Background. Fear of falling scales typically have a strong floor effect in active people and use short phrases to state overall context of fear-related activities. We developed the Iconographical Falls Efficacy Scale (Icon-FES), which includes more demanding activities and uses pictures to provide more complete environmental contexts. Methods. Two-hundred and fifty community-dwelling older people (70–90 years) were assessed on the Icon-FES in conjunction with the Falls Efficacy Scale International (FES-I). Results. Overall structure and measurement properties of the 30-item Icon-FES (evaluated with item-response theory) were good. It measured a single factor with 2 dimensions assessing fear about less and more demanding daily activities. It had high internal consistency (Cronbach's alpha = 0.96) and excellent test–retest reliability. The Icon-FES distribution was considerably closer to normal compared with FES-I, indicating absence of floor and ceiling effects. Construct validity of the Icon-FES was supported by its relation with FES-I and its ability to discriminate between groups relating to demographic characteristics and fall risk factors. A shortened 10-item Icon-FES showed similar psychometric properties to the 30-item Icon-FES. Conclusions. The Icon-FES is an innovative way of assessing fear of falling using pictures to describe a range of activities and situations. This initial validation study showed that the Icon-FES has excellent psychometric properties and showed close continuity with the FES-I. Main advantages of the Icon-FES over the FES-I are its normal distribution and its ability to assess fear of falling in high functioning older people.

Item Type:	Refereed Article
Keywords:	Accidental falls; Fear of falling ; Aging; Sensitivity to change; Rasch analysis
Research Division:	Health Sciences
Research Group:	Allied health and rehabilitation science
Research Field:	Rehabilitation
Objective Division:	Health
Objective Group:	Specific population health (excl. Indigenous health)
Objective Field:	Health related to ageing
UTAS Author:	Smith, ST (Associate Professor Stuart Smith)
ID Code:	85404
Year Published:	2011
Web of Science® Times Cited:	74
Deposited By:	Health Sciences A
Deposited On:	2013-07-04
Last Modified:	2013-07-04
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