Reliability and validity of the Chinese version of the Falls Behavioural Scale for Older People (FaB) among community-dwelling older adults in China

Objective To evaluate the reliability and validity of the Chinese version of the Falls Behavioural Scale for Older People (FaB) among community-dwelling older adults in China, thus providing a sound instrument for assessing fall risk in this population.

Methods The FaB was translated and culturally adapted by a translation–back translation–expert review procedure. In August 2025, a total of 113 community-dwelling older adults aged ≥ 60 years were randomly selected from Jiangyin city, Wuxi city, Jiangsu province to complete the Chinese version of the FaB. Item analysis and Cronbach′s α coefficient were employed to assess reliability. Content validity index (CVI) and exploratory factor analysis (EFA) were employed to examine validity.

Results Item analysis showed that all the 24 items of the Chinese version of the FaB demonstrated good discriminative power, with critical ratio (CR) values > 3.0 (t = 15.289, P < 0.001) and coefficients of variation (CV) > 25%. The overall Cronbach′s α coefficient was 0.851, indicating good internal consistency reliability. For content validity, the scale-level content validity index (S-CVI/Ave) was 0.89 for content relevance, 0.93 for clarity of expression, and 0.96 for cultural appropriateness. The item-level content validity index (I-CVI) ranged from 0.67 to 1.00, 0.56 to 1.00, and 0.67 to 1.00 across the three dimensions, respectively. Exploratory factor analysis yielded a Kaiser-Meyer-Olkin (KMO) value of 0.711 and Bartlett′s test of sphericity indicated statistically significant differences (χ² = 986.722, P < 0.001), indicating suitability for factor analysis. Principal component analysis with varimax rotation extracted seven common factors: situational behavioral regulation, proactive protective behavior, environmental vigilance and adaptation, body stability management, risky daily behaviors, planned safety habits, and high-reach risk coping and social learning. The cumulative variance explained was 64.58%, demonstrating good structural validity.

Conclusions The Chinese version of the FaB exhibits good reliability and validity. It comprehensively reflects fall-related behavioral characteristics in daily life and is suitable for assessing fall risk among community-dwelling older adults in China.