OBJECTIVES To design a questionnaire to evaluate and distinguish between cognitive and physical aspects of fatigue in different age groups of "nondiseased" people and guide appropriate prevention and interventions for the impact of frailty occurring in normative aging. STUDY DESIGN AND PARTICIPANTS The Norfolk QOL-Fatigue (QOL-F) with items of cognitive and physical fatigue, anxiety, and depression from validated questionnaires including items from the Patient-Reported Outcomes Measure Information System (PROMIS) databank was developed. The preliminary QOL-F was administered to 409 healthy multiethnic local participants (30-80 years old) in 5 age groups. METHODS The authors distilled the item pool using exploratory (EFA) and confirmatory factor analysis (CFA). EFA identified 5 latent groups as possible factors related to problems due to fatigue, subjective fatigue, reduced activities, impaired activities of daily living (ADL), and depression. RESULTS CFA demonstrated good overall fit [χ2(172) = 1094.23, P < .001; Tucker-Lewis index = 0.978; root mean square error of approximation = 0.049] with factor loadings >0.617 and strong interfactor correlations (0.69-0.83), suggesting that fatigue in each domain is closely related to other domains and to the overall scale except for ADL. The 5-factor solution displayed good internal consistency (Cronbach α = 0.78-0.94). Total and domain scores were fairly equivalent in all age groups except for the 40 to 49-year-old group with better overall scores. In addition, 70 to 79-year-olds had better ADL scores. In item response analysis, factor scores in different age groups were similar, so age may not be a significant driver of fatigue scores. Fatigue scores were significantly higher in females than in males (P < .05). CONCLUSIONS AND CLINICAL IMPLICATIONS The developed Norfolk QOL-F tool demonstrated fatigue as a perceived cognitive phenomenon rather than an objective physical measure, suggesting mandatory inclusion of cognitive as well as physical measures in the evaluation of people as they age. QOL-F is able to distinguish QOL-F domain scores unique to different age groups, proposing clinical benefits from physical, balance, and cognitive interventions tailored to impact frailty occurring in normative aging.

中文翻译：

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诺福克生活质量疲劳工具 (QOL-F) 的开发和验证：一种新的疲劳感知方法

目的 设计一份调查问卷，以评估和区分“非疾病”人群不同年龄组疲劳的认知和身体方面，并指导适当的预防和干预措施，以应对正常衰老中出现的虚弱的影响。研究设计和参与者开发了诺福克 QOL-Fatigue (QOL-F)，其中包含来自验证问卷的认知和身体疲劳、焦虑和抑郁，包括来自患者报告结果测量信息系统 (PROMIS) 数据库的项目。对 5 个年龄组的 409 名健康的多民族本地参与者（30-80 岁）进行了初步 QOL-F。方法 作者使用探索性 (EFA) 和验证性因素分析 (CFA) 提取项目库。EFA 将 5 个潜在群体确定为与疲劳、主观疲劳、活动减少、日常生活活动受损 (ADL) 和抑郁症相关的问题的可能因素。结果 CFA 表现出良好的整体拟合 [χ2(172) = 1094.23, P < .001; 塔克-刘易斯指数 = 0.978；近似均方根误差 = 0.049] 因子载荷 >0.617 和强因子间相关性 (0.69-0.83)，表明每个领域的疲劳与其他领域以及除 ADL 之外的整体规模密切相关。5 因子解决方案显示出良好的内部一致性（Cronbach α = 0.78-0.94）。除了 40 至 49 岁组的总体分数更高之外，所有年龄组的总分和领域分数相当。此外，70 到 79 岁的人有更好的 ADL 分数。在项目响应分析中，不同年龄组的因素评分相似，因此年龄可能不是疲劳评分的重要驱动因素。女性的疲劳评分显着高于男性（P < .05）。结论和临床意义 开发的诺福克 QOL-F 工具证明疲劳是一种感知到的认知现象，而不是客观的身体测量，这表明随着年龄的增长，必须将认知和身体测量纳入评估。QOL-F 能够区分不同年龄组特有的 QOL-F 域评分，提出了针对影响正常衰老中发生的虚弱而量身定制的身体、平衡和认知干预的临床益处。结论和临床意义 开发的诺福克 QOL-F 工具证明疲劳是一种感知到的认知现象，而不是客观的身体测量，这表明随着年龄的增长，必须将认知和身体测量纳入评估。QOL-F 能够区分不同年龄组特有的 QOL-F 域评分，提出了针对影响正常衰老中发生的虚弱而量身定制的身体、平衡和认知干预的临床益处。结论和临床意义 开发的诺福克 QOL-F 工具证明疲劳是一种感知到的认知现象，而不是一种客观的身体测量，这表明随着年龄的增长，必须将认知和身体测量纳入评估。QOL-F 能够区分不同年龄组特有的 QOL-F 域评分，提出了针对影响正常衰老中发生的虚弱而量身定制的身体、平衡和认知干预的临床益处。