Cross-Cultural Adaptation, Validity, and Reliability Testing of the Tilburg Frailty Indicator (TFI) Amharic Version for Screening Frailty in Community-Dwelling Ethiopian Older People

Figures & data

Table 1 Sociodemographic Characteristics of the Study Participants, 2022 (n = 96)

Variables		Non-Frail (n, %)	Frail (n, %)	Total (n, %)
Sex	Male	16 (47.1)	18 (52.9)	34 (35.4)
	Female	27 (43.5)	35 (56.5)	62 (64.6)
Age	=< 64	26 (49.1)	27 (50.9)	53 (55.2)
	≥ 65	17 (39.5)	26 (60.5)	43 (44.8)
Education	Cannot read or write	9 (50.0)	9 (50.0)	18 (18.8)
	Able to read and write with no formal education	23 (36.5)	40 (63.5)	63 (65.5)
	Primary school completed	8 (72.7)	3 (27.3)	11 (11.5)
	High school and above	3 (75.0)	1 (25.0)	4 (4.2)
Living arrangement	With spouse	28 (45.2)	34 (54.8)	62 (64.6)
	With children	4 (40.0)	6 (60.0)	10 (10.4)
	With both spouse and children	7 (70.0)	3 (30.0)	10 (10.4)
	Alone	4 (28.6)	10 (71.4)	14 (14.6)
Caregiver/assistant	Yes	37 (46.3)	43 (53.8)	80 (83.3)
	No	6 (37.5)	10 (62.5)	16 (16.7)

Table 2 Content Validity of the TFI-AM, 2022

Item No.	Item Description	I-CVI for the Instrument TFI-AM Version							I-CVI
		Ept 1	Ept 2	Ept 3	Ept 4	Ept 5	Ept 6	Number of Agreements
Item 1	አሁን ባሉበት ሁኔታ አካላዊ ጤንነት ይሰማዎታል? Do you feel physically healthy in your current state?	4	3	4	4	4	4	6	1
Item 2	ያለፍላጎትዎ ብዙ የክብደት መቀነስ አሳይተዋል? (ብዙ ማለትም 6ኪ.ግ ወይም ከዚያ በላይ ባለፉት ስድስት ወራት ውስጥ ወይም 3ኪ.ግ እና ከዚያ በላይ ባለው የመጨረሻ ወር ጊዜ ውስጥ) Have you recently lost a lot of unwanted weight? (a lot means 6 kg or more in the last six months or 3 kg or more in the last month)	3	4	4	4	4	4	6	1
Item 3	በመራመድ ችግር ምክንያት በቀን ከቀን እንቅስቃሴዎ (ተግባርዎ) ላይ እክል/ችግር አጋጥሞዎት ያውቃል? Have you ever had problems with your daily activities due to difficulty in walking?	4	4	4	3	4	4	6	1
Item 4	የሰውነት ሚዛንዎን ጠብቆ ማቆየት ባለመቻል ምክንያት በቀን ከቀን እንቅስቃሴዎ (ተግባርዎ) ላይ እክል/ችግር አጋጥሞዎት ያውቃል? Have you ever had problems with your daily activities due to difficulties in maintaining your balance?	4	4	3	4	4	3	6	1
Item 5	በድምፅ መስማት መቀነስ ምክንያት በቀን ከቀን እንቅስቃሴዎ (ተግባርዎ) ላይ እክል/ችግር አጋጥሞዎት ያውቃል? Have you ever had a problem with your daily activities due to poor hearing?	3	3	4	2	4	3	5	0.83
Item 6	በዓይንዎ እይታ መቀነስ ምክንያት በቀን ከቀን እንቅስቃሴዎ (ተግባርዎ) ላይ እክል/ችግር አጋጥሞዎት ያውቃል? Have you ever had problems with your daily activities due to poor vision?	3	2	3	3	4	3	5	0.83
Item 7	በእጆችዎ ጥንካሬ ማነስ ምክንያት በቀን ከቀን እንቅስቃሴዎ (ተግባርዎ) ላይ እክል/ችግር አጋጥሞዎት ያውቃል? Have you ever had a problem with your daily activities due to a lack of strength in your hands?	4	3	4	4	2	4	5	0.83
Item 8	በአካላዊ ድካም ምክንያት በቀን ከቀን እንቅስቃሴዎ (ተግባርዎ) ላይ እክል/ችግር አጋጥሞዎት ያውቃል? Have you ever had problems with your daily activities due to physical tiredness?	4	3	4	4	4	4	6	1
Item 9	የማስታወስ ችሎታዎ ላይ ችግሮች አሉብዎት? Do you have problems with your memory?	4	4	4	4	2	4	5	0.83
Item 10	ባለፈው አንድ ወር ውስጥ የመጨነቅ ስሜት ተሰምቶዎት ያውቃል? Have you ever felt down in the last month?	4	4	4	4	4	4	6	1
Item 11	ባለፈው አንድ ወር ውስጥ ብስጭት ተሰምቶዎት ያውቃል? Have you ever felt nervous in the last month?	4	2	4	3	4	4	5	0.83
Item 12	የሚፈጠሩ ችግሮችን እና ሁኔታዎችን በጥሩ ሁኔታ መቋቋም ይችላሉ? Can you cope problems and situations well?	3	3	4	2	4	4	5	0.83
Item 13	ብቻዎን ነው ሚኖሩት? Do you live alone?	4	4	4	4	4	4	6	1
Item 14	አንዳንድ ጊዜ በአካባቢዎ ያሉ ሰዎችን አጥተው ወይም ናፍቀው ያዉቃሉ? Do you sometimes miss people around you?	4	4	4	3	3	2	5	0.83
Item 15	ከሌሎች ሰዎች በቂ ማህብራዊ ድጋፍ ያገኛሉ? Do you get enough social support from other people?	2	4	4	4	4	4	5	0.83
Ept: Expert, I-CVI: Item level content validity index, S-CVI/Ave: Total content validity index average for the scale, TFI-AM: Tilburg Frailty Indicator Amharic Version							S-CVI/Ave		0.91
							Total Agreement		7

