Tilburg Frailty Indicator (TFI) Questionnaire was developed at Tilburg University in Holland. It uses a multidimensional method which measures the impact of health, social circumstances, income and even education levels attained on the risk of developing frailty.


The TFI is validated to identify frailty in community settings, and predict health care utilisation and quality of life by older people living with frailty.  The questionnaire can be filled by non-medical care workers or the individual being assessed as it does not require any specialist medical knowledge to use.  It can therefiore be used as a population-based approach for identifying frailty, for example by sending the questionnaire to all individuals on the GP practice list over the age of 75.  An example of this approach is included in the Over 75s screening project case study .  It does have limitations as those who complete the TFI questionnaire under these circumstances are likely to be more motivated and less congitively and physically impaired (or have more engaged family and carers) than those who do not complete the questionnaire.

Originally written in Dutch, the TFI has been translated into a number of languages.  It is made up of 25 questions.  Part A (questions 1 – 10) covers the determinants of frailty and is not scored.  Part B (questions 11 – 25) covers the components of frailty (defined as physical, psychological and social).  There is 1 point available for each question providing a possible range of 0-15.  The cutoff for frailty is considered to be 5.

The TFI is shown below:

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