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

Last reviewed: March 2026

Background and Rationale

Malaysia, like much of Southeast Asia, is undergoing a demographic transition characterised by an increasingly ageing population. By 2030, the country is projected to attain “aged nation” status, with the proportion of citizens aged 60 and above reaching 15% of the total population. This shift presents significant public health challenges, particularly regarding the maintenance of physical function and the prevention of falls among older adults.

Negative attitudes towards ageing have long been linked to adverse psychological, physical, and health outcomes. Research conducted internationally has shown that older adults who hold pessimistic views about the ageing process tend to experience greater functional impairment, lower levels of physical activity, and diminished wellbeing. However, much of this evidence has been generated in Western populations, and relatively little is known about how attitudes towards ageing influence physical performance among middle-aged and older adults in the Malaysian context.

This is particularly relevant for the 55-to-64-year age group, an often-overlooked cohort that represents a critical window for preventive intervention. Adults in this age range are typically still active but beginning to experience the physiological changes associated with ageing. Understanding their attitudes and how these attitudes relate to physical performance may inform early intervention strategies aimed at promoting healthier ageing trajectories.

Study Design and Methods

This cross-sectional study was conducted at five senior citizen activity clubs in the Klang Valley region of Malaysia. A total of 154 community-dwelling adults aged 55 and above participated, with a mean age of 65.8 years (standard deviation: 6.82). The study employed several validated assessment tools to measure the key variables of interest.

Attitude towards ageing was assessed using Kogan’s Attitude towards Older People Questionnaire (KAOP), a well-established instrument that evaluates both positive and negative perceptions of the ageing process. The KAOP demonstrated acceptable internal consistency in this population, with a Cronbach’s alpha of 0.8. Mobility was measured using a standardised gait speed test, which has been shown to correlate significantly with established measures of balance and functional mobility. Agility was assessed using a ten-step test. Falls risk was evaluated using the Physiological Profile Approach (PPA), a comprehensive assessment battery that combines five key physiological measures to generate an overall falls risk score.

Additional screening instruments included the Geriatric Depression Scale (GDS-15) to identify depressive symptoms, the Short Falls Efficacy Scale–International (Short FES-I) to assess fear of falling, and the Modified Baecke Questionnaire (MBQ) to measure habitual physical activity levels. These covariates were included to provide a more complete picture of the factors that may influence the relationship between ageing attitudes and physical performance.

Principal Findings

The results revealed a somewhat paradoxical pattern. Despite the fact that approximately three-quarters of participants expressed positive attitudes towards ageing, a substantial proportion simultaneously demonstrated high to very high risk of falls on the PPA assessment. This finding suggests that positive attitudes alone may be insufficient to protect against age-related declines in physical function, and that objective physiological assessments remain essential for identifying at-risk individuals.

Correlation analysis revealed statistically significant relationships between attitude towards ageing and both falls risk and gait speed (p < 0.05). Participants who held more positive attitudes tended to have faster gait speeds and lower falls risk scores, though the strength of these associations was moderate. Regression analysis further demonstrated that attitudes toward ageing had a significant predictive relationship with falls risk, accounting for approximately 6% of the variance in falls risk scores (F(1, 152) = 10.26, p < 0.01).

The Relationship Between Attitude and Falls Risk

The finding that attitudes towards ageing accounted for 6% of the variance in falls risk, while statistically significant, indicates that many other factors contribute to falls risk in this population. Physical factors such as muscle strength, vision, proprioception, and reaction time are well-established contributors to falls risk. Psychological factors including depression and fear of falling also play important roles, as do environmental hazards and medication use.

Nevertheless, the fact that attitude towards ageing emerged as a significant independent predictor of falls risk suggests that psychosocial factors deserve greater attention in falls prevention programmes. Adults who view ageing negatively may be less likely to engage in physical activity, less motivated to participate in exercise programmes, and more likely to adopt sedentary behaviours that contribute to functional decline. Conversely, those with more positive attitudes may be more proactive about maintaining their physical fitness and seeking opportunities for social engagement and physical activity.

Implications for Malaysian Public Health

These findings carry particular relevance for Malaysia’s evolving public health landscape. As the country moves towards aged-nation status, there is an urgent need for evidence-based strategies to promote healthy ageing. The current study suggests that interventions aimed at fostering positive attitudes towards ageing—implemented in middle adulthood, before the onset of significant age-related decline—may contribute to better physical health outcomes in later life.

Such interventions could include community-based education programmes that challenge negative stereotypes about ageing, promote intergenerational interaction, and emphasise the potential for continued physical and social engagement throughout the lifespan. Integrating attitude-focused components into existing falls prevention programmes may enhance their effectiveness by addressing both the physiological and psychological dimensions of falls risk.

Senior citizen clubs, such as those that served as recruitment sites for this study, represent valuable community resources for delivering such programmes. These settings offer regular access to older adults who are already engaged in some level of community participation, making them ideal venues for health promotion activities.

Limitations

Several limitations should be considered when interpreting these findings. The cross-sectional design precludes causal inferences; it is not possible to determine whether positive attitudes lead to better physical performance or whether better physical function contributes to more positive attitudes towards ageing. The study sample was drawn exclusively from senior citizen clubs in the Klang Valley, which may limit generalisability to the broader Malaysian population, particularly those in rural areas or institutional settings. The relatively small sample size of 154 participants may have limited the statistical power to detect smaller effect sizes. Furthermore, the reliance on self-report measures for attitudes introduces the potential for social desirability bias.

Significance of This Research

Despite these limitations, this study makes an important contribution to the limited body of evidence on ageing attitudes and physical performance in the Malaysian context. It highlights the need for holistic approaches to healthy ageing that address both physical and psychological dimensions, and it underscores the importance of early intervention—targeting adults in their mid-fifties and beyond—to promote positive ageing trajectories. As Malaysia continues to grapple with the challenges of an ageing population, research of this nature will be essential for informing evidence-based policy and practice.

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