The Reliability and Validity of the Turkish Version of the Survey of Activities and Fear of Falling in the Elderly

Background and Purpose: The Survey of Activities and Fear of Falling in the Elderly (SAFE) was originally developed in English to determine the level of fear of falling and its interactions with activities of daily living. The purpose of this study was to translate and cross-culturally adapt the SAFE instrument into Turkish and investigate its psychometric properties. Participants: One hundred eleven older adults (72 females) with a mean age of 69 years (SD = 7.22; range, 60-87) were included. Methods: For cross-cultural adaptation, 2 bilingual translators used the back-translation procedure. Within a 5- to 7-day period after the first assessment, the participants completed the Turkish version of the SAFE (SAFE-T) to evaluate test-retest reliability. Cronbach's alpha was used to assess internal consistency. The correlation with the Turkish version of the Falls Efficacy Scale-International (FES-T) was determined to check the validity. Results: The SAFE-T had excellent internal consistency (alpha = 0.96) and test-retest reliability (intraclass correlation coefficient [ICC2,1] = 0.96 for activity level, ICC2,1 = 0.95 for fear of falling, and ICC2,1 = 0.86 for activity restriction subscales). The SAFE-T activity level and SAFE-T activity restriction subscales were moderately correlated with the FES-I (rho = -0.51, P < .001; rho = 0.55, P < .001, respectively). A strong positive correlation was found between the SAFE-T fear of falling subscale and the FES-I (rho = 0.75, P < .001), indicating good concurrent validity. Conclusions: The results show that the SAFE-T is semantically and linguistically adequate to assess the fear of falling in adults older than 60 years. Excellent internal validity and test-retest reliability of the SAFE-T were defined to evaluate the fear of falling among Turkish speaking older adults.

Automated summary

The purpose of this study was to translate and cross-culturally adapt the Survey of Activities and Fear of Falling in the Elderly (SAFE) instrument into Turkish, and investigate its psychometric properties. The results showed that the Turkish version of SAFE had excellent internal consistency and test-retest reliability, indicating its effectiveness in assessing fear of falling among older adults aged 60 and above.