Perceptions of Aging and Control Beliefs: A Study on Older Patients' Views of Aging

Locus of control (LoC) may shape how older adults appraise aging, particularly in acute geriatric rehabilitation. Evidence linking internal/external LoC to domain-specific Views on Aging (VoA, containing Physical Loss, Social Loss, Personal Growth, Self-awareness/Gains) remains limited.

We analyzed a cross-sectional cohort of patients aged 70 and above from an acute geriatric rehabilitation unit (N = 103) and contextualized findings with a 1:1 Mahalanobis-matched subsample from the German Ageing Survey. Internal and external LoC and covariates (age, sex, Barthel, cognitive function, depressive symptoms, health satisfaction) were standardized (z). Associations were estimated using (i) ordinary least squares (OLS) regression across eight LoC effects, as well as (ii) proportional-odds ordinal models (quartiles; logit link), as a complementary, distribution-robust approach.

For the Physical VoA domain, higher internal LoC related to more positive appraisals (OLS β = 0.133, 95% CI 0.043-0.223, p = 0.035; OR = 3.52), whereas higher external LoC related to less positive appraisals (β = -0.165, 95% CI -0.285 to -0.045, p = 0.035; OR = 0.274). Internal LoC also increased the odds of more positive Personal Growth (OR = 1.64, 95% CI 1.04-2.72), while effects on Social Loss (external LoC OR = 0.649, 95% CI 0.418-0.991) and Gains were smaller. Univariate Spearman correlations were directionally consistent. In the DEAS comparison, older patients showed greater endorsement of both physical losses and gains.

In acute geriatric rehabilitation, internal control beliefs align with more positive views of physical aging and growth, whereas external control aligns with less positive physical (and modestly social) views. The results position LoC as a clinically relevant correlate of aging appraisals.