Cross-Cultural Adaptation and Psychometric Evaluation of the Turkish Short Falls Efficacy Scale–International (Short FES-I) for Assessing Concerns About Falling in Community-Dwelling Older Adults

Abstract

Background/Objectives: This study aimed to evaluate the psychometric properties of the Turkish version of the Short Falls Efficacy Scale–International (Short FES-I) in community-dwelling older adults. Methods: This cross-sectional methodological study included 200 adults aged ≥65 years recruited from Family Health Centers. Following translation and cross-cultural adaptation, internal consistency was assessed using Cronbach’s alpha, McDonald’s omega, and corrected item–total correlations. Structural validity was examined using confirmatory factor analysis (CFA) with diagonally weighted least squares estimation, including an initial single-factor model and a modified model incorporating two post-hoc correlated residuals. Construct validity was evaluated through hypothesis testing, including Spearman correlations and known-groups comparisons. Multiple linear regression was performed as a supplementary analysis of factors associated with Short FES-I scores. Results: The Turkish Short FES-I demonstrated high internal consistency (Cronbach’s α = 0.910; McDonald’s ω = 0.915), with corrected item–total correlations ranging from 0.608 to 0.839. The initially specified single-factor CFA model showed an elevated RMSEA (0.113). Following the introduction of two post-hoc correlated residuals between Items 4 and 6 and between Items 5 and 7, the modified model showed improved fit (CFI = 0.999, TLI = 0.998, SRMR = 0.045, RMSEA = 0.066, 95% CI: 0.018–0.108). Short FES-I scores were positively correlated with Katz ADL (Spearman’s ρ = 0.589) and FRAIL scores (ρ = 0.618) and negatively correlated with Berg Balance Scale scores (ρ = −0.800; all p < 0.001). Known-groups comparisons were generally consistent with the prespecified hypotheses. In the multivariable regression analysis, lower BBS scores, higher FRAIL scores, and greater fear of falling were significantly associated with higher Short FES-I scores (adjusted R2 = 0.710). Conclusions: The Turkish Short FES-I demonstrated high internal consistency and preliminary evidence supporting its construct validity. Although the modified single-factor model showed improved fit after two data-driven residual covariances were introduced, these structural findings require confirmation in an independent sample. Test–retest reliability, measurement error, and responsiveness also remain to be evaluated.