Background and Purpose: 

Balance confidence assessment in older adults has implications for falls prevention and quality of life. It remains unclear whether the original Activities-specific Balance Confidence Scale (ABC-16) or the shortened 6-item scale (ABC-6) is recommended clinically. This study examined ABC-16 and ABC-6 association and agreement, internal consistencies, and relationships with self-rated health (SRH) in community-dwelling older adults.

Methods: 

Secondary analysis of an existing dataset (N = 77) was performed. Scale association and agreement were assessed with a Spearman ρ correlation (r_s), intraclass correlation coefficient, 95% limits of agreement (LoA), and Bland-Altman plot. Cronbach α values were calculated to determine internal consistencies. Separate multiple linear regression models with SRH as the outcome and ABC-6 and ABC-16 scores as primary predictors were estimated and subsequently used to conduct Hotelling t test.

Results and Discussion: 

Participants were primarily female (80.5%) with a median age of 68 years living in the metro Detroit area. The ABC-6 and ABC-16 were closely associated [r_s = 0.97, P < .001; intraclass correlation coefficient (2,1) = 0.80] but demonstrated discrepancy (95% LoA range of −3.9 to +18.2; mean difference = 7.2 points in the direction of the ABC-16). Cronbach α values were 0.95 (ABC-16) and 0.89 (ABC-6). Regression model 1 (ABC-6 = primary predictor) explained more of the variance (R² = 0.36) in SRH compared with model 2 (ABC-16 = primary predictor; R² = 0.29). Hotelling t test [t(74) = 2.4, P = .008] found that the predicted values from the ABC-6 model were significantly more highly correlated with SRH than those from the ABC-16 model.

Conclusions: 

Despite a high correlation between the ABC-16 and ABC-6, the 2 scales showed limited agreement and should not be considered interchangeable. Given that the ABC-16 takes longer to administer, does not relate to SRH as strongly, and could have redundant items, the ABC-6 may be preferable to the ABC-16 for balance confidence assessment in older adults living in cold weather, urban, or well-resourced areas.

中文翻译：

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社区老年人活动特定平衡信心 (ABC) 量表的原始版本和简短版本：基于量表一致性、内部一致性以及与自评健康关联的临床意义

背景与目的： 

老年人的平衡信心评估对预防跌倒和生活质量有影响。目前尚不清楚临床上是否推荐使用原始活动特定平衡信心量表（ABC-16）或缩短的 6 项量表（ABC-6）。本研究检查了 ABC-16 和 ABC-6 的关联和一致性、内部一致性以及与居住在社区的老年人的自评健康(SRH) 的关系。

方法： 

对现有数据集 (N = 77) 进行了二次分析。使用 Spearman ρ 相关性 ( rs )、组内相关系数、95% 一致性限度 (LoA) 和 Bland-Altman 图评估量表关联和一致性_。计算 Cronbach α 值以确定内部一致性。以 SRH 作为结果和 ABC-6 和 ABC-16 分数作为主要预测因子的独立多元线性回归模型被估计并随后用于进行 Hotelling t检验。

结果与讨论： 

参与者主要是女性 (80.5%)，居住在底特律都会区，中位年龄为 68 岁。ABC-6 和 ABC-16 密切相关 [ rs = _0.97，P < .001；类内相关系数 (2,1) = 0.80] 但表现出差异（95% LoA 范围为 -3.9 至 +18.2；ABC-16 方向的平均差异 = 7.2 点）。Cronbach α 值分别为 0.95 (ABC-16) 和 0.89 (ABC-6)。与模型 2（ABC-16 = 主要预测因子； R ² = 0.29）相比，回归模型 1（ABC-6 = 主要预测因子）解释了更多 SRH 方差（R ² = 0.36）。Hotelling t检验 [ t (74) = 2.4, P= .008] 发现 ABC-6 模型的预测值与 SRH 的相关性明显高于 ABC-16 模型的预测值。

结论： 

尽管 ABC-16 和 ABC-6 之间存在高度相关性，但这两个量表的一致性有限，不应被视为可互换。鉴于 ABC-16 需要更长的时间来管理，与 SRH 的关系不那么强烈，并且可能有多余的项目，ABC-6 可能比 ABC-16 更适合生活在寒冷天气、城市的老年人的平衡信心评估, 或资源丰富的地区。