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. 2001 Feb;77(904):103–108. doi: 10.1136/pmj.77.904.103

Falls and confidence related quality of life outcome measures in an older British cohort

S Parry 1, N Steen 1, S Galloway 1, R Kenny 1, J Bond 1
PMCID: PMC1741890  PMID: 11161077

Abstract

Falls are common in older subjects and result in loss of confidence and independence. The Falls Efficacy Scale (FES) and the Activities-specific Balance Confidence scale (ABC) were developed in North America to quantify these entities, but contain idiom unfamiliar to an older British population. Neither has been validated in the UK. The FES and the ABC were modified for use within British culture and the internal consistency and test-retest reliability of the modified scales (FES-UK and ABC-UK) assessed. A total of 193 consecutive, ambulant, new, and return patients (n=119; 62%) and their friends and relatives ("visitors", n=74; 38%) were tested on both scales, while the last 60 subjects were retested within one week. Internal reliability was excellent for both scales (Cronbach's alpha 0.97 (FES-UK), and 0.98 (ABC-UK)). Test-retest reliability was good for both scales, though superior for the ABC-UK (intraclass correlation coefficient 0.58 (FES-UK), 0.89 (ABC-UK)). There was evidence to suggest that the ABC-UK was better than the FES-UK at distinguishing between older patients and younger patients (|tABC| = 4.4; |tFES| = 2.3); and between fallers and non-fallers (|tABC| = 8.7; |tFES| = 5.0) where the t statistics are based on the comparison of two independent samples. The ABC-UK and FES-UK are both reliable and valid measures for the assessment of falls and balance related confidence in older adults. However, better test-retest reliability and more robust differentiation of subgroups in whom falls related quality of life would be expected to be different make the ABC-UK the current instrument of choice in assessing this entity in older British subjects.


Keywords: quality of life; falls; elderly; health status measurement

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Selected References

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  1. Buchner D. M., Hornbrook M. C., Kutner N. G., Tinetti M. E., Ory M. G., Mulrow C. D., Schechtman K. B., Gerety M. B., Fiatarone M. A., Wolf S. L. Development of the common data base for the FICSIT trials. J Am Geriatr Soc. 1993 Mar;41(3):297–308. doi: 10.1111/j.1532-5415.1993.tb06708.x. [DOI] [PubMed] [Google Scholar]
  2. Campbell A. J., Borrie M. J., Spears G. F. Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol. 1989 Jul;44(4):M112–M117. doi: 10.1093/geronj/44.4.m112. [DOI] [PubMed] [Google Scholar]
  3. Campbell A. J., Robertson M. C., Gardner M. M., Norton R. N., Tilyard M. W., Buchner D. M. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ. 1997 Oct 25;315(7115):1065–1069. doi: 10.1136/bmj.315.7115.1065. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Davies A. J., Kenny R. A. Falls presenting to the accident and emergency department: types of presentation and risk factor profile. Age Ageing. 1996 Sep;25(5):362–366. doi: 10.1093/ageing/25.5.362. [DOI] [PubMed] [Google Scholar]
  5. Hu M. H., Woollacott M. H. Multisensory training of standing balance in older adults: I. Postural stability and one-leg stance balance. J Gerontol. 1994 Mar;49(2):M52–M61. doi: 10.1093/geronj/49.2.m52. [DOI] [PubMed] [Google Scholar]
  6. King M. B., Tinetti M. E. Falls in community-dwelling older persons. J Am Geriatr Soc. 1995 Oct;43(10):1146–1154. doi: 10.1111/j.1532-5415.1995.tb07017.x. [DOI] [PubMed] [Google Scholar]
  7. Murphy J., Isaacs B. The post-fall syndrome. A study of 36 elderly patients. Gerontology. 1982;28(4):265–270. doi: 10.1159/000212543. [DOI] [PubMed] [Google Scholar]
  8. Nevitt M. C., Cummings S. R., Kidd S., Black D. Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA. 1989 May 12;261(18):2663–2668. [PubMed] [Google Scholar]
  9. O'Mahony P. G., Rodgers H., Thomson R. G., Dobson R., James O. F. Is the SF-36 suitable for assessing health status of older stroke patients? Age Ageing. 1998 Jan;27(1):19–22. doi: 10.1093/ageing/27.1.19. [DOI] [PubMed] [Google Scholar]
  10. Parker S. G., Peet S. M., Jagger C., Farhan M., Castleden C. M. Measuring health status in older patients. The SF-36 in practice. Age Ageing. 1998 Jan;27(1):13–18. doi: 10.1093/ageing/27.1.13. [DOI] [PubMed] [Google Scholar]
  11. Powell L. E., Myers A. M. The Activities-specific Balance Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci. 1995 Jan;50A(1):M28–M34. doi: 10.1093/gerona/50a.1.m28. [DOI] [PubMed] [Google Scholar]
  12. Reinsch S., MacRae P., Lachenbruch P. A., Tobis J. S. Attempts to prevent falls and injury: a prospective community study. Gerontologist. 1992 Aug;32(4):450–456. doi: 10.1093/geront/32.4.450. [DOI] [PubMed] [Google Scholar]
  13. Richardson D. A., Bexton R. S., Shaw F. E., Kenny R. A. Prevalence of cardioinhibitory carotid sinus hypersensitivity in patients 50 years or over presenting to the accident and emergency department with "unexplained" or "recurrent" falls. Pacing Clin Electrophysiol. 1997 Mar;20(3 Pt 2):820–823. doi: 10.1111/j.1540-8159.1997.tb03912.x. [DOI] [PubMed] [Google Scholar]
  14. Sattin R. W. Falls among older persons: a public health perspective. Annu Rev Public Health. 1992;13:489–508. doi: 10.1146/annurev.pu.13.050192.002421. [DOI] [PubMed] [Google Scholar]
  15. Thompson P. G. Preventing falls in the elderly at home: a community-based program. Med J Aust. 1996 May 6;164(9):530–532. [PubMed] [Google Scholar]
  16. Tinetti M. E., Baker D. I., McAvay G., Claus E. B., Garrett P., Gottschalk M., Koch M. L., Trainor K., Horwitz R. I. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994 Sep 29;331(13):821–827. doi: 10.1056/NEJM199409293311301. [DOI] [PubMed] [Google Scholar]
  17. Tinetti M. E., Speechley M., Ginter S. F. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988 Dec 29;319(26):1701–1707. doi: 10.1056/NEJM198812293192604. [DOI] [PubMed] [Google Scholar]
  18. Vellas B., Cayla F., Bocquet H., de Pemille F., Albarede J. L. Prospective study of restriction of activity in old people after falls. Age Ageing. 1987 May;16(3):189–193. doi: 10.1093/ageing/16.3.189. [DOI] [PubMed] [Google Scholar]
  19. Vetter N. J., Lewis P. A., Ford D. Can health visitors prevent fractures in elderly people? BMJ. 1992 Apr 4;304(6831):888–890. doi: 10.1136/bmj.304.6831.888. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Walker J. E., Howland J. Falls and fear of falling among elderly persons living in the community: occupational therapy interventions. Am J Occup Ther. 1991 Feb;45(2):119–122. doi: 10.5014/ajot.45.2.119. [DOI] [PubMed] [Google Scholar]
  21. Ware J. E., Jr, Sherbourne C. D. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473–483. [PubMed] [Google Scholar]

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