Validation of the Traditional Chinese Version of the Pittsburgh Fatigability Scale for Older Adults

ABSTRACT

Objectives

The Pittsburgh Fatigability Scale (PFS) is a self-administered 10-item tool to measure physical and mental fatigability in older adults. The aim of the current study was to validate the psychometric properties of the traditional Chinese version of PFS (TC-PFS).

Methods

We recruited 114 community-dwellingolder adults, where 35 were diagnosed with late-life depression (LLD), 26 with mild cognitive impairment (MCI), and 53 were cognitively normal (CN) from a larger community study of older adults. Statistical analyses were done separately for TC-PFS Physical and Mental subscales. Factor analysis was used for reliability, Cronbach’s alpha for internal consistency, Pearson’s correlation for construct validity, and group comparison for discriminative validity.

Results

Factor analysis revealed a two-factor structure for both the TC-PFS Physical and Mental subscales with high reliability (α = 0.89 and 0.89, respectively). Patients with LLD had the highest PFS scores, with 80.0% and 82.9% classified as having greater physical and mental fatigability. For concurrent validity, we found moderate associations with the vitality and physical functioning subscales of the 36-Item Short Form Health Survey. For convergent validity, TC-PFS showed moderate association with emotional-related psychometrics, particularly for the Physical subscale in those with LLD. In contrast, TC-PFS Mental subscale showed correlations with cognitive function, particularly in the MCI group.

Conclusions

Our results indicate that the TC-PFS is a valid instrument to measure perceived physical and mental fatigability in older Taiwanese adults.

Clinical implications: Perceived fatigability reflects the underlying physical, mental or cognitive function in older adults with or without depression.

KEYWORDS:

• Fatigability
• fatigue
• validity
• late-life depression
• cognitive function

Acknowledgments

We acknowledge Jinghui Ju, MBBBS, MPH for her technical assistance in the back-translation of the traditional Chinese version of the Pittsburgh Fatigability Scale.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors Contributions

CL and CKC have made substantial contributions to conception and design, analysis and interpretation of data, and drafting the manuscript. NWG and TG contributed to analyzing, interpreting, drafting and critical review and revision of the manuscript. YCW, YLC and YCS conducted surveys and collected the data from participants. CMH has a role for neuropsychological tasks design. All authors read and appr

Ethics declarations

All tasks in studies from human participants met the ethical standards of the Helsinki declaration and the amendments or general ethical standards. The institutional review board from Chang Gung Memorial Hospital approved the study (IRB number: 201600269B0 and 201600580B0). The inform and consent were obtained from each participant.

Additional information

Funding

Supported by (1) medical research grant [CRRPG2G0061/CRRPG2K0021] from Chang Gung Memorial Hospital and [NRRPG2H0031] from Ministry of Science and Technology, Taiwan to Chemin Lin and (2) the medical research grant [CRRPG2G0051/CRRPG2K0021] from Chang Gung Memorial Hospital to Chih-Ken Chen. The authors report no financial relationships with commercial interests. The original Pittsburgh Fatigability Scale development and validation was funded by the University of Pittsburgh Claude D. Pepper Older Americans Independence Center Research Registry and Developmental Pilot Grant [NIH P30 AG024827] and from the Intramural Research Program, National Institute on Aging, National Institutes of Health to Nancy W. Glynn. Theresa Gmelin is supported by the Epidemiology of Aging Training Grant at the University of Pittsburgh, [NIA T32-AG000181].