Evaluating the psychometric properties of the iconographical falls efficacy scale (ICON-FES)

This study aims to analyze the construct and content validity of the Iconographical Falls Efficacy Scale (Icon-FES) in order to measure the fear of falling in community-dwelling older adults. The Icon-FES was applied to 333 older adults. An exploratory factor analysis was performed to assess internal consistency. Item response theory (IRT) and confirmatory factor analysis (CFA) were used to evaluate the consistency of the questionnaire and whether it corresponded satisfactorily to the construct “concern about falling.” Concurrent validity with the Falls Efficacy Scale-International (FES-I) and convergent validity with the Senior Fitness Test (SFT) were also assessed. Receiving operator characteristic (ROC) curves were used to determine the sensitivity and specificity. The structural model of the 30-item and 10-item Icon-FES showed some theoretical fragility. The final model of the new short version of the Icon-FES consisted of 13 items, yielding a theoretically satisfactory structural model. Validity analyses indicated that the 13-item Icon-FES had a moderate relationship with the SFT, a strong relationship with the FES-I, and good sensitivity and specificity for a history of falls. The 13-item Icon-FES has excellent psychometric properties for measuring fear of falling in community-dwelling older adults. It can be recommended as a screening tool for fear of falling for both research and clinical purposes.