The prediction of quality of life by physical, psychological and social components of frailty in community-dwelling older people

Purpose
To assess the predictive validity of the 15 components of the Tilburg Frailty Indicator (TFI), a self-report questionnaire, for quality of life domains physical health, psychological, social relations and environmental in community-dwelling older persons in a longitudinal study.
Methods
The predictive validity of the components of the TFI was tested in a sample of 484 community-dwelling persons aged 75 years and older in the Netherlands in 2008 (response rate 42 %). A subset of all respondents participated two years later, in 2010 (n = 261, 54 %), and a subset of these respondents participated again in 2012 (n = 196, 75 %). The WHOQOL-BREF was used for measuring four quality of life domains.
Results
Four physical frailty components (physical unhealthy, difficulty in maintaining balance, difficulty in walking and physical tiredness), one psychological frailty component (feeling down) and one social frailty component (lack of social support) predicted future scores on quality of life domains, even after controlling for background characteristics and diseases.
Conclusion
This longitudinal study showed that quality of life is predicted by physical as well as psychological and social frailty components. This finding emphasizes the relevance of a multidimensional assessment of frailty. To improve quality of life of older persons, special attention should go to the screening and subsequent interventions focusing on the frailty components difficulty in walking, feeling down and lack of social support.