Positive self-perceptions about aging linked to better post-fall physical recovery

There is a strong association between an older person's view of how they are aging and how well they will physically recover after a fall.

That is the finding of a new research study from Imperial College London and Coventry University, which is the first to suggest how important psychological factors may be in post-fall physical recovery. The study is published in the Journal of the American Geriatrics Society.

Falls in older adults are a major health concern because they can lead to high levels of physical disability and hospitalisation, as well as affecting people's ability to live independently. The consequences of falls in older adults cost the NHS an estimated £5 million a day. However, not every older adult who falls experiences physical decline, so understanding why some recover much better than others is vital for developing therapies and interventions.

In the study, researchers found that individuals with more positive self-perceptions about aging at baseline – such as a person saying that age wasn't stopping them from doing what they wanted to do in life – were significantly less likely to experience physical problems or need help with daily activities after the fall.

The study involved longitudinal data from nearly 700 older adults across England between the ages of 60-90, who had not suffered any falls in the previous years. The data included questionnaire responses that measured mindsets and beliefs about aging. The researchers then assessed the members of this group who experienced a fall in the following year, to explore links between their subsequent recovery from this fall and their initial aging-related mindset and beliefs. This included measurements of post-fall walking speed, whether assistance was needed for daily living activities, and how physically inactive the person was after their fall.

Those who had initially shown more 'positive' aging mindsets-such as believing that aging was not stopping them doing what they wanted to do-were far more likely to physically recover in the months after a fall. 

The results were found to be independent of other important factors such as age, gender, depression, and pre-fall physical function. The results also controlled for whether the fall led to physical injury or not. As such, the researchers say the findings cannot simply be attributed to the older adults with a 'positive' mindset being younger, fitter, less depressed, or sustaining fewer injuries in general.

The researchers found that an individual scoring the highest possible score on the 'self perceptions of aging' measurements – or, having the most positive mindset – would have 162% lower odds of showing slow gait speed, 200% lower odds of being dependent on others to perform daily living activities, and 123% lower odds of physical inactivity following a fall, compared to an individual scoring the lowest possible score.

Dr. Toby Ellmers of Imperial College London's Department of Brain Sciences, who co-led the study, said: "Those who expressed more positive feelings about their own aging seemed to be protected against worse physical consequences after a fall. There was substantial difference in the rate of physical recovery in the people we studied, and this seemed to be linked to their initial beliefs about growing older."

Although we knew from previous research that negative mindsets and beliefs about aging are associated with increased risk of negative health outcomes, such as stroke and mortality, this is the first research linking these specifically to physical recovery after a fall."

Dr. Mathew Hill, Co-Lead, of Coventry University's Research Centre for Physical Activity, Sport and Exercise Sciences

Dr. Ellmers added: "Our results suggest that changing the way that some older people view their aging process could play a key role in improving recovery and wellbeing. It's even possible that simple 'tweaks' to help people develop a more positive mindset around aging – such as having discussions with a friend or relative about the positives associated with aging – could help. This is something we are very keen to explore in future research."

The authors note that the present study did not control for the severity of different falls (but only if injury did occur) and does not allow definitive conclusions about causality. As a next step, the researchers are hoping to explore whether addressing negative beliefs about aging can help stave off physical decline following a fall.