Reliability and validity of a steadiness score

OBJECTIVES: To determine the internal consistency and construct and predictive validity of three survey questions regarding steadiness in a sample of community-dwelling lower-income older adults. DESIGN: A 6-month prospective cohort study. SETTING: Community-based. PARTICIPANTS: Three hundred fifty-seven older adults who completed a baseline and 6-month follow-up interviewer-administered survey. These older adults received care at a single, public health system and were judged by insurance status to be of low income. MEASUREMENTS: Self-report measures of steadiness while walking and transferring; difficulty in mobility, activities of daily living (ADLs), and instrumental activities of daily living (IADLs); chronic illness; falls; hospitalization; and sociodemographic characteristics. RESULTS: The three steadiness questions showed good internal consistency (0.88); construct validity in Pearson correlations with mobility (0.57), ADL (0.53), and IADL scores (0.41); and predictive validity. With regard to predictive validity, steadiness was predictive of falls, hospitalization, and decline in ADL and IADL function over a subsequent 6-month period. CONCLUSION: Steadiness questions are a potentially valuable addition to survey research and clinical screening to identify persons with current impairment status and falls and disability risk.