Self-Perceptions of Aging Predict Recovery After a Fall: Prospective Analysis From the English Longitudinal Study of Aging

Objective: To investigate how mindsets around aging at baseline affect physical recovery following a subsequent fall. Design: Longitudinal observational study. Setting: English Longitudinal Study of Aging (ELSA). Participants: We analyzed data for 694 individuals who had not fallen in the 2 years prior to baseline (Wave 4) but experienced a fall during follow-up (between Waves 4 and 5). Measurements: Self-perceptions of aging at baseline (Wave 4) and gait speed, activities of daily living (ADL) dependence, and physical (in)activity after a fall at a 2-year follow-up (Wave 5). Multivariable logistic regression analyses were used to determine to what extent aging-related mindset variables as measured at baseline predicted outcome measures at follow-up. Results: In a fully-adjusted model controlling for confounding baseline factors (including baseline gait speed, ADL dependence and physical inactivity), individuals with positive self-perceptions of aging at baseline had significantly lower odds of slow gait speed (OR = 0.729; 95% CI = 0.627–0.849), ADL dependence (OR = 0.667; 95% CI = 0.561–0.792) and physical inactivity (OR = 0.795; 95% CI = 0.700–0.904) following a fall at a 2-year follow-up. Conclusions: These findings identify self-perceptions of aging as a strong predictor of physical recovery and disability following a fall, independent of other important factors such as age, gender, and pre-fall physical function. These novel observations advance our understanding of the psychological factors impacting physical recovery from a fall. Future work should explore if targeting such perceptions can directly improve physical recovery and outcomes following a fall.