How do you score the falls efficacy scale? A comprehensive guide

Over one-third of adults over 65 fall each year, but less than half report it to their doctor. The Falls Efficacy Scale is a key tool for gauging confidence and fear of falling, which helps address this silent risk. Here's a breakdown of how you score the falls efficacy scale for accurate assessment.

Quick Summary

To score the Falls Efficacy Scale, you sum the scores from each item on a patient's questionnaire, whether using the 10-item FES or 16-item FES-I, and compare the total to established cut-off points to determine the level of concern about falling.

Key Points

• Scoring the FES-I: For the 16-item FES-I, add scores from a 4-point scale (1-4). Total range 16-64, higher scores mean more concern.

• Scoring the original FES: For the 10-item FES, sum scores from a 10-point scale (1-10). Range 10-100, lower scores mean more confidence.

• Interpreting FES-I cut-offs: Scores of 16-19 (low), 20-27 (moderate), 28-64 (high concern) for falling.

• Interpreting original FES scores: A score over 70 often indicates a fear of falling.

• Handling missing data (FES-I): An adjusted score can be calculated if four or fewer items are missing.

• Context is key: Use FES scores with other clinical data for a complete fall prevention strategy.

Understanding the Different Versions of the Falls Efficacy Scale

The Falls Efficacy Scale (FES) is a measure of a person's confidence in their ability to perform daily activities without falling. Knowing which scale is being used is essential for correct scoring.

Scoring the Falls Efficacy Scale-International (FES-I)

The FES-I is a 16-item scale where participants rate their concern about falling during activities on a 4-point scale (1=not at all concerned, 4=very concerned). The total score is the sum of these items, ranging from 16 to 64. Higher scores indicate greater concern. If up to four items are missing, an estimated score can be calculated. Scores are interpreted in ranges: 16-19 (low concern), 20-27 (moderate concern), and 28-64 (high concern).

Scoring the Original 10-Item Falls Efficacy Scale

The original FES has 10 items focusing on indoor activities. Participants rate their confidence on a 10-point scale (1=very confident, 10=not confident at all). The total score, ranging from 10 to 100, is the sum of these ratings. A higher score indicates less confidence and more fear of falling, with a score above 70 often suggesting a fear of falling.

Comparison of FES and FES-I Scoring

A table summarizing the scoring differences is available from {Link: ScienceDirect https://www.sciencedirect.com/topics/medicine-and-dentistry/falls-efficacy-scale}.

Using FES and FES-I Scores in Practice

FES scores help identify fear of falling, which can increase fall risk. Scores should be used alongside other clinical information. Healthcare providers use results to create personalized intervention plans, track progress, and encourage patient engagement. For more information on fall prevention, you can visit the {Link: National Institute on Aging https://www.nia.nih.gov/health/falls-and-falls-prevention/falls-and-fractures-older-adults-causes-and-prevention}.

Conclusion: More Than Just a Number

Scoring the Falls Efficacy Scale involves summing or averaging item responses and comparing the total to established ranges or cut-off points, depending on the version used. The scale's value lies in revealing psychological factors affecting mobility. Understanding these scores helps healthcare providers develop personalized plans to address fear of falling and support older adults in maintaining independence and confidence.

Frequently Asked Questions

What is the primary difference between scoring the original FES and the FES-I?

The main difference is the rating scale and interpretation. The original 10-item FES uses a 1-to-10 scale where lower scores mean more confidence. The 16-item FES-I uses a 1-to-4 scale where higher scores mean more concern. Always check which version you're scoring.

Is there a shorter version of the Falls Efficacy Scale, and how do you score it?

Yes, a shorter 7-item FES-I also exists. It is scored by summing the scores from the 4-point scale. The total score range is 7 to 28, with a score of 14-28 indicating high concern.

What if a person skips some questions when completing the FES-I?

If a person misses four or fewer items on the 16-item FES-I, you can calculate an estimated score. Sum completed items, divide by the number completed, multiply by 16, and round up.

What do the different cut-off scores on the FES-I mean?

Scores of 16-19 indicate low concern, 20-27 moderate concern, and 28-64 high concern about falling. These should be used in a broader clinical context.

How do you score the Falls Efficacy Scale for someone who can't perform an activity?

The FES/FES-I measure concern, not ability. A person should answer based on their concern if they were to perform the activity.

Why is the score on the FES-I different from other balance tests?

The FES-I measures perceived confidence and concern about falling, a psychological factor, unlike objective physical balance tests. It provides a subjective perspective.

After scoring a high FES, what are the next steps for a healthcare provider?

A high score suggests a need to address fear of falling. This involves personalized strategies, balance exercises, physical therapy, and addressing psychological barriers.