title: The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal validation study.
abstract: OBJECTIVE
  this study aimed to perform a comprehensive validation of the 16-item and 7-item Falls Efficacy Scale International (FES-I) by investigating the overall structure and measurement properties, convergent and predictive validity and responsiveness to change.
  
  
  METHODS
  five hundred community-dwelling older people (70-90 years) were assessed on the FES-I in conjunction with demographic, physiological and neuropsychological measures at baseline and at 12 months. Falls were monitored monthly and fear of falling every 3 months.
  
  
  RESULTS
  the overall structure and measurement properties of both FES-I scales, as evaluated with item response theory, were good. Discriminative ability on physiological and neuropsychological measures indicated excellent validity, both at baseline (n = 500, convergent validity) and at 1-year follow-up (n = 463, predictive validity). The longitudinal follow-up suggested that FES-I scores increased over time regardless of any fall event, with a trend for a stronger increase in FES-I scores when a person suffered multiple falls in a 3-month period. Additionally, using receiver-operating characteristic (ROC) curves, cut-points were defined to differentiate between lower and higher levels of concern.
  
  
  CONCLUSIONS
  the current study builds on the previously established psychometric properties of the FES-I. Both scales have acceptable structures, good validity and reliability and can be recommended for research and clinical purposes. Future studies should explore the FES-I's responsiveness to change during intervention studies and confirm suggested cut-points in other settings, larger samples and across different cultures.
authors.affiliation: Falls and Balance Research Group, Prince of Wales Medical Research Institute, University of New South Wales, Randwick, Sydney, Australia.
authors.forename: Kim
authors.initials: K
authors.lastname: Delbaere
authors.forename: Jacqueline C T
authors.initials: JC
authors.lastname: Close
authors.forename: A Stefanie
authors.initials: AS
authors.lastname: Mikolaizak
authors.forename: Perminder S
authors.initials: PS
authors.lastname: Sachdev
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D005239:Fear / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D012372:ROC Curve; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires