Reliability, construct validity, and clinical feasibility of the activities-specific fall caution scale for residential living seniors.

OBJECTIVE: To examine the reliability, validity, and feasibility of the Activities-specific Fall Caution (AFC) Scale.

DESIGN: Cross-sectional studies with test-retest and interrater reliability.

SETTING: Residential care facilities in Ontario, Canada: 10 in study 1 and 6 in study 2.

PARTICIPANTS: Convenience samples of 101 and 31 residents.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: In study 1, the AFC Scale was readministered to 44 residents, 64 were assessed using the Berg Balance Scale, Timed Up & Go, and Self-Paced Walk Test, and the Nursing Home Life-Space Diameter was completed for 80 residents. In study 2, staff administered the AFC Scale to 31 residents on 2 occasions.

RESULTS: In study 1, test-retest reliability (intraclass correlation coefficient [ICC]) was .87 (95% confidence interval, .78-.93). AFC scores were associated with physical performance and mobility patterns (P<.001) and able to discriminate on the basis of gait aid use (P<.001), balance disorders (P<.05), and transfer assistance and walk speed (P<.01). Comparatively, general fear of falling showed weaker associations and a sex bias. In study 2, staff administration was fairly consistent (ICC=.71) and similar associations emerged for AFC scores.

CONCLUSIONS: The AFC Scale shows good reproducibility, convergent and discriminative validity, and is feasible for clinical as well as research use.