The onset of falls and its effects on perceived social exclusion and loneliness. Evidence from a nationally representative longitudinal study.

Purpose It remains unclear how falls affect older people's social relations. In particular, the characteristics of fallers in their second half of life are unclear. Several studies have reported that people with a low educational level fall more often, and that low educational level is a predictor for perceived social exclusion. We conducted the first longitudinal analysis on the association between falls and social relations among people of different educational levels. Methods Longitudinal data were used from two waves (2014 and 2017) of the German Ageing Survey with an analytical sample of 11,227 individuals aged ≥ 40 years. Fall history in the past 12 months (yes; no) was assessed. Perceived social exclusion (outcome measure) was assessed using a validated scale developed by Bude and Lantermann. Loneliness (outcome measure) was measured using a short form of the validated De Jong Gierveld Loneliness Scale. Results Controlling for various potential confounding variables, fixed effects regression analysis stratified by educational level and gender revealed that experiencing a fall was associated with greater perceived social exclusion (β = 0.21 p < 0.05) among men with low/medium educational level. The experience of a fall was not associated with increased loneliness. Conclusion Our results suggest an association between falls and feelings of social exclusion. This association was found only for men in their second half of life with low/medium educational level. Falls were not associated with loneliness.