Cross-cultural adaptation and evaluation of the psychometric properties of the Falls Efficacy Scale - International Among Elderly Brazilians (FES-I-BRAZIL)

Objectives: To culturally adapt the Falls Efficacy Scale International (FES-I) and assess its psychometric properties in a sample of community-dwelling elderly Brazilians. Methods: The instrument was translated into Brazilian Portuguese and culturally adapted to the Brazilian population (FES-I-Brazil) as recommended by the Prevention of Falls Network Europe. FES-I-Brazil was applied to 163 elderly people (73.44 +/- 5.51 years), and the demographic data and history of falls were also collected. From this group, 58 participants were randomly distributed to evaluate reliability. The reliability was analyzed using the intraclass correlation coefficient (ICC) and the internal consistency, using Cronbach's alpha coefficient (alpha). The internal structure of FES-I-Brazil was evaluated by means of exploratory factor analysis. The logistic regression model was used to determine which tasks on the scale were more relevant for discriminating falls. To analyze the sensitivity and specificity of FES-I-Brazil, the receiver operating characteristic (ROC) curve was used. Results: The internal consistency of FES-I-Brazil was alpha=0.93, and the intra- and inter-examiner reliability were ICC=0.84 and 0.91, respectively. Factor analysis suggested two factors: concern about falling during social activities and activities of daily living (basic and instrumental), and postural control tasks. FES-I-Brazil scores >= 23 suggested an association with a previous history of sporadic falls, whereas scores >= 31 suggested an association with recurrent falls. Conclusions: FES-I-Brazil was shown to be semantically, linguistically and psychometrically appropriate to evaluate the fear of falling in the community-dwelling Brazilian elderly population.