Review article Cross-cultural validation of the falls efficacy scale international in elderly: Systematic literature review Cristina Maria Alves Marques-Vieira, MSc CRRN a , Luís Manuel Mota Sousa, MSc CRRN b, c , Sandy Severino, MSc CRRN c, * , Lisete Sousa, PhD d , Sílvia Caldeira, PhD MSc RN a a School of Nursing e Lisbon, Institute of Health Sciences, Universidade Cat olica Portuguesa, Lisbon, Portugal b Universidade Atl^ antica, Lisbon, Portugal c Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Entidade Pública Empresarial (EPE), Lisbon, Portugal d Department of Statistics and Operations Research and CEAUL (Projeto FCT projecto PEst-OE/MAT/UI0006/2014), Faculty of Sciences, Universidade de Lisboa, Lisbon, Portugal article info Article history: Received 15 October 2015 Received in revised form 15 November 2015 Accepted 17 December 2015 Available online 7 March 2016 Keywords: accidental fall aged fear reproducibility of results validation studies abstract The aim of this study is to describe the psychometric properties of cultural adaptations of the Falls Ef- ficacy Scale International (FES-I) in the elderly dwelling in the community. A systematic literature review was performed according to the research question: What are the psychometric properties of the FES-I in the elderly dwelling in the community in different cultural backgrounds? The Population, Interest, Context (PICo) strategy was used for inclusion criteriadPopulation: elderly; Interest area/intervention: psychometric properties of the FES-I; Context: dwelling in the community in various cultural settings. The sample was made up of 10 articles. Metric properties have been evaluated by the criteria of validity, reproducibility, reliability, and responsiveness. The FES-I is considered acceptable, understandable to measure the fear of falling in the elderly, valid, reliable, and comparable cross-culturally, so it is rec- ommended in rehabilitation research, clinical trials, clinical practice, and in fall-prevention programs in elderly. Copyright © 2016, Asia Pacific League of Clinical Gerontology & Geriatrics. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/). 1. Introduction The increased longevity of people poses new challenges to health policies and scientific research priorities. Population aging is a reality ever more present in most countries, leading transitions of society itself. The increasing number of elderly favors discussion with regard to impairments related to this age group, which highlights the occurrence of falls. 1 It is understood as an unintended drop event, which results in changing the individual position, to a lower level in relation to its initial position. 2 In a study performed in Brazil, 3 the prevalence of a fall in a 6- month period was 33.3% in a sample of 240 elderly people who lived in the community, of whom 25% had one or two falls and 6.3% had three or four falls. The greatest fall prevalence was found in women, the elderly, and the young, and most occurred in the yard and in the bathroom. The intrinsic factors that stood out in the cause of the falls in the elderly were altered balance, muscle weakness, dizziness/vertigo, and difficulty in walking. The extrinsic factors were: slippery surfaces, uneven floors or holes, high step and/or tread gap, objects on the floor, and throw rugs. Regarding the consequences, the elderly reported fear of falling again, anxiety, and depression. 3 Nurses need to be aware of the physical and physiological changes that come from the aging process, under- standing the fragility of the elderly, but also possible changes in family dynamics. It is important to know how the elderly feel in their context because a situation of dependence and reduced functional capacity can have an impact on people's lives as it in- volves biological, physical, emotional and social issues. 4 Reduced muscle strength and flexibility associated with aging, as well as postural changes, may lead to the fear of falling, even though they had never experienced a fall. 5 The fear of falling causes a loss of confidence in performing daily tasks, restrictions on social * Corresponding author. Intensive Care Unit e UCIP 7, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Entidade Pública Empresarial (EPE), Rua da Benefic^ encia, n.º 8, 1069-166 Lisboa, Portugal. E-mail address: sandyseverino@gmail.com (S. Severino). Contents lists available at ScienceDirect Journal of Clinical Gerontology & Geriatrics journal homepage: www.e-jcgg.com http://dx.doi.org/10.1016/j.jcgg.2015.12.002 2210-8335/Copyright © 2016, Asia Pacific League of Clinical Gerontology & Geriatrics. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Journal of Clinical Gerontology & Geriatrics 7 (2016) 72e76