title: Measuring frailty in Dutch community-dwelling older people: Reference values of the Tilburg Frailty Indicator (TFI).
abstract: The objectives of this study were to provide reference values of the Tilburg Frailty Indicator (TFI) for community-dwelling older people by age, sex, marital status, ethnicity, education, income, and residence, and examine the effects of these seven socio-demographic variables on frailty.
  
  
  
  47,768 individuals aged 65 years and older living in the Netherlands completed a health questionnaire (58.5% response rate), including the TFI. The TFI is a self-report questionnaire for measuring frailty, developed from an integral approach of frailty, including physical, psychological, and social domains.
  
  
  
  Reference values were provided for men and women separately, as a function of age. We found associations of all socio-demographic variables with frailty, also after controlling for the effects of age. These associations held for both sexes and for big cities as wells as more rural areas. For instance, the effect of age was large for total and physical frailty, women were more frail than men, and some very large average frailty differences between the ethnic groups were found, with autochthon people having the lowest frailty score.
  
  
  
  In conclusion, this study offers reference values of the TFI by socio-demographic characteristics and explains frailty using these characteristics. This information will support researchers, policymakers and health care professionals in interpreting scores of the TFI, which may guide their efforts to reduce frailty and its adverse outcomes.
authors: Department of Methodology and Statistics, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands; Department of Sociology, Utrecht University, Utrecht, The Netherlands.
authors: Marcel A L M
authors: MA
authors: van Assen
authors: Department of Health Promotion, Regional Public Health Service, Hart voor Brabant, 's-Hertogenbosch, The Netherlands.
authors: Esther
authors: E
authors: Pallast
authors: Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands.
authors: Fatima El
authors: FE
authors: Fakiri
authors: Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands; Zonnehuisgroep Amstelland, Amstelveen, The Netherlands. Electronic address: robbert.gobbens@inholland.nl.
authors: Robbert J J
authors: RJ
authors: Gobbens
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly / Q000523:psychology / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D008403:Mass Screening; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011594:Psychometrics / Q000379:methods; D012016:Reference Values; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Community-dwelling older people; Ethnicity; Frailty; Reference values; Socio-demographic variables; Tilburg Frailty Indicator (TFI)