The onset of falls and its effects on perceived social exclusion and loneliness. Evidence from a nationally representative longitudinal study

•First longitudinal analysis examined the association between falls and social relations.•People with low educational level are at higher risk for falls.•Falls among men with low/medium educational level are associated with higher perceived social exclusion.•Falls are not associated with increased loneliness. It remains unclear how falls affect older people's social relations. In particular, the characteristics of fallers in their second half of life are unclear. Several studies have reported that people with a low educational level fall more often, and that low educational level is a predictor for perceived social exclusion. We conducted the first longitudinal analysis on the association between falls and social relations among people of different educational levels. Longitudinal data were used from two waves (2014 and 2017) of the German Ageing Survey with an analytical sample of 11,227 individuals aged ≥ 40 years. Fall history in the past 12 months (yes; no) was assessed. Perceived social exclusion (outcome measure) was assessed using a validated scale developed by Bude and Lantermann. Loneliness (outcome measure) was measured using a short form of the validated De Jong Gierveld Loneliness Scale. Controlling for various potential confounding variables, fixed effects regression analysis stratified by educational level and gender revealed that experiencing a fall was associated with greater perceived social exclusion (β = 0.21 p