Validation of the Persian version of the 9-item Berg Balance Scale Among Older Iranians

Objectives: Old age is often associated with a progressive decline in the capacity of individuals to maintain dynamic and static balance, leading to falls and fear of falling. This study aimed to validate the 9-item Berg Balance Scale (BBS-9) for the older Iranian population. Methods: The current psychometric study involved translation of the BBS-9 to Persian language and its validation among a cohort of Persian-speaking elderly people. Confirmatory factor analysis, exploratory factor analysis, internal consistency, construct validity, test-retest reliability, receiver operating characteristic analysis, inter-rater, and convergent validity of the BBS-9 (Persian) were investigated and statistically analyzed. Results: The participants were 9117 Iranians with an average age of 64.3±2.45 years. The cohort was 54.1% female. Nearly three quarters of the subjects (72.4%) lived alone, 92.9% needed help with activities of daily living, and 93.0% sustained falls in the previous two years. Internal consistency was confirmed using intraclass correlation coefficient and McDonald’s Omega (≥ 0.75). The receiver operating characteristic analysis represented the exact cut-off values for male and female and with or without fear of falling with good specificity and sensitivity. Analysis of variance revealed that fear of falling was significantly related to age, Aging in Place, loneliness, hospitalization rate, frailty, and sense of anxiety (effect size ≥ 0.130, p ≤ 0.050). Conclusions: The Persian version of BBS-9, a psychometrically sound self-reported measure of fear of falling, retained the original’s satisfactory psychometric properties. It has the potential to be used among older Iranians in community-based and clinical settings.