Background and Purpose: Fear of falling is highly prevalent in community-dwelling older adults and is associated with low health-related quality of life. However, screening for fear of falling does not identify domains in which the clinician should target intervention. Many outcome measures have ceiling effects and do not detect subtle changes in mobility. This study aimed to determine whether there is a correlation among balance confidence, fear of falling avoidance behaviors, and performance on high-level mobility tests in community-dwelling older adults and whether peformance on high-level mobility tests is a dicriminator between fallers and non-fallers. Methods: 89 community-dwelling older adults completed the World Health Organization Quaility of Life-BREF (WHOQOL-BREF), Activities-specific Balance Confidence Scale (ABC), Fear of Falling Avoidance Behavior Questionnaire (FFABQ), Functional Gait Assessment (FGA), and Community Balance and Mobility Scale (CB&M). Receiver operating characteristic curves were calculated to determine the ability of the ABC, FFABQ, FGA, and CB&M to discriminate between fallers and non-fallers. Correlation analyses were calculated to determine the relationship between the outcome measures. Multiple regression analyses were used to determine if there was a relationship between scores on the FGA, CB&M, ABC, and FFABQ and the WHOQOL-BREF. Results and Discussion: The ABC, FFABQ, FGA, and CB&M did not distinguish among fallers and non-fallers. There were significant correlations between the CB&M and ABC, FGA and ABC, CB&M and FFABQ, and FGA and FFABQ and between all outcome measures and QOL. Conclusion: Scores on performance-based outcome measures were correlated with patient-reported balance confidence and fear of falling avoidance behavior in community-dwelling older adults, but did not discriminate between fallers and non-fallers. Individuals who scored higher on the CB&M and FGA had higher QOL scores. These findings suggest that clinicians should test high-level mobility performance in older adults who report activity avoidance or low balance confidence.
