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

Falls are common in older subjects and result in loss of confidence and ind ependence. The Falls Efficacy Scale (FES) and the Activities-specific Balan ce Confidence scale (ABC) were developed in North America to quantify these entities, but contain idiom unfamiliar to an older British population. Nei ther has been validated in the UK. The FES and the ABC were modified for us e within British culture and the internal consistency and test-retest relia bility 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 frie nds and relatives ("visitors", n=74; 38%) were tested on both scales, while the last 60 subjects were retested within one week. internal reliability w as 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 fo r the ABC-UK (intraclass correlation coefficient 0.58 (FES-UK), 0.89 (ABC-U K)). There was evidence to suggest that the ABC-UK was better than the FES- UK at distinguishing between older patients and younger patients ( /t(ABC)/ = 4.4; /t(FES)/ = 2.3); and between fallers and non-fallers (/t(ABC)/ = 8. 7; /t(FES)/ = 5.0) where the t statistics are based on the comparison of tw o independent samples. The ABC-UK and FES-UK are both reliable and valid me asures for the assessment of fans and balance related confidence in older a dults. However, better test-retest reliability and more robust differentiat ion of subgroups in whom falls related qualify 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.