JMIR Publications

ABSTRACT

Background:

Portugal is facing the challenge of population ageing, resulting in a notable increase in the proportion of older individuals. This has positioned the country among those in Europe with a high prevalence of frailty. Frailty, a geriatric syndrome characterized by diminished physiological reserve and heightened vulnerability to stressors, imposes a substantial burden on public health. It escalates the risks of adverse outcomes, including falls, hospitalization, disability, and mortality.

Objective:

This exploratory research focuses on two primary objectives. First, it involves the translation and psychometric evaluation of the European Portuguese version of the Groningen Frailty Indicator (GFI). Second, it entails the development and evaluation of the FRAILSURVEY app, a novel assessment tool for frailty based on the GFI.

Methods:

The study encompasses two major phases: the initial translation and validation of the GFI into European Portuguese and the development of the FRAILSURVEY app, followed by an examination of its validity and reliability compared to the conventional paper version of the GFI. For this, a randomized repeated crossover design was employed using the paper form of the Groningen Frailty Indicator and the smartphone application FRAILSURVEY.

Results:

The meticulous translation process yields a final version of the GFI with robust psychometric properties, ensuring clarity and comprehensibility. The study includes 522 participants, predominantly women (n=367, 70.3%), with an average age of 73.7 ± 6.7 years. Psychometric evaluation of the European Portuguese GFI in paper form demonstrates good reliability (internal consistency: Cronbach's alpha 0.759; temporal stability: ICC 0.974) and construct validity (revealing a four-dimensional structure explaining 56.0% of variance). Evaluation of the app-based European Portuguese GFI indicates good reliability (inter-instrument reliability: Cohen’s Kappa=0.790; temporal stability: ICC=0.800) and concurrent validity (r=0.694, p<0.001).

Conclusions:

The study’s main hypothesis proposed that participants would perceive both the smartphone application and paper version of the GFI as feasible and acceptable for use, with the smartphone app not being inferior to the standard paper version. The findings supported this hypothesis, as FRAILSURVEY exhibited comparable validity and reliability to its paper counterpart. FRAILSURVEY employs a standardized and validated assessment tool, offering objective and consistent measurements while eliminating subjective biases, enhancing accuracy, and ensuring reliability. This app holds promising potential for aiding healthcare professionals in identifying frailty in older individuals, enabling early intervention, and improving the management of adverse health outcomes associated with this syndrome.