Turkish Adaptation, Validity and Reliability of the Pictorial Fit–Frail Scale


Sırmatel Bücük P., Kilavuz A., Kayhan Kocak F. O., Cavdar S., SAVAŞ E. S., Demiral Yilmaz N.

Geriatrics and Gerontology International, cilt.26, sa.3, 2026 (SCI-Expanded, SSCI, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 3
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1111/ggi.70444
  • Dergi Adı: Geriatrics and Gerontology International
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, Abstracts in Social Gerontology, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
  • Anahtar Kelimeler: frailty, pictorial fit-frail scale, reliability, Turkish, validity
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Aim: This study aimed to translate, culturally adapt, and evaluate the psychometric properties, including feasibility, reliability, and validity, of the Pictorial Fit–Frail Scale (PFFS) in Turkish older adults (PFFS-TR). Methods: A multicenter methodological study was conducted with 202 older adults recruited from geriatrics outpatient clinics. The PFFS was translated and adapted using a six-step protocol. Psychometric analyses included Confirmatory Factor Analysis (CFA) for construct validity, Kendall's tau-b correlation with the Clinical Frailty Scale (CFS) for convergent validity, and Intraclass Correlation Coefficients (ICC) for test–retest and inter-rater reliability. Results: Mean age was 72.99 ± 6.36 years; 67.8% were female. The PFFS-TR demonstrated good internal consistency (α = 0.881) and excellent reliability, with ICCs of 0.97 for test–retest and 0.98 for inter-rater agreement. Convergent validity with the CFS was strong, showing a significant positive correlation (Kendall's tau-b = 0.629, p < 0.001). The scale also showed strong discriminative ability for CFS-defined frailty (AUC = 0.877). The CFA results indicated that the unidimensional model provided partial support for the scale's structure. While the CFI and TLI values were within acceptable ranges (Comparative Fit Index = 0.91, Tucker–Lewis Index = 0.90), the RMSEA was 0.12, reflecting a significant indicator of discordance that suggests the model shows limited fit. Higher PFFS-TR scores were significantly associated with older age, multimorbidity, hospitalization in past 6 months, using assistive devices, and falls. Conclusions: The PFFS-TR is highly suitable for routine use in various clinical and community settings where screening is required, due to its low literacy requirements, strong visual support, and quick administration. It is a psychometrically practical, reliable, and valid screening-first tool for identifying frailty in older adults in Türkiye, particularly prior to more advanced clinical assessment.