Activities-specific balance confidence scale for predicting future falls in Indian older adults

BACKGROUND Activities-specific balance confidence (ABC) scale is a subjective measure of confidence in performing various ambulatory activities without falling or experiencing a sense of unsteadiness. OBJECTIVE This study aimed to examine the ability of the Hindi version of the ABC scale (ABC-H scale) to discriminate between fallers and non-fallers and to examine its predictive validity for prospective falls. DESIGN This was a prospective cohort study. MATERIALS AND METHODS A total of 125 community-dwelling older adults (88 were men) completed the ABC-H scale. The occurrence of falls over the follow-up period of 12 months was recorded. Discriminative validity was analyzed by comparing the total ABC-H scale scores between the faller and non-faller groups. A receiver operating characteristic curve analysis and a logistic regression analysis were used to examine the predictive accuracy of the ABC-H scale. RESULTS The mean ABC-H scale score of the faller group was significantly lower than that of the non-faller group (52.6±8.1 vs 73.1±12.2; P<0.001). The optimal cutoff value for distinguishing faller and non-faller adults was ≤58.13. The sensitivity, specificity, area under the curve, and positive and negative likelihood ratios of the cutoff score were 86.3%, 87.3%, 0.91 (P<0.001), 6.84, and 0.16, respectively. The percentage test accuracy and false-positive and false-negative rates were 86.87%, 12.2%, and 13.6%, respectively. A dichotomized total ABC-H scale score of ≤58.13% (adjusted odds ratio =0.032, 95% confidence interval =0.004-0.25, P=0.001) was significantly related with future falls. CONCLUSION The ABC-H scores were significantly and independently related with future falls in the community-dwelling Indian older adults. The ability of the ABC-H scale to predict future falls was adequate with high sensitivity and specificity values.