Recognizing Frailty Through Pictures: Turkish Validation of the Pictorial Fit–Frail Scale in Older Adults


Boz S., Dikmeer A., Tuna Dogrul R., Erdogan K., Gozukan G., Nevin Dagdemir A., ...Daha Fazla

MEDICINA (KAUNAS, LITHUANIA), cilt.62, sa.7, ss.1330-1340, 2026 (Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 62 Sayı: 7
  • Basım Tarihi: 2026
  • Doi Numarası: 10.3390/medicina62071330
  • Dergi Adı: MEDICINA (KAUNAS, LITHUANIA)
  • Derginin Tarandığı İndeksler: Health Research Premium Collection (ProQuest), Scopus, EMBASE, MEDLINE, Directory of Open Access Journals
  • Sayfa Sayıları: ss.1330-1340
  • Kocaeli Üniversitesi Adresli: Evet

Özet

Background and Objectives: This study aimed to translate and culturally adapt the Pictorial Fit–Frail Scale (PFFS) into Turkish and to evaluate its validity and reliability in older adults. Materials and Methods: The study included 156 community-dwelling older adults aged ≥ 65 years. Frailty status was determined using the Clinical Frailty Scale (CFS), and participants with a CFS ≥ 4 were classified as frail. All participants underwent the PFFS, Katz ADL, Lawton–Brody IADL, Short-Form Geriatric Depression Scale (GDS), Mini Nutritional Assessment—Short Form (MNA-SF), Standardized Mini-Mental State Examination (SMMSE), and Charlson Comorbidity Index (CCI). The reliability of the PFFS was assessed using internal consistency (Cronbach α), inter-rater reliability, and test–retest reliability (ICC); its construct validity was assessed using correlation analysis with the CFS. Furthermore, the diagnostic performance of PFFS in identifying frailty was analyzed using the ROC curve. Results: Of the 156 individuals participating in the study, 63.5% were women, and 89 individuals (57.1%) were frail. The Turkish version of PFFS showed high internal consistency (Cronbach α = 0.838). Inter-rater and test–retest reliability were found to be ICC = 0.995 and 0.996, respectively. A strong and positive correlation was found between PFFS and CFS scores (Spearman r = 0.760, p < 0.001). ROC analysis showed that PFFS had good performance in distinguishing frailty (AUC = 0.851, optimal cut-off ≥ 14; sensitivity = 69.7%, specificity = 83.6%). Frail individuals were older, had higher comorbidities, and showed greater dependence in activities of daily living. Conclusions: The Turkish version of the PFFS appears to be a reliable, valid, rapid, and multidimensional tool for assessing frailty in older adults. The PFFS can contribute to the effective assessment of frailty in clinical practice and research.