COSMIN database

Measuring the psychological outcomes of falling: a systematic review

Jorstad, E. C., Hauer, K., Becker, C., Lamb, S. E., and ProFa, N. E. Group
The objectives were to identify fall-related psychological outcome measures and to undertake a systematic quality assessment of their key measurement properties. A Cochrane review of fall-prevention interventions in older adults was used to identify fall-related psychological measurements. PubMed, CINAHL, and PsycINFO were systematically searched to identify instruments not used in trials and papers reporting the methodological quality of relevant measures. Reference lists of articles were searched for additional literature, and researchers were contacted. Two reviewers undertook quality extraction relating to content, population, reliability, validity, responsiveness, practicality, and feasibility. Twenty-five relevant papers were identified. Twenty-three measures met the inclusion criteria: six single-item questions, Falls Efficacy Scale (FES), revised FES, modified FES, FES-UK, Activities-specific Balance and Confidence Scale (ABC), ABC-UK, Confidence in maintaining Balance Scale, Mobility Efficacy Scale, adapted FES, amended FES, Survey of Activities and Fear of Falling in the Elderly (SAFFE), University of Illinois at Chicago Fear of Falling Measure, Concern about Falling Scale, Falls Handicap Inventory, modified SAFFE, Consequences of Falling Scale, and Concern about the Consequences of Falling Scale. There is limited evidence about the measurement properties of single-item measures. Several multiitem measures obtained acceptable reliability and validity, but there is less evidence regarding responsiveness, practicality, and feasibility. Researchers should select measures based on the constructs they intend to study. Further research is needed to establish and compare the instruments' measurement properties.
J Am Geriatr Soc
0002-8614 (Print)
Publication year:
Symptom status:
Cognitive/mental state
Emotional state
Adults (18-65)
Seniors (65+)
Mental and behavioural disorders and related symptoms
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
ABC scale - Activities-specific Balance Confidence scale    
aFES - adapted Falls Efficacy Scale
amFES - amended Falls Efficacy Scale
CaF - Concern about Falling Measure
CoF - Consequences of Falling Scale
CONFbal - Confidence in maintaining balance Scale
CONSfall - Concern about the Consequences of Falling
FES-I - Falls Efficacy Scale International   
FES-UK - Falls Efficacy Scale United Kingdom
FFM - Fear of Falling Measure (University of Illinois at Chicago)
FHI - Falls Handicap Inventory
MES - Mobility Efficacy Scale
mFES - modified Falls Efficacy Scale
mSAFFE - modified Survey of Activities and Fear of Falling in the Elderly
rFES - revised Falls Efficacy Scale
SAFFE - Survey of Activities and Fear of Falling in the Elderly