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Groningen Frailty Indicator (GFI)
GFI: 15-item questionnaire covering physical, cognitive, social, and psychological domains. Can be self-administered.
Answer all 15 items
Mobility
1. Can you do shopping independently?
Mobility
2. Can you walk around outside independently?
Mobility
3. Can you dress and undress yourself independently?
Mobility
4. Can you go to the toilet independently?
Physical Fitness
5. What mark do you give your physical fitness (1-10)?
Vision
6. Do you experience problems in daily life due to poor vision?
Hearing
7. Do you experience problems in daily life due to poor hearing?
Nourishment
8. Have you lost a lot of weight unintentionally during the last 6 months?
Morbidity
9. Do you take 4 or more different types of medicine?
Cognition
10. Do you have complaints about your memory?
Psychosocial
11. Do you sometimes experience an emptiness around you?
Psychosocial
12. Do you sometimes miss people around you?
Psychosocial
13. Do you sometimes feel abandoned?
Psychosocial
14. Did you recently feel sad or dejected?
Psychosocial
15. Did you recently feel nervous or anxious?
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Identifying frailty in community-dwelling older adults.
Screening for multidimensional frailty in primary care or geriatric outpatient settings.
Self-administered or informant-assisted frailty screening.
Holistic Frailty Concept
The GFI measures the loss of resources in four domains: physical, cognitive, social, and psychological. It is particularly strong in capturing psychosocial elements of frailty (loneliness, anxiety) often missed by purely physical scales like the Fried Phenotype.
Section 2
Formula & Logic
Scoring
15 items across 4 domains.
Total score: 0–15
Score ≥ 4 indicates moderate to severe frailty.
Emotional loneliness, social isolation, lacking people to rely on.
Psychological (2 items)
Depressive symptoms and anxiety.
Section 3
Pearls/Pitfalls
Self-Administration Advantage
The GFI is one of the few validated frailty screening tools that can be mailed to patients or completed in the waiting room without requiring a clinician's time or physical performance testing.
Section 4
Next Steps
Management
Section 5
Evidence Appraisal
Primary Reference
Measuring frailty: developing and testing the GFI (Groningen Frailty Indicator).
Steverink N et al. • Gerontologist.. 2001;41(1):236-7. Initial development establishing validity and the multidimensional construct of the GFI.
Section 6
Origins
University of Groningen
Developed by researchers at the University of Groningen in the Netherlands. It was designed to bridge the gap between heavy, clinician-administered CGAs and oversimplified physical frailty screens, providing a patient-centred view of declining functional reserve.
