Psychometric Evaluation of the Japanese Brief Multidimensional Falls Efficacy Scale (MdFES-J) in Community-Dwelling Older Adults

Introduction

Concern about falling (CaF), balance confidence, and falls efficacy are conceptually distinguishable psychological constructs in geriatric rehabilitation. Although interrelated, they require construct-specific measurement. Currently, no validated instrument exists to measure falls efficacy in Japan. The Brief Multidimensional Falls Efficacy Scale (MdFES), 4-item instrument for assessing falls efficacy, was recently developed; therefore, this study aimed to evaluate the psychometric properties of the Japanese version of MdFES (MdFES-J).

Methods

This cross-sectional study included 58 community-dwelling older adults (mean age 76.3 [SD 6.4] years, range 65.0–90.0). Caf was assessed by the short version of the Falls Efficacy Scale-International (FES-I), and balance confidence by the Activities-specific Balance Confidence (ABC) scale. Reliability was evaluated via Cronbach’s alpha and weighted kappa coefficients. Validity was assessed using exploratory factor analysis, correlations with ABC scale and FES-I, and comparisons between groups categorized by ABC score (≤80 vs. >80) and FES-I score (<14 vs. ≥14).

Results

The MdFES-J showed excellent internal consistency (Cronbach’s alpha = 0.875) and moderate test-retest agreement (weighted kappa = 0.443–0.565). Exploratory factor analysis supported a single-factor structure (64.5% variance). MdFES-J correlated significantly with the ABC scale (rho = 0.499, p < 0.01), but not with FES-I (p = 0.55). Known-groups validity was supported by significant score differences: higher scores were observed in the high balance confidence group (8.9 [2.7] vs. 6.9 [1.5], p < 0.01) and the low/moderate CaF group (8.8 [2.8] vs. 7.6 [1.9], p = 0.04).

Conclusions

The MdFES-J is a valid and reliable instrument for assessing falls efficacy in Japanese older adults. Its ability to discriminate psychological risk groups and its specific association with balance confidence suggest it captures a distinct construct of perceived capability in managing fall-related situations, providing clinical insights that complement existing measures of CaF.