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Losing confidence in the ability to maintain balance can be more debilitating than a fall; therefore, the accurate measurement of balance confidence is critical. The purpose of this study was to examine the validity and reliability of the ABC-6, a shortened version of the Activities-specific Balance Confidence scale (ABC), among underserved older adults. The final sample included 251 older adults (M age = 71.2 years, SD = 8.9; 72.1% African Americans, 62.5% low-income, 61% low-education). Participants completed assessments of multiple falls risk factors, physical activity, and balance confidence. The ABC-6 had excellent internal consistency reliability, substantial intraclass correlations, and significant moderate to large correlations with physical activity, mobility, balance, and total falls risk. It also demonstrated the ability to discriminate between fallers and nonfallers, and it was a significant predictor of total falls risk. The ABC-6 was a valid and reliable measure of balance confidence among underserved older adults., (© The Author(s) 2013.)

We examined the measurement properties offall-related psychological instruments with a sample of 133 older adults (M age = 74.4 years, SD = 9.4). Measures included the Comprehensive Falls Risk Screening Instrument, Falls-efficacy Scale-International (FES-I), Activities-specific Balance Confidence (ABC), modified Survey ofActivities and Fear ofFalling in the Elderly (mSAFFE), Consequences of Falling (CoF), Physical Activity Scale for the Elderly (PASE), and 36-Item Short-Form Health Survey (SF-36). The FES-I, ABC, mSAFFE, and CoF were significantly correlated with each othe, with SF-36, and with mobility. The ABC and mSAFFE were significantly correlated with PASE. The ABC differentiated between fallers and nonfallers and predicted total falls risk. Findings can assist with the selection of psychological instruments in a falls risk screening context.

Clinical Problem: Falls are the leading cause of nonfatal injuries and injurious death among older adults; the aftermath of a fall stresses the health care system and places financial and psychological burdens on the patient and family. Because of this, fall prevention/risk reduction is a primary focus of numerous health care agendas. Over the last 2 decades, clinical research has provided clinicians with a variety of screening tools to quantify risk factors for falls. The majority of these measures focus on single domain intraindividual (eg, balance, strength, vision) or extraindividual (eg, home safety) falls risk factors. Some of these single domain instruments are easily introduced and administered by community lay leaders. When a more comprehensive assessment across multiple domains is required, the assessment cannot easily be administered by community program leaders. A physical therapist must determine which instrument, or combination of instruments, best targets risk of falling for a given older adult., Purpose: This integrative review of the literature will provide clinicians and researchers a concise examination of falls risks factors and a compendium of falls risk screening and assessment instruments., Methods: Searchable databases, such as Medline and CINAHL were used to identify articles about strategies used for fall risk assessment. Information about measurement properties and characteristics were extracted and are presented in table format., Conclusion: Comparison of recently developed multidimensional and comprehensive screening algorithms for falls risk identification may aid in lowering the rates of false negatives associated with using very specific instruments that screen or assess in only 1 falls risk factor domain.

Objectives: Falls and the fall-related psychological concerns associated with these events pose a serious public health problem among aging adults. The measurement of fall-related psychological concerns can serve as important endpoints for fall prevention programs, yet there is some confusion regarding the best method of defining and measuring fall-related psychological constructs. Consequently, greater attention should be devoted to investigating fall-related psychological constructs and their measurement. Therefore, the purpose of this paper was to review the published research literature on the measurement of fall-related psychological constructs among independent-living older adults., Method: Electronic searches of PubMed, EBSCO, Academic Search Premier, PsycINFO, CINAHL and online library catalogs were conducted using search terms including but not limited to 'fear of falling', 'falls efficacy', 'fall-related self-efficacy', 'balance confidence', 'fall-related psychological outcome(s)' and 'independent-living'., Results: Each of these constructs is unique, yet instruments are often employed to measure constructs other than those the instruments were designed to assess. Inconsistencies were also revealed both within and across studies in terms of providing evidence of validity for these instruments., Conclusion: Fall-related psychological constructs, although similar in nature, are unique constructs and should be measured as such.

The purpose of this investigation was to determine associations among race, education, and income and falls risk scores from the Comprehensive Falls Risk Screening Instrument (CFRSI). Participants (N = 626) were Black (n = 318) and White (n = 308) older adults (M age = 72.62, SD = 9.31). The CFRSI assessed history, physical functioning, medication, vision, and home environment, and produced an average total falls risk score. A 3 (Income) × 3 (Education) × 2 (Race) MANCOVA showed main effects for income and race. Univariate tests revealed that low-income participants had greater scores for history, physical functioning, and total falls risk than high income participants. Similarly, Black participants had greater scores on history, physical functioning, medication, and total falls risk than White participants. Low income and Black race were associated with greater falls risk, and professionals should consider these disparities when designing community-based falls prevention programs. [ABSTRACT FROM PUBLISHER]