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Chinese Version of Groningen Frailty Index: Validation in a Chinese Elderly Population

Author(s): Ray-Ling Luh, Shu Yu, Cheng-Hung Yang


Early recognition and assessment of frailty status in elderly is essential for clinical treatment. The standard frailty assessment tools normally include a comprehensive but timeconsuming geriatric assessment requiring special training. We translated the Groningen Frailty Indicator (GFI), a 15-item frailty screening tool, into Chinese language and validated the translated version.


The English version GFI was translated into Chinese following the Brislin’s forward and backward translation model, and validated in a group of community-dwelling elderly. Content validity index (CVI), confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were used to evaluate the content validity and construct validity, respectively. A total of 331 participants were recruited for construct validity and 54 of them were interviewed twice for the use of test-retest reliability. All statistical analyses were calculated using SPSS 18.0 for Windows.


The Chinese GFI demonstrated excellent test-retest reliability. The I-CVI values ranged from 0.83 to 1.0, and the S-CVI was 0.98. The EFA yielded a 4-factor structure and subsequent CFA results were satisfactory. Individual linear regressions showed that gender, age and marital status were associated with frailty.


The Chinese GFI is a valid and specific screening tool for frailty in Chinese population. A priority of preventive care in very old subjects is recommended with distinguished strategies in different genders according to our findings. Further investigation of possible reasons of lower frailty prevalence in Chinese population and necessity of additional items to increase sensitivity of the tool are warranted.

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