title: Assessing the relative and absolute reliability of the Falls Efficacy Scale-International questionnaire in elderly individuals with increased fall risk and the questionnaire's convergent validity in elderly women with osteoporosis.
abstract: The Falls Efficacy Scale-International (FES-I) is a highly reliable questionnaire for assessing fear of falling in elderly individuals with increased fall risk and has low or no convergent validity with balance performance tests and health-related quality of life (HRQL) among elderly women with osteoporosis, which indicates that both measurements should be included as they are measuring different components.
  
  
  BACKGROUND
  Fear of falling is increased in elderly individuals with osteoporosis and FES-I is a widely used questionnaire to assess fear of falling. There is limited evidence of the reliability and convergent validity in elderly with increased risk of falling and osteoporosis.
  
  
  METHODS
  Reliability and validity study of the FES-I. Community-dwelling elderly with increased fall risk, 59 subjects, were recruited to the reliability assessment, and 81 women with osteoporosis, in the validity assessment. For the reliability assessment, two postal surveys were used. For the validity assessment, we used baseline data from an on-going study in women with osteoporosis. The FES-I was correlated to a single-item question regarding fear of falling, self-reported history of falls, balance performance tests and health-related quality of life.
  
  
  RESULTS
  The FES-I had very good relative reliability (intra-class correlation 0.88) and internal consistency reliability (Cronbach's alpha 0.94). The value for absolute reliability was a standard error of measure 2.9 (10.6 %), smallest real difference 7.9 (29 %). There was "little if any" to "low" correlation between the FES-I and the single-item question regarding fear of falling and self-reported history of falls, HRQL and balance performance tests.
  
  
  CONCLUSIONS
  The FES-I seems to be a highly reliable questionnaire for assessing fear of falling in elderly with increased fall risk but has low relation to/convergent validity with balance performance and HRQL among elderly women with osteoporosis.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23100, SE-141 83 Huddinge, Stockholm, Sweden. alexandra.halvarsson@ki.se
authors.forename: A
authors.initials: A
authors.lastname: Halvarsson
authors.forename: E
authors.initials: E
authors.lastname: Franzén
authors.forename: A
authors.initials: A
authors.lastname: Ståhle
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D005239:Fear / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D015663:Osteoporosis, Postmenopausal / Q000523:psychology*; D011434:Proprioception; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012307:Risk Factors; D020377:Self Efficacy; D011795:Surveys and Questionnaires / Q000592:standards*; D013548:Sweden