Original Research
Gerontology

Attitude Towards Ageing and Physical Performance Among Adults 55 Years Old and Above

Authors: Low S, Cheng M, Pheh K

Affiliation: Physiotherapy Programme, Centre for Rehabilitation & Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

Published: Malaysian Journal of Public Health Medicine, 2018; Special Volume (1), Pages 10–17

Last reviewed: March 2026

Background and Rationale

Population ageing is a defining demographic trend of the 21st century, and Malaysia is no exception. According to projections, Malaysia’s older adult population is expected to double by 2030, driven by increases in life expectancy and declining fertility rates. This demographic shift has profound implications for healthcare systems, social services, and the well-being of older adults themselves. Among the many factors that influence health outcomes in later life, attitudes towards the ageing process have emerged as an area of growing research interest.

Negative attitudes towards ageing have been linked to detrimental psychological and physical health outcomes among older adults. These attitudes may influence the choices individuals make regarding activity levels, independence, engagement with healthcare services, and overall quality of life. Conversely, positive ageing attitudes have been associated with better functional outcomes and greater resilience in the face of age-related challenges. However, much of the existing research on attitudes towards ageing has been conducted in Western populations, with limited data from Southeast Asian countries including Malaysia.

A particularly important yet understudied area is the relationship between ageing attitudes and physical performance in adults aged 55 to 64 years—a period during which many age-related physical changes begin to manifest. Understanding this relationship in the pre-elderly and early-elderly population could inform early intervention strategies aimed at preventing functional decline and reducing falls risk.

Study Design and Methods

This cross-sectional study was conducted at five senior citizen clubs in the Klang Valley region of Malaysia. A total of 154 community-dwelling adults aged 55 years and above were recruited. The mean age of participants was 65.8 years (standard deviation: 6.82 years), indicating a relatively diverse age range within the older adult category.

Attitudes towards ageing were measured using Kogan’s Attitude towards Older People Questionnaire (KAOP), a validated instrument that assesses both positive and negative perceptions of the ageing process. The KAOP demonstrated acceptable reliability in this population, with a reported Cronbach’s alpha of 0.8.

Physical performance was assessed through multiple measures. Mobility was evaluated using the gait speed test, which has demonstrated significant correlations with the Timed Up and Go test (r = -0.75), weight shifting (r = -0.49 to 0.72), and the Berg Balance Scale (r = 0.81). Agility was measured using the ten-step test. Falls risk was assessed using the Physiological Profile Approach (PPA), a comprehensive tool that evaluates vision, peripheral sensation, muscle strength, reaction time, and postural sway to generate an overall falls risk score.

Principal Findings

Attitudes Towards Ageing

Approximately 75% of the participants demonstrated positive attitudes towards ageing as measured by the KAOP. This relatively high prevalence of positive attitudes is encouraging but must be interpreted in the context of the study setting—senior citizen clubs tend to attract more socially active and engaged individuals, who may inherently hold more positive views about ageing compared to the broader older adult population.

Physical Performance and Falls Risk

Despite the generally positive attitudes, the physical performance assessments revealed concerning patterns. Most participants demonstrated high to very high risk of falls based on the PPA assessment. This discordance between positive attitudes and elevated falls risk highlights the complexity of the relationship between psychological perspectives on ageing and actual physical health status.

Statistical analysis revealed significant correlations (p < 0.05) between attitude towards ageing, falls risk, and gait speed. Regression analysis further demonstrated that attitudes toward ageing had a statistically significant relationship with falls risk, explaining approximately 6% of the variance (F[1, 152] = 10.26, p < 0.01). While this effect size is modest, it suggests that psychological factors may play a meaningful, if limited, role in physical performance outcomes among older adults.

Implications for Falls Prevention and Healthy Ageing

The findings carry important implications for falls prevention programmes and healthy ageing initiatives in Malaysia. The observation that positive attitudes alone do not protect against elevated falls risk underscores the need for multifactorial approaches to falls prevention. Programmes that combine attitudinal interventions—such as promoting positive expectations about ageing—with targeted physical training addressing strength, balance, and gait may be more effective than either approach in isolation.

The study also supports the case for early screening of physical performance in adults from age 55 onwards, rather than waiting until conventional retirement age. Gait speed assessment, which proved to be a sensitive measure in this study, is a simple and cost-effective screening tool that could be incorporated into routine primary care visits for middle-aged and older adults.

Within the broader Malaysian context, these findings are relevant to the country’s response to its ageing population. Malaysia’s National Policy for Older Persons and the establishment of the Pusat Aktiviti Warga Emas (PAWE) centres reflect governmental recognition of the need for comprehensive older adult services. Research such as this study provides evidence to guide the content and focus of programmes offered at these centres.

Related Research in the Malaysian Context

This study contributes to a growing body of Malaysian research on ageing. The validated Malay version of the Attitude to Ageing Questionnaire (AAQ-M), confirmed by researchers working with 254 older adults at a public primary care clinic in Seremban, Malaysia, has established a three-factor model encompassing physical change, psychosocial loss, and psychological growth. Research on ageing attitudes among residents of an elderly care institution in Penang found mean AAQ scores slightly above average (76.6 out of a possible maximum), with quality of life and sleep quality significantly associated with positive attitudes. Barriers and facilitators of physical activity among Malaysian older adults have also been examined through systematic reviews, identifying gender, age, education, health status, ethnicity, attitude, social support, and locality as key determinants.

Limitations

The study’s cross-sectional design precludes causal inference about the relationship between ageing attitudes and physical performance. The recruitment from senior citizen clubs introduces selection bias, as these individuals may be more socially active and health-conscious than the general older adult population. The modest sample size of 154 participants limits statistical power for subgroup analyses. The 6% variance explained by attitudes in the regression model, while statistically significant, suggests that many other factors contribute to falls risk that were not captured in this study. Future longitudinal studies with larger, more representative samples would strengthen the evidence base.