Mathew W Hill, Elmar Kal, Stephen Ronald Lord, Hayley Wright, David Broom, Toby J Ellmers
{"title":"衰老的自我认知预测跌倒后的恢复:来自英国老龄化纵向研究的前瞻性分析。","authors":"Mathew W Hill, Elmar Kal, Stephen Ronald Lord, Hayley Wright, David Broom, Toby J Ellmers","doi":"10.1111/jgs.19486","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate how mindsets around aging at baseline affect physical recovery following a subsequent fall.</p><p><strong>Design: </strong>Longitudinal observational study.</p><p><strong>Setting: </strong>English Longitudinal Study of Aging (ELSA).</p><p><strong>Participants: </strong>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).</p><p><strong>Measurements: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Self-Perceptions of Aging Predict Recovery After a Fall: Prospective Analysis From the English Longitudinal Study of Aging.\",\"authors\":\"Mathew W Hill, Elmar Kal, Stephen Ronald Lord, Hayley Wright, David Broom, Toby J Ellmers\",\"doi\":\"10.1111/jgs.19486\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate how mindsets around aging at baseline affect physical recovery following a subsequent fall.</p><p><strong>Design: </strong>Longitudinal observational study.</p><p><strong>Setting: </strong>English Longitudinal Study of Aging (ELSA).</p><p><strong>Participants: </strong>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).</p><p><strong>Measurements: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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. 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Future work should explore if targeting such perceptions can directly improve physical recovery and outcomes following a fall.</p>\",\"PeriodicalId\":94112,\"journal\":{\"name\":\"Journal of the American Geriatrics Society\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-05-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Geriatrics Society\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1111/jgs.19486\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Geriatrics Society","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1111/jgs.19486","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的:研究基线衰老心态对随后跌倒后身体恢复的影响。设计:纵向观察研究。设置:英国老龄化纵向研究(ELSA)。参与者:我们分析了694名患者的数据,他们在基线前2年内没有跌倒(第4波),但在随访期间(第4波和第5波之间)经历了跌倒。测量:基线时对衰老的自我认知(波4)和步态速度、日常生活活动(ADL)依赖性、跌倒后2年的身体活动(波5)。使用多变量逻辑回归分析来确定在基线时测量的与年龄相关的心态变量在多大程度上预测随访时的结果。结果:在控制混杂基线因素(包括基线步态速度、ADL依赖和缺乏运动)的完全调整模型中,基线时自我认知为积极的个体步态速度慢的几率显著降低(OR = 0.729;95% CI = 0.627-0.849), ADL依赖性(OR = 0.667;95% CI = 0.561-0.792)和缺乏运动(OR = 0.795;95% CI = 0.700-0.904),随访2年。结论:这些发现确定了衰老的自我认知是跌倒后身体恢复和残疾的一个强有力的预测因素,独立于其他重要因素,如年龄、性别和跌倒前的身体功能。这些新颖的观察结果促进了我们对影响跌倒后身体恢复的心理因素的理解。未来的工作应该探索针对这些感知是否可以直接改善跌倒后的身体恢复和结果。
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.