Ann Geriatr Med Res.  2021 Dec;25(4):294-300. 10.4235/agmr.21.0086.

Determination of an Optimal Frailty Cutoff Score of Tilburg Frailty Indicator and Frailty Associated Factors in Community-Dwelling Turkish Older Adults

  • 1Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Selcuk University, Konya, Turkey
  • 2Department of Geriatric Medicine, Adana City Training and Research Hospital, Adana, Turkey
  • 3School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
  • 4Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey


Frailty is a multidimensional and dynamic state that has adverse physical, psychological, and social outcomes. The Tilburg Frailty Indicator (TFI) has the most robust evidence of reliability and validity for assessing frailty. However, the characteristics of TFI have not been investigated in detail. This study aimed to set a cutoff score for frailty and evaluate frailty-associated factors in community-dwelling older adults.
This cross-sectional study assessed frailty according to both the TFI and Fried criteria. The Geriatric Depression Scale, basic and instrumental activities of daily living, and Hospital Anxiety and Depression Scale-Anxiety subscale were also implemented.
This study included 166 older adults. The area under the receiver operating characteristic curve was 0.735 (95% confidence interval, 0.648–0.823). A TFI cutoff point of 8, showed a sensitivity of 60% and specificity of 72.5% for the prediction of frailty (p<0.05). Frailty according to the TFI was more associated with the physical and psychological parameters, while frailty according to the Fried score was more closely related to the physical parameters (p<0.05).
The results of this study suggested an optimal TFI cutoff score of 8 as a frailty instrument in community-dwelling older adults. Additionally, the TFI included physical, psychological, and social aspects, thereby providing a multidimensional evaluation of frailty.


Older adults; Frailty; Tilburg Frailty Indicator
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