Cultural adaptation and validation of Eye Frailty Self-Check List for middle-aged and older adult in China

Visual function is central to the health-related quality of life of middle-aged and older adults. As population aging accelerates, eye frailty has become a new focus in public health. This condition represents an early state characterized by increased vulnerability of the visual system due to aging, diminished accommodative capacity, and impaired visual function. This study translated the Eye Frailty Self-Check List into Chinese and to evaluate its psychometric properties in a Chinese middle-aged and older adult population. Based on Brislin’s translation model and cross-cultural adaptation guidelines, forward and back translation, cultural adaptation, and cognitive interviews were conducted for the scale. Using a convenience sampling method, middle-aged and older adults from a tertiary hospital and two communities in Shanghai were recruited as study participants from January to April 2026. The reliability and validity of the Chinese version were evaluated under classical test theory. A total of 749 valid questionnaires were collected, yielding an effective response rate of 96.77%. The Chinese version of the Eye Frailty Self-Check List comprises 10 items distributed across three dimensions. Exploratory factor analysis identified three common factors, which collectively accounted for a cumulative variance contribution rate of 76.604%. The item-level content validity index (I-CVIs) ranged from 0.87 to 1.00. Construct validity was established through correlation with the Visual Function Index Scale, resulting in a correlation coefficient of -0.639 ( P < 0.001). The overall Cronbach’s α for the scale was 0.765, with factor 1 at 0.819, factor 2 at 0.827, and factor 3 at 0.862. The test-retest reliability coefficient was 0.857. The Chinese version of the Eye Frailty Self-Check List showed satisfactory reliability and preliminary evidence of construct validity among middle-aged and older adults, recruited from one tertiary hospital and two urban communities in Shanghai.