Development and validation of the Multidimensional Frailty Scale (EFM): Initial phases

INTRODUCTION: Although various instruments have been developed to assess frailty, they generally do not cover all its dimensions and have not demonstrated satisfactory psychometric properties. The aim of this study was to develop the Multidimensional Frailty Scale, originally called the Escala de Fragilidad Multidimensional (EFM), to assess the physical, cognitive, affective, social, and environmental dimensions of frailty in individuals aged 65 and over and to conduct the initial phases of the validation process. This was carried out over the course of three sequential studies. METHODS: A series of items were developed for each dimension and then evaluated by a panel of 13 experts. Subsequently, cognitive interviews were conducted with a sample of 23 older adults to examine the response processes. Finally, a pilot study was performed with a sample of 50 individuals aged between 65 and 98 years. RESULTS: The panel of experts awarded the items a mean appropriateness rating of between 3.18 and 4 out of 4. The cognitive interviews provided insight into response processes and comprehension difficulties. The corrected item-dimension correlations ranged between .02 and .83. Based on the results obtained in the three studies, some items were removed. Following these modifications, the internal consistency of the five dimensions ranged between .71 and .90. CONCLUSIONS: The results of this study enabled the first version of the EFM to be refined, obtaining satisfactory internal consistency and item functioning indexes.