The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal validation study

Age Ageing. 2010 Mar;39(2):210-6. doi: 10.1093/ageing/afp225. Epub 2010 Jan 8.


Objective: this study aimed to perform a comprehensive validation of the 16-item and 7-item Falls Efficacy Scale International (FES-I) by investigating the overall structure and measurement properties, convergent and predictive validity and responsiveness to change.

Method: five hundred community-dwelling older people (70-90 years) were assessed on the FES-I in conjunction with demographic, physiological and neuropsychological measures at baseline and at 12 months. Falls were monitored monthly and fear of falling every 3 months.

Results: the overall structure and measurement properties of both FES-I scales, as evaluated with item response theory, were good. Discriminative ability on physiological and neuropsychological measures indicated excellent validity, both at baseline (n = 500, convergent validity) and at 1-year follow-up (n = 463, predictive validity). The longitudinal follow-up suggested that FES-I scores increased over time regardless of any fall event, with a trend for a stronger increase in FES-I scores when a person suffered multiple falls in a 3-month period. Additionally, using receiver-operating characteristic (ROC) curves, cut-points were defined to differentiate between lower and higher levels of concern.

Conclusions: the current study builds on the previously established psychometric properties of the FES-I. Both scales have acceptable structures, good validity and reliability and can be recommended for research and clinical purposes. Future studies should explore the FES-I's responsiveness to change during intervention studies and confirm suggested cut-points in other settings, larger samples and across different cultures.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Accidental Falls / prevention & control*
  • Activities of Daily Living / psychology
  • Aged
  • Aged, 80 and over
  • Australia
  • Fear / psychology*
  • Female
  • Follow-Up Studies
  • Geriatric Assessment / methods*
  • Humans
  • Longitudinal Studies
  • Male
  • Personality Inventory / statistics & numerical data*
  • Predictive Value of Tests
  • Psychometrics / statistics & numerical data
  • Quality of Life / psychology
  • ROC Curve
  • Reproducibility of Results
  • Surveys and Questionnaires