The onset of falls reduces perceived autonomy among middle aged and older adults. Results from a longitudinal nationally representative sample

AIM: The purpose of this study was to identify whether the onset of falls is associated with reduced autonomy among individuals in the second half of life.

METHODS: Longitudinal data (with 7626 observations) were drawn from the German Ageing Survey, which is a nationally representative sample of individuals residing in private households ≥ 40 years. An established scale developed by Schwarzer was used to assess perceived autonomy. Falls in the preceding 12 months served as the main independent variable. Age, marital status, employment status, income, self-rated health, physical functioning and the number of physical illnesses were adjusted for in the analysis.

RESULTS: Adjusting for potential confounders, linear fixed effects regressions showed that the onset of falls was associated with lower perceived autonomy (β=-0.06, p < .01). This link was moderated by neither sex, age nor education. Moreover, a decrease in perceived autonomy was associated with worsening self-rated health (β=-.03, p < .01) and decreases in physical functioning (β = .002, p < .001). Furthermore, changes from employment to retirement were associated with an increase in perceived autonomy (β = .07, p < .05).

CONCLUSIONS: The study findings suggest that avoiding falls may assist in maintaining autonomy in the second half of life.