's alpha: 0.67) and satisfactory test-retest reliability within a 1- to 2-week interval (intraclass correlation coefficient: 0.84). As expected, the FRAIL-NH scale was correlated to the validated measurements, presenting convergent validity. Using the frailty phenotype as a reference criterion, the area under the curve was 0.79. The optimal cutoff point for frailty was 2 (sensitivity: 69.90% and 77.33%) in Chinese nursing homes. The FRAIL-NH scale was significantly associated with the frailty phenotype (correlation coefficient = 0.61, P < 0.001), but showed fair agreement with it (kappa = 0.46, p < 0.001). The FRAIL-NH scale was found to be suitable for frailty measurement with acceptable validity and reliability, and the optimal cutoff point for frailty was 2. The FRAIL-NH scale can be applied in Chinese nursing homes.

Zhao M ，Mou H ，Zhu S ，Li M ，Wang K ... -  《-》

Cross-cultural adaptation and validation of the Comprehensive Frailty Assessment Instrument in Chinese community-dwelling older adults.

To cross-culturally adapt and validate the Comprehensive Frailty Assessment Instrument (CFAI) among Chinese community-dwelling older adults. The Chinese CFAI was developed through forward-backward translations. An urban sample of 1235 community-dwelling older adults received face-to-face interviews to examine the validity (construct validity and criterion validity) and reliability (internal consistency and test-retest reliability). The Chinese CFAI achieved semantic and idiomatic equivalence, and showed acceptable reliability and an expected factor structure, except for the social support domain. The exploratory factor analysis extracted five factors explaining 53.8% of the total variance of frailty. The confirmatory factor analysis showed that the data fit well to the second-order factor theoretical model, with a root mean square error of approximation of 0.05, Tucker-Lewis Index of 0.93 and Comparative Fit Index of 0.95. The receiver operating characteristic analysis presented an acceptable criterion validity using the Rockwood Frailty Index as an external criterion (area under the curve 0.80), with balanced sensitivity (65.31%) and specificity (81.19%) at the optimal 39-point frailty cut-off of the CFAI. The Chinese CFAI has good validity and reliability as a practical frailty measure in Chinese community-dwelling older adults. Geriatr Gerontol Int 2018; 18: 301-307.

Qiao X ，Wang C ，Tian X ，Dong L ，Liu N ，Jin Y ，Si H ... -  《-》

Development of a Fried Frailty Phenotype Questionnaire for Use in Screening Community-Dwelling Older Adults.

The aim of this study was to develop a Fried Frailty Phenotype Questionnaire (FFPQ) and a Japanese FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight) scale (FRAIL-J) and to evaluate the reliability and validity of both questionnaires in Japanese community-dwelling older adults. Cross-sectional analysis of Itoshima Frail Study (IFS). The IFS is an ongoing community-based prospective study in Itoshima (Japan). A total of 858 older adults age 65-75 years. The FRAIL-J comprises 5 existing items comparable to those in original FRAIL scale but with broader utilization in the Japanese healthcare system. In FFPQ, resistance, ambulation, and loss of weight were the same as those in FRAIL-J. Fatigue was the same with exhaustion in FFP and inactivity was assessed using a yes or no question. Data including demographics, and physical and cognitive functions, and objective physical activity was collected and analyzed in relation to both questionnaires. The FFPQ and FRAIL-J showed low internal consistency (Kuder-Richardson formula 20 coefficients = 0.32 and 0.29) and good test-retest reliability (intraclass correlation coefficients = 0.79 and 0.72). The correlations ranged from -0.22 to 0.49 when correlating each item with cross-sectional outcomes. Using FFP as a criterion, the ares under the curve for FRAIL-J and FFPQ were 0.86 and 0.88, respectively. The optimal cut-off for FRAIL-J was 2, with a higher Youden index (66.7% vs 20.3% for 3) and a high negative predictive value (99.5%) but low positive predictive value (13.1%). As for FFPQ, either 2 or 3 was evaluated as cut-off because the Youden index (62.2% vs 58.5%) and negative predictive value (99.7% vs 99.2%) were similar although the positive predictive value was low (9.7% vs 33.3%). Using a 2-point cut-off, both questionnaires had slight agreement with FFP. The highest agreement (kappa = 0.42) was found between FFP and FFPQ using a 3-point cut-off. The FFPQ and FRAIL-J can be used for frailty screening in Japanese community-dwelling older adults.

Chen S ，Chen T ，Kishimoto H ，Susaki Y ，Kumagai S ... -  《-》