{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:14:08Z","timestamp":1783682048749,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This study aimed to translate and culturally adapt the Pictorial Fit\u2013Frail Scale (PFFS) into Turkish and to evaluate its validity and reliability in older adults. Materials and Methods: The study included 156 community-dwelling older adults aged \u2265 65 years. Frailty status was determined using the Clinical Frailty Scale (CFS), and participants with a CFS \u2265 4 were classified as frail. All participants underwent the PFFS, Katz ADL, Lawton\u2013Brody IADL, Short-Form Geriatric Depression Scale (GDS), Mini Nutritional Assessment\u2014Short Form (MNA-SF), Standardized Mini-Mental State Examination (SMMSE), and Charlson Comorbidity Index (CCI). The reliability of the PFFS was assessed using internal consistency (Cronbach \u03b1), inter-rater reliability, and test\u2013retest reliability (ICC); its construct validity was assessed using correlation analysis with the CFS. Furthermore, the diagnostic performance of PFFS in identifying frailty was analyzed using the ROC curve. Results: Of the 156 individuals participating in the study, 63.5% were women, and 89 individuals (57.1%) were frail. The Turkish version of PFFS showed high internal consistency (Cronbach \u03b1 = 0.838). Inter-rater and test\u2013retest reliability were found to be ICC = 0.995 and 0.996, respectively. A strong and positive correlation was found between PFFS and CFS scores (Spearman r = 0.760, p &lt; 0.001). ROC analysis showed that PFFS had good performance in distinguishing frailty (AUC = 0.851, optimal cut-off \u2265 14; sensitivity = 69.7%, specificity = 83.6%). Frail individuals were older, had higher comorbidities, and showed greater dependence in activities of daily living. Conclusions: The Turkish version of the PFFS appears to be a reliable, valid, rapid, and multidimensional tool for assessing frailty in older adults. The PFFS can contribute to the effective assessment of frailty in clinical practice and research.<\/jats:p>","DOI":"10.3390\/medicina62071330","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:46:47Z","timestamp":1783676807000},"page":"1330","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Recognizing Frailty Through Pictures: Turkish Validation of the Pictorial Fit\u2013Frail Scale in Older Adults"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5997-7639","authenticated-orcid":false,"given":"Serap","family":"Boz","sequence":"first","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3016-8173","authenticated-orcid":false,"given":"Ayse","family":"Dikmeer","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Tuna Dogrul","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9193-5327","authenticated-orcid":false,"given":"Kubra","family":"Erdogan","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2962-811X","authenticated-orcid":false,"given":"Gokberk","family":"Gozukan","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arzu","family":"Nevin Dagdemir","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0244-4866","authenticated-orcid":false,"given":"Busragul","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma","family":"Kaplan Efe","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1939-4738","authenticated-orcid":false,"given":"R\u0131dvan","family":"Erten","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ertugrul","family":"Demirel","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hande","family":"Selvi Oztorun","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"},{"name":"Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, Ankara 06010, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunes","family":"Eken","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"},{"name":"Geriatrics Clinic, Ankara Bilkent City Hospital,   Faculty of Medicine, Health Science University, Ankara 06200, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0384-4957","authenticated-orcid":false,"given":"Kamile","family":"Silay","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Ankara Bilkent City Hospital, Ankara 06800, T\u00fcrkiye"},{"name":"Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, Ankara 06010, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1111\/j.1532-5415.2012.04054.x","article-title":"Prevalence of frailty in community-dwelling older persons: A systematic review","volume":"60","author":"Collard","year":"2012","journal-title":"J. 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