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Background: Falls are a common and complex geriatric syndrome. The fear of falling has negative consequences for older adults. Fall Efficacy Scale-International (FES-I) is one of the questionnaires that assesses fear of falling and its Arabic version has established validity. Aim of the work: To evaluate the validity of the modification on original Arabic FES-I to be suitable for the Egyptian culture. Materials and Methods: 100 geriatric patients participated in this research. All participants were subjected to full medical history taking, application of the modified Arabic Falls Efficacy Scale-International (FES-I), Mini mental state examination, Time Up and go test. Results: The present study group included 100 participants 46 men and 54 women with female predominance, with a mean age of 66 years, the minimum age was 60 years and maximum was 85 years. Most of participants age lies between 60ys & 69ys. Medical history revealed that 67 % of participants had no history of falling and 33% with positive history of falling once or more; also 31 % with history of imbalance and 69 % without history of imbalance. From the participants in our study there were 40% below cut off value of TUG (14 sec) (low risk of falling), and 60% above or equal cut off value of TUG (14 sec) (high risk of falling). Also according to Mini Mental Status Examination (MMSE), 59% with mild cognitive impairment (21 to 26 points) and 41% with normal cognitive function. As regards the categories of modified Arabic FES-I; 16% in low concern category, 22% in moderate concern category, 62% in high concern category. In the current study, the validity and reliability of the modified Arabic FES-I have been proved, there was a statistically significant difference between the two ROC curves in favor of the modified FES-I regarding sensitivity (90.9% compared to 72.7%) and in favor of original FES-I regarding specificity (68.7% compared to 58.2%). Modified Arabic FES-I showed significant positive correlation with age and Time Up and go test, history of falling and history of imbalance and a negative correlation with the MMSE. Conclusion: The validated modified Arabic FES-I can be used in assessment of risk of falling among Egyptian geriatric population. The modified Arabic FES-I is more sensitive than the original Arabic FES-I.

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