OBJECTIVES Fear of falling (FOF) is common in older persons and related to negative outcomes. This study aimed to investigate the relationship between 2 FOF measures: the Falls Efficacy Scale-International (FES-I) and the single question on FOF and activity restriction (SQ-FAR). Factors associated with disagreement between the 2 measures were further examined. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Participants (N = 1359) were community-dwelling persons aged 65 to 70 years who were enrolled in the Lausanne cohort 65+. METHODS Data included demographic, functional, cognitive, affective, and health status. FOF was measured with FES-I and the 3-level SQ-FAR (no FOF, FOF without activity restriction (AR, FOF with AR). FES-I concern about falling was categorized as low (score 16-19), moderate (score 20-27), and high (score 28-64). RESULTS Weighted agreement between the FES-I and the SQ-FAR was 87.8% (Kappa = 0.57). Using the FES-I as gold standard, the performance of SQ-FAR was good (specificity 86%; sensitivity 74%, negative predicting value 89%, positive predicting value 69%). Among participants with moderate/high FOF according to FES-I, male sex (P = .011) and the absence of previous falls (P < .001) were associated with disagreement between the 2 tools. Among participants with low FOF, female sex (P = .005), falls history (P < .001), and pre-frailty/frailty status (P = .050) were associated with disagreement. CONCLUSIONS AND IMPLICATIONS The SQ-FAR has a moderate agreement with FES-I and might be used as a screening tool. The results also may help design a step-by-step strategy to evaluate and address FOF in the clinical setting.

中文翻译：

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作为评估年轻社区居民跌倒恐惧的筛选工具的单一问题

目标 害怕跌倒 (FOF) 在老年人中很常见，并且与负面结果有关。本研究旨在调查 2 FOF 措施之间的关系：国际跌倒疗效量表 (FES-I) 和关于 FOF 和活动限制的单一问题 (SQ-FAR)。进一步检查了与 2 项措施之间存在分歧的相关因素。设计横断面研究。地点和参与者 参与者 (N = 1359) 是年龄在 65 至 70 岁之间的社区居民，他们参加了洛桑 65 岁以上的队列。方法 数据包括人口统计学、功能、认知、情感和健康状况。FOF 是用 FES-I 和 3 级 SQ-FAR（无 FOF，没有活动限制的 FOF（AR，带 AR 的 FOF）测量的。FES-I 对跌倒的担忧被归类为低（得分 16-19）、中等（得分 20-27）和高（得分 28-64）。结果 FES-I 和 SQ-FAR 之间的加权一致性为 87.8% (Kappa = 0.57)。以FES-I为金标准，SQ-FAR的性能良好（特异性86%；敏感性74%，阴性预测值89%，阳性预测值69%）。在根据 FES-I 具有中/高 FOF 的参与者中，男性 (P = .011) 和之前没有跌倒 (P < .001) 与两种工具之间的分歧有关。在低 FOF 的参与者中，女性 (P = .005)、跌倒史 (P < .001) 和虚弱前/虚弱状态 (P = .050) 与分歧有关。结论和意义 SQ-FAR 与 FES-I 具有中等一致性，可用作筛选工具。结果也可能有助于设计一个分步策略来评估和解决临床环境中的 FOF。