title: Explaining quality of life of older people in the Netherlands using a multidimensional assessment of frailty.
abstract: OBJECTIVE
  Although frailty was originally a medical concept, nowadays more and more researchers are convinced of its multidimensional nature, including a psychological and social domain of frailty as well as a physical domain. The objective of this study was to test the hypothesis that the prediction of quality of life by physical frailty components is improved by adding psychological and social frailty components.
  
  
  METHODS
  This cross-sectional study was carried out with a sample of Dutch citizens. A total of 1,031 people aged 65 years and older completed a Web-based questionnaire containing the Tilburg Frailty Indicator for measuring physical, psychological, and social frailty, and the WHOQOL-BREF for measuring four quality of life domains (physical health, psychological, social relations, environmental).
  
  
  RESULTS
  The findings show that the prediction of all quality of life domains by eight physical components of frailty was improved after adding four psychological and three social frailty components. The psychological frailty component 'feeling down' significantly improved the prediction of all four quality of life domains, after controlling for the effects of background characteristics and all other frailty components.
  
  
  CONCLUSIONS
  This study emphasizes the importance of a multidimensional assessment of frailty in the prediction of quality of life in older people.
authors.affiliation: Rotterdam University of Applied Sciences, PO Box 25035, 3001 HA, Rotterdam, The Netherlands, gobrj@hr.nl.
authors.forename: Robbert J J
authors.initials: RJ
authors.lastname: Gobbens
authors.forename: Katrien G
authors.initials: KG
authors.lastname: Luijkx
authors.forename: Marcel A L M
authors.initials: MA
authors.lastname: van Assen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D016330:Frail Elderly / Q000523:psychology* / Q000706:statistics & numerical data; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D009426:Netherlands; D011237:Predictive Value of Tests; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life; D012044:Regression Analysis; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations; D014944:World Health Organization