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 (beta = -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 (beta = -.03, p < .01) and decreases in physical functioning (beta = .002, p < .001). Furthermore, changes from employment to retirement were associated with an increase in perceived autonomy (beta = .07, p < .05). Conclusions: The study findings suggest that avoiding falls may assist in maintaining autonomy in the second half of life.