Convergent and Predictive Validity of Three Scales Related to Falls in the Elderly

Abstract

The purpose of this study was to determine if the Activities-specific Balance Confidence (ABC) Scale, Falls Efficacy Scale (FES), and Survey of Activities and Fear of Falling in the Elderly (SAFE) assessments measured fear of falling in the same manner (convergent validity) and to determine if they predicted those individuals who, based upon a previous history of falls, limitation of activity, and not leaving home, had an increased potential for falling (predictive validity). One hundred and eighteen individuals, 60 years of age and older, completed each of the assessments. They self-reported activity restriction, fall history, and the number of times they left the home each week. The convergent validity of each assessment was established by correlating each assessment tool with each of the others. Findings indicated the ABC and FES were highly correlated with each other, indicating they measured similar constructs, and both were moderately correlated with the SAFE, suggesting these assessments measured different constructs. The predictive validity of each instrument in relation to the frequency of falls, limitation of activity, and frequency of leaving the home revealed no individual tool could accurately predict any of these characteristics of the sample. As a result, no one test by itself was able to identify individuals who may be at risk and a candidate for an intervention program.

Reconceptualizing the Role of Fear of Falling and Balance Confidence in Fall Risk

“…As such, the FES and the ABC assess very similar constructs and show high correlations (e.g., .86) with one another (Hotchkiss et al, 2004). In contrast, correlations of falls efficacy with fear of falling measures are considerably lower (Hotchkiss et al, 2004).…”

“…As such, the FES and the ABC assess very similar constructs and show high correlations (e.g., .86) with one another (Hotchkiss et al, 2004). In contrast, correlations of falls efficacy with fear of falling measures are considerably lower (Hotchkiss et al, 2004). Given the similarity of items designed to measure falls efficacy and balance confidence (e.g., both the ABC and FES questions are about the extent to which the person is confident that he or she can perform day-to-day activities without falling), as well as the high correlation of balance confidence and falls efficacy measures, we consider the two constructs to be equivalent.…”

The Impact of Fear of Falling on Functional Independence Among Older Adults Receiving Home Health Services

“…However, older adults who have experienced a non-injurious fall or who have never fallen also report a fear of falling (Hotchkiss et al, 2004). Researchers have hypothesized that a fear of falling leads to a restriction of activity in the home and in the community (Hotchkiss et al, 2004;Schepens, Sen, Painter, & Murphy, 2012).…”

“…However, older adults who have experienced a non-injurious fall or who have never fallen also report a fear of falling (Hotchkiss et al, 2004). Researchers have hypothesized that a fear of falling leads to a restriction of activity in the home and in the community (Hotchkiss et al, 2004;Schepens, Sen, Painter, & Murphy, 2012). Although the desire to avoid futher falls leads to a restriction of activity, it also sets in motion a loss of independence resulting from decreased strength, balance, and endurance, which further increases the risk of falling (Petrella, Payne, Myers, Overend, & Chesworth, 2000).…”

Establishing Normative Values for the Barnett Balance Assessment Tool: A Preliminary Study

“…One specific assessment, the FES-I, relies on the subjective interpretation of data by the administrator and the participant. This may reduce the reliability of assessment scores, as interpretations of the survey questions and the participants' perceived abilities may differ among individuals (Hotchkiss et al, 2004;Trader et al, 2003). Another common balance assessment, the BBS, requires use of common household objects that may differ in regard to key physical characteristics relevant to testing outcomes (such as the presence of arms on a chair).…”