Cross-cultural validation of the Falls Efficacy Scale-International (FES-I) in Portuguese community-dwelling older adults

Abstract

The Falls Efficacy Scale-International (FES-I) is a highly reliable instrument to assess fear of falling among older population. This study aimed to develop a European Portuguese version of the FES-I (FES-I(P)) and analyse its psychometric properties in terms of internal consistency, test-retest reliability, concurrent and convergent validity.A cross-sectional study was conducted. Data collection integrated a socio-demographic questionnaire which included falls history and presence/absence of fear of falling, the Activities-specific Balance Confidence Scale (ABC), the Hospital Anxiety and Depression Scale (HADS), the Timed Up and Go (TUG) and the Five Times Sit to Stand Test (FTSST). Descriptive and inferential statistical analyses were performed.A total of 100 Portuguese community-dwelling older people (74.27±8.7years old) have participated in the study. From these, 82 have participated in the reliability study. The FES-I(P) had excellent internal consistency (α=0,978) and test-retest reliability (ICC2,1=0,999). A significant negative correlation was found between the FES-I(P) and the ABC (rs=−0.85; p<0.001), indicating good concurrent validity. FES-I(P) scores were significantly higher among those who were female, had ≥1 falls in the last year and reported having fear of falling. Significant correlations were found between the FES-I(P) and age (rs=0.337; p<0.01), HADS (rs=0.488; p<0.01), TUG (rs=0.500; p<0.01) and FTSST (rs=0.545; p<0.01), indicating acceptable convergent validity.FES-I(P) is a reliable and valid measure of fear of falling for Portuguese community-living older people. Future studies should explore the FES-I(P) responsiveness to change over time and analyse its psychometric properties in samples of both non-community-dwelling and community-dwelling older adults with different health conditions.