Table 3 Statistical Characteristics and the Reliability of Items of the Amharic Version of the Tilburg Frailty Indicator (TFI-AM), 2022

Item	Variables in the Domain	Mean ± SD	Corrected Item-Total Correlation
	Physical Domain/Physical Frailty	3.36 ± 2.06
1	አሁን ባሉበት ሁኔታ አካላዊ ጤንነት ይሰማዎታል? Do you feel physically healthy in your current state?	0.58 ± 0.49	0.36
2	ያለፍላጎትዎ ብዙ የክብደት መቀነስ አሳይተዋል? (ብዙ ማለትም 6ኪ.ግ ወይም ከዚያ በላይ ባለፉት ስድስት ወራት ውስጥ ወይም 3ኪ.ግ እና ከዚያ በላይ ባለው የመጨረሻ ወር ጊዜ ውስጥ) Have you recently lost a lot of unwanted weight? (a lot means 6 kg or more in the last six months or 3 kg or more in the last month)	0.36 ± 0.48	0.43
3	በመራመድ ችግር ምክንያት በቀን ከቀን እንቅስቃሴዎ (ተግባርዎ) ላይ እክል/ችግር አጋጥሞዎት ያውቃል? Have you ever had problems with your daily activities due to difficulty in walking?	0.31 ± 0.46	0.42
4	የሰውነት ሚዛንዎን ጠብቆ ማቆየት ባለመቻል ምክንያት በቀን ከቀን እንቅስቃሴዎ (ተግባርዎ) ላይ እክል/ችግር አጋጥሞዎት ያውቃል? Have you ever had problems with your daily activities due to difficulties in maintaining your balance?	0.44 ± 0.49	0.37
5	በድምፅ መስማት መቀነስ ምክንያት በቀን ከቀን እንቅስቃሴዎ (ተግባርዎ) ላይ እክል/ችግር አጋጥሞዎት ያውቃል? Have you ever had a problem with your daily activities due to poor hearing?	0.43 ± 0.49	0.39
6	በዓይንዎ እይታ መቀነስ ምክንያት በቀን ከቀን እንቅስቃሴዎ (ተግባርዎ) ላይ እክል/ችግር አጋጥሞዎት ያውቃል? Have you ever had problems with your daily activities due to poor vision?	0.47 ± 0.50	0.55
7	በእጆችዎ ጥንካሬ ማነስ ምክንያት በቀን ከቀን እንቅስቃሴዎ (ተግባርዎ) ላይ እክል/ችግር አጋጥሞዎት ያውቃል? Have you ever had a problem with your daily activities due to a lack of strength in your hands?	0.35 ± 0.48	0.59
8	በአካላዊ ድካም ምክንያት በቀን ከቀን እንቅስቃሴዎ (ተግባርዎ) ላይ እክል/ችግር አጋጥሞዎት ያውቃል? Have you ever had problems with your daily activities due to physical tiredness?	0.42 ± 0.49	0.40
	Psychological domain/Psychological frailty	1.32 ± 1.17
9	የማስታወስ ችሎታዎ ላይ ችግሮች አሉብዎት? Do you have problems with your memory?	0.39 ± 0.48	0.60
10	ባለፈው አንድ ወር ውስጥ የመጨነቅ ስሜት ተሰምቶዎት ያውቃል? Have you ever felt down in the last month?	0.43 ± 0.49	0.49
11	ባለፈው አንድ ወር ውስጥ ብስጭት ተሰምቶዎት ያውቃል? Have you ever felt nervous in the last month?	0.27 ± 0.44	0.50
12	የሚፈጠሩ ችግሮችን እና ሁኔታዎችን በጥሩ ሁኔታ መቋቋም ይችላሉ? Can you cope problems and situations well?	0.24 ± 0.43	0.34
	Social domain/Social frailty	1.07 ± 0.42
13	ብቻዎን ነው ሚኖሩት? Do you live alone?	0.09 ± 0.29	0.30
14	አንዳንድ ጊዜ በአካባቢዎ ያሉ ሰዎችን አጥተው ወይም ናፍቀው ያዉቃሉ? Do you sometimes miss people around you?	0.50 ± 0.50	0.17
15	ከሌሎች ሰዎች በቂ ማህብራዊ ድጋፍ ያገኛሉ? Do you get enough social support from other people?	0.48 ± 0.50	0.38