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A study from Flinders University's Caring Futures Institute published in the journal BMC Public Health has highlighted the importance of fostering positive attitudes towards ageing as this can have a huge impact on how people adjust to their later stages of life.

Loneliness, feeling older than your age and a negative attitude to ageing are all associated with early stages of frailty, even in people as young as 40, the new research can reveal.

Lead author and PhD Candidate Tom Brennan from Flinders University's Caring Futures Institute says the study highlights an important intervention point that could help to prevent the progression of frailty later in life.

Brennan notes "many people assume frailty is something that happens when we get much older, but our research shows the psychological and behavioural warning signs can emerge decades earlier, in people in their 40s, 50s, and 60s.

"For example, feeling older than you are might sound like a throwaway comment, but it turns out it can be a sign that something's not quite right.

"With the impact frailty has on our healthcare system, alongside our growing ageing population, it's important we investigate ways to slow its progression."

Usually associated with older age, frailty is a recognised medical condition, marked by reduced strength, energy, and ability to recover from illness.

Pre-frailty is the reversible transition stage that comes before; however experts say it's ill-defined and requires more understanding.

In the study, Brennan and colleagues analysed data from 321 Australian adults aged 40 and over; 60% of participants were classified as pre-frail, 35% as non-frail, and 5% as frail.

Participants completed detailed surveys that assessed frailty status alongside their physical activity, chronic conditions, quality of life, loneliness, social isolation, as well as their perspectives on ageing.

The analysis found both pre-frail and frail individuals were more likely to report loneliness and holding negative attitudes toward ageing, compared to non-frail participants.

Brennan added "loneliness was one of the strongest predictors of pre-frailty in our sample, highlighting that social isolation is a critical factor that can affect overall resilience, even in relatively healthy and mobile population.

"At the same time, people's mindset around ageing matters; if you believe that getting older means giving up, you're more likely to experience both physical and psychological symptoms associated with frailty."

Another key finding was that pre-frail individuals commonly reported feeling older than their chronological age, even when physical health markers were within expected ranges.

"Feeling older than you are can be a meaningful psychological signal," said Brennan.

"We need to emphasise the importance of fostering positive attitudes towards ageing as this can have a huge impact on how people adjust to their later stages of life."

The authors recommend future frailty prevention strategies incorporate psychosocial screening tools and provide support for maintaining social engagement and a positive self-view of ageing.

"By recognising and addressing these early warning signs, communities and healthcare providers can implement targeted interventions to help people stay healthier for longer, potentially reducing healthcare costs and improving quality of life as our population ages," added Brennan.

"Ageing well isn't just about avoiding disease, it's about fostering resilience-physically, mentally and socially. The earlier we start, the better our chances."

The paper, 'Behavioural and psychological factors associated with pre‑frailty in community‑dwelling adults aged 40 and over: a cross‑sectional study' by Tom H. Brennan, Lucy K. Lewis, Susan J. Gordon and Ivanka Prichard is published in the journal BMC Public Health. DOI: 10.1186/s12889-025-21957-4

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