Abstract
Objective
To determine whether self-perceptions of aging (SPA) predict physical resilience following
a fall and whether SPA and physical resilience affect subsequent social engagement
in older adults with a fall.
Design
Prospective cohort study.
Setting
General community.
Participants
Older adults who reported a fall within 2 years after baseline data collection (n=1707,
mean age 72.9 years, 60.9% women).
Main outcome measure
Physical resilience indicates the ability to resist or recover from functional decline
from a stressor. The change in frailty status from directly after the fall to up to
two years of follow-up was used to generate four physical resilience phenotypes. Social
engagement was dichotomized based on the presence at one of the five social activities
at least once a month. The 8-item Attitudes Toward Own Aging Scale was used to assess
SPA at baseline. Multinomial logistic regression and nonlinear mediation analysis
were used.
Results
Positive prefall SPA predicted more resilient phenotypes after a fall. Both positive
SPA and physical resilience affected subsequent social engagement. Physical resilience
partially mediated the association between SPA and social re-engagement (mediated
percentage of 14.5 %, P = 0.004). This mediation effect was fully driven by those with previous falls.
Conclusion
Positive SPA promotes physical resilience in older adults with a fall, both of which
affect subsequent social engagement. Physical resilience partially mediated the effect
of SPA on social engagement but only for previous fallers. Multidimensional recovery
incorporating psychological, physiological and social aspects should be stressed in
the rehabilitation of older adults who fall.
Keyword
List of abbreviations:
SPA (self-perceptions of aging), HRS (Health and Retirement Study), LBQ (Leave-Behind Questionnaire), FI (frailty index), KHB (Karlson/Holm/Breen), RR (risk ratio), OR (odds ratio), CI (confidence interval), CV (coefficient of variance)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
February 13,
2023
Received in revised form:
February 3,
2023
Received:
August 3,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
