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Development and initial validation of the Iconographical Falls Efficacy Scale.

Kim Delbaere1, Stuart T Smith, Stephen R Lord

  • 1Falls and Balance Research Group, Neuroscience Research Australia, Barker Street, Randwick, Sydney, NSW 2031, Australia. k.delbaere@neura.edu.au

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
|February 26, 2011
PubMed
Summary

The Iconographical Falls Efficacy Scale (Icon-FES) effectively measures fear of falling in active older adults using pictures. This new scale shows excellent reliability and avoids floor effects common in other fear of falling assessments.

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Area of Science:

  • Gerontology
  • Psychometrics
  • Public Health

Background:

  • Traditional fear of falling scales exhibit floor effects in active populations.
  • Existing scales often use brief phrases for fear-related activities, lacking environmental context.

Purpose of the Study:

  • To introduce the Iconographical Falls Efficacy Scale (Icon-FES) for assessing fear of falling.
  • To evaluate the Icon-FES's psychometric properties and utility in community-dwelling older adults.

Main Methods:

  • The Icon-FES was administered to 250 community-dwelling older adults (aged 70-90).
  • The Falls Efficacy Scale International (FES-I) was used for comparative analysis.
  • Item-response theory was employed to evaluate the 30-item Icon-FES structure and properties.

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Main Results:

  • The 30-item Icon-FES demonstrated good structure and measurement properties, assessing fear across less and more demanding activities.
  • High internal consistency (Cronbach's alpha = 0.96) and excellent test-retest reliability were observed.
  • The Icon-FES showed a normal distribution, unlike the FES-I, indicating no floor or ceiling effects. Construct validity was supported by correlations with FES-I and demographic factors. A 10-item version retained similar psychometric properties.

Conclusions:

  • The Icon-FES offers an innovative, visually contextualized approach to assessing fear of falling.
  • The scale exhibits excellent psychometric properties and aligns with the FES-I.
  • Key advantages include its normal distribution and suitability for high-functioning older adults, addressing limitations of existing measures.