Abstract BACKGROUND: Frailty is often measured by the Fried criteria, which state that a person is frail when three or more of the following criteria are met: weight loss, exhaustion, diminished...Show moreAbstract BACKGROUND: Frailty is often measured by the Fried criteria, which state that a person is frail when three or more of the following criteria are met: weight loss, exhaustion, diminished physical activity, diminished gait speed and diminished grip strength. Validated screening instruments are the Groningen Frailty Indicator (GFI) and the Tilburg Frailty Indicator (TFI). Within the psychiatric population little is known about the psychometric properties of these screening instruments. OBJECTIVES: The aim of this study is to determine the internal consistency, sensitivity, specificity, positive predictive value, negative predictive value, area under the curve of the receiver operating characteristics curve and the underlying dimensionality of the GFI and TFI in older psychiatric patients. METHODS: The present study only uses cross-sectional baseline data. Among 190 patients of 65 years and older the GFI, TFI and Fried criteria were administered. RESULTS: The internal consistencies, measured by the Cronbach’s alpha, of the GFI and TFI were 0.76 and 0.74, respectively. The AUC was 0.80 for the GFI and 0.79 for the TFI. With the best-fitting cut-offs the sensitivity of the GFI was 0.72 and the specificity was 0.71. The positive and negative predictive values were 0.63 and 0.82, respectively. The sensitivity of the TFI was 0.85 and specificity was 0.60. The positive predictive value was 0.70 and the negative predictive value was 0.76. The factor analysis showed that the GFI has a fourdimensional structure and the TFI has a three-dimensional structure. CONCLUSIONS: The present findings show moderate psychometric outcomes of the GFI and TFI among the psychiatric population. However, the outcomes do show clearly that the cut-offs for the psychiatric population should be higher than for the general population.Show less
This research has focussed on frailty and stress in the late medieval and early modern populations of the Broerenkerk in Zwolle and the Eusebiuskerk in Arnhem, in order to understand how stress...Show moreThis research has focussed on frailty and stress in the late medieval and early modern populations of the Broerenkerk in Zwolle and the Eusebiuskerk in Arnhem, in order to understand how stress affected individuals from different sexes, age categories, and status. To understand this, three methods were used: linear enamel hypoplasia, cribra orbitalia, and porotic hyperostosis. In total, 84 skeletons were analysed. The populations have been analysed with each other as well as on their own. The methods have been compared to each other to understand whether they might relate to each other and whether it was likely that they occurred within a skeleton simultaneously. Results showed that there was no statistical significance within or between the sex and age-at-death categories within and between the populations, except for the cribra orbitalia results between the population of the Eusebiuskerk and the Broerenkerk. This has been linked to status: the population buried in the Broerenkerk was of a higher status than the population of the Eusebiuskerk. Although they were likely not extremely rich, as illustrated by the job names presented on the covering slabs, they likely had better access to food. The population of the Eusebiuskerk was likely to be of a very poor status due to trade tokens found with the individuals and because they were buried in the northern church grounds. The fact that the individuals from Zwolle showed less linear enamel hypoplasia might be the result of them experiencing less long term stress. Poor individuals lived close together in guesthouses, which means that illnesses could spread faster. So, it is clear that stress affected statuses differently, and that individuals from Arnhem were more fragile as a result. Yet, care must be taken as limitations are present.Show less
