Abstract
Objective
To cross-culturally adapt and test the FRAIL scale in Chinese community-dwelling older
adults.
Design
Cross-sectional study.
Methods
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.
Results
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).
Conclusions
The Chinese FRAIL scale presents acceptable validity and reliability and can apply
to Chinese community-dwelling older adults.
Keywords
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Article info
Publication history
Published online: July 28, 2017
Footnotes
L.D. and X.Q. contributed equally to this work.
The authors declare no conflicts of interest.
This work was supported by the National Natural Science Foundation of China (NSFC: 71673168).
Identification
Copyright
© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
