Introduction. Fear of falling (FOF) has emerged as an important health concern in older adults, yet it has rarely been investigated in people with intellectual disabilities (ID). Valid and reliable measurement approaches are a particular challenge. Scales that have been developed to measure FOF have not been validated for use with older people with ID and are not routinely used with proxy respondents. Method. 63 people comprised purposeful samples of 3 groups, people with ID , their nominated key workers , and additional support workers . Test-retest reliability and interrater reliability were assessed for using a dichotomous, single-item FOF screening measure. The degree of FOF and activity restriction due to FOF were also investigated. Results. Inter-rater reliability was found to be moderate to excellent with Kappa？=？0.77 on ratings of the FOF item. Test-retest reliability for each group of reviewers for the FOF item were also found to be excellent (0.95). Conclusion. The global item is a suitable screening measure for FOF in older adults with ID and can assist in identification of individuals requiring further assessment. Proxies, if carefully selected, can provide consistent and reliable reports of the presence of FOF in people with ID. 1. Introduction Fear of falling (FOF) has emerged as an important health concern in all older adults given its demonstrated association with restrictions in daily activity and in many cases activity avoidance [1]. The substantial body of literature that has emerged addresses prevalence, risk factors, and consequences [2–4]. Reported prevalence of FOF in the general elderly population is as high as 85% [3]; identified risk factors include having had a previous fall [5], increasing age [4], female gender [6], dizziness, depression and anxiety [7], and balance and gait disorders [8] and documented consequences of FOF include a decline in physical and mental performance, activity avoidance, and a loss of health-related quality of life [9, 10]. A consequence of FOF is an increased risk of falling [5, 11] and there is a likelihood of additional falls, given reported rates of 29% and 92% of FOF among recent fallers with previous falls [3, 12]. Studies suggest that FOF is a psychological experience resulting in reduced physical activity leading to poor balance, mobility impairment, and social isolation [13]. Such consequences may lead to increased likelihood for falling in the future. By comparison very little is known about FOF among older people with ID despite studies showing that older people with ID have higher rates
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