The psychometric qualities of the Groningen Frailty Indicator in Romanian community-dwelling old citizens

Background. Primary health care may play an important role in identifying persons at risk for frailty. The Groningen Frailty Indicator (GFI) is considered a valid instrument to assess frailty in old age. However, it is not tested yet in a different cultural context. The aim of this study is to analyse the construct, content and criterion validity of the GFI in independent-living old Romanians. Methods. Twenty-two GPs participated in this study. They have sent he GFI questionnaire to 215 patients of 65 years and over. The GPs assessed the frailty of the patients, independently from the questionnaire. Results. The mean age of the respondents was 74.9 years. The mean GFI score was 5.5 (SD 2.9). Three-quarters of the respondents fit into the 'moderate' or 'severe' frailty category. Citizens 80 years old and older scored higher in terms of frailty. Ninety-eight per cent of the respondents completed at least 75% of the GFI items. The construct validity was good (Cronbach's alpha 0.746). All the items contributed statistically significant to the total GFI score (content validity). The old citizens who were rated as frail by the GPs (criterion validity) had a higher GFI score Conclusion: This study showed the GFI to be a feasible and valid instrument to assess frailty in independent-living old Romanians. Compared with the Dutch old, the prevalence of frailty in independently living old Romanians is high. Further research is needed to determine the appropriate cut-off points in the GFI scores in different care systems.