The Short FES-I: a shortened version of the falls efficacy scale-international to assess fear of falling

Background: the 16-item Falls Efficacy Scale-International (FES-I) has been shown to have excellent reliability and construct validity. However, for practical and clinical purposes, a shortened version of the FES-I would be useful. Objective: to develop and validate a shortened version of FES-I while preserving good psychometric properties. Design: initial development of a shortened version using data from a UK survey (Short FES-I; n = 704), test of reliability and validity of the Short FES-I using data from a Dutch survey (n = 300). Setting: community samples. Methods: comparison of reliability and validity of the Short FES-I and the FES-I in a random sample of 193 people aged between 70 and 92. Results: the internal and 4-week test–retest reliability of the Short FES-I is excellent (Cronbach's alpha 0.92, intra-class coefficient 0.83) and comparable to the FES-I. The correlation between the Short FES-I and the FES-I is 0.97. Patterns in differences with respect to mean scores according to age, sex, falls history, and overall fear of falling are similar for the Short FES-I and the FES-I. The FES-I had slightly better power to discriminate between groups differentiated by age, sex, falls history, and fear falling, but differences are small. Conclusions: the Short FES-I is a good and feasible measure to assess fear of falling in older persons. However, if researchers or clinicians are particularly interested in the distributions of specific fear of falling-related activities not included in the Short FES-I, the use of the full FES-I is recommended.