Development and validation of a fall-related impulsive behaviour scale for residential care

Abstract

Introduction: impulsivity in older people with cognitive impairment has yet to be examined rigorously as a risk factor for falls. The objective of this study was to evaluate the psychometric properties of a new fall-related impulsive behaviour scale (FIBS) for a cognitively impaired population living in residential care. Methods: one hundred and nine care home residents (84.5 ± 8.3 years) were assessed on the FIBS and a range of behavioural, physical and neuropsychological measures. Participants were then prospectively followed up for falls for 6 months. Results: the internal reliability (Cronbach's α = 0.77) and test-retest reliability (intra-class correlation coefficient = 0.93) of the FIBS were both good. Construct validity was supported by significant correlations between the FIBS and the neuropsychiatric inventory (r = 0.43, P < 0.001), wandering (r = 0.33, P = 0.001) and global cognition (r = -0.2, P = 0.04). Compared with residents with FIBS scores <1, those with FIBS scores of ≥1 were nearly three times more likely to fall in the following 6 months, AOR = 2.92 (95% CI: 1.03-8.29). Conclusion: the FIBS is a simple, valid and reliable scale for assessing fall-related impulsivity in care home residents and can be recommended for use in this group for both research and clinical purposes. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.