- BACKGROUND: The Balance Evaluation Systems Test (BESTest) and its two abbreviated versions (mini-BESTest and briefBESTest) are functional balance tools that have yet to be validated in middle aged and elderly people living in the community. OBJECTIVE: Determine the construct validity of the three BESTest versions by comparing them with commonly-used measures of balance, balance confidence and physical activity, and examining their ability to discriminate between groups with respect to falls and fall risk. METHODS: This was a secondary analysis of data from 79 adults (mean age 68.7±10.57 years). Pearson correlation coefficients were used to examine the relationships between each BESTest measure and the Activities-Specific Balance Confidence (ABC) scale, the Physical Activity Scale for the Elderly (PASE), the Timed Up and Go (TUG) and the Single Leg Stance (SLS) test. Independent t-tests were used to examine differences in balance between fallers (≥1 fall in previous year) and non-fallers and individuals classified at low versus high fall risk using the Elderly Falls Screening Test (EFST). RESULTS: The BESTest measures showed moderate associations with the ABC scale and TUG (r=0.62-0.67 and -0.60 to -0.68 respectively), fair associations (r=0.33-0.40) with the PASE and moderate to high associations (r=0.67-0.77) with the SLS. Fallers showed a trend (p=0.054) for lower scores on the original BESTest, and people at high risk for falls had significantly lower scores on all BESTest versions. CONCLUSIONS: These findings support the construct validity of the BESTest, mini-BESTest and briefBESTest in adults over 50 years old.