A Thematic Analysis of Lived Experiences of Falls in Middle-Aged and Older Adults.

Objectives: Fall-related injuries occur at a similar prevalence rate in middle-aged and older adults and may increase concerns about falling and future falls. No research to date has examined how experiences of falls and related concerns, differ between middle-aged and older fallers. This study aimed to address this using qualitative interviews. Methods: Ten middle-aged (55-64 years) and ten older adults (68-83 years) were interviewed about their experiences of falls and concerns about falling. Guided by a social constructivist epistemology, reflexive thematic analysis was used to categorise themes within the data. Results: Five overarching themes were identified. Four themes showed distinctions between groups (i) perceptions of age-related decline; (ii) ageism: stigma associated with 'fallers'; (iii) concerns about loss of independence; and (iv) unravelling perceived control. The fifth theme (v) perceptions of falls risk: concerns and awareness, demonstrated the most similarities. Conclusions: Whilst middle-aged and older fallers showed similar ratings of concern about falling, the behaviours underlying these were qualitatively different. For older adults, concerns led to protective adaptations to reduce their fall risk. Contrastingly, middle-aged adults showed a lack of personal responsibility over their fall risk. The findings highlight the importance of early educational intervention to reduce future falls and frailty.