. 2020 Oct;26(Supp 1):i67-i74.

doi: 10.1136/injuryprev-2019-043347. Epub 2020 Feb 28.

Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017

Juanita A Haagsma¹, Branko F Olij^{2

3}, Marek Majdan⁴, Ed F van Beeck⁵, Theo Vos^{6

7}, Chris D Castle⁶, Zachary V Dingels⁶, Jack T Fox⁶, Erin B Hamilton⁶, Zichen Liu⁶, Nicholas L S Roberts⁶, Dillon O Sylte⁶, Olatunde Aremu⁸, Till Winfried Bärnighausen^{9

10}, Antonio M Borzì¹¹, Andrew M Briggs^{12

13}, Juan J Carrero¹⁴, Cyrus Cooper^{15

16}, Ziad El-Khatib¹⁷, Christian Lycke Ellingsen^{18

19}, Seyed-Mohammad Fereshtehnejad^{20

21}, Irina Filip^{22

23}, Florian Fischer²⁴, Josep Maria Haro^{25

26}, Jost B Jonas^{27

28}, Aliasghar A Kiadaliri²⁹, Ai Koyanagi^{30

31}, Raimundas Lunevicius^{32

33}, Tuomo J Meretoja^{34

35}, Shafiu Mohammed^{36

37}, Ashish Pathak^{17

38}, Amir Radfar^{39

40}, Salman Rawaf^{41

42}, David Laith Rawaf^{43

44}, Lidia Sanchez Riera^{45

46}, Ivy Shiue⁴⁷, Tommi Juhani Vasankari⁴⁸, Spencer L James⁶, Suzanne Polinder²

Affiliations

¹ Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands j.haagsma@erasmusmc.nl.
² Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
³ Consumer Safety Institute, Amsterdam, The Netherlands.
⁴ Department of Public Health, Trnava University, Trnava, Slovakia.
⁵ Department of Public Health, Erasmus University, Rotterdam, The Netherlands.
⁶ Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.
⁷ Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
⁸ School of Health Sciences, Birmingham City University, Birmingham, UK.
⁹ Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany.
¹⁰ T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.
¹¹ General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
¹² School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia.
¹³ Ageing and Life Course, World Health Organization (WHO), Geneva, Switzerland.
¹⁴ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
¹⁵ Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
¹⁶ Department of Rheumatology, University of Oxford, Oxford, UK.
¹⁷ Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
¹⁸ Department of Pathology, Stavanger University Hospital, Stavanger, Norway.
¹⁹ Norwegian Institute of Public Health, Oslo, Norway.
²⁰ Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
²¹ Division of Neurology, University of Ottawa, Ottawa, Ontario, Canada.
²² Psychiatry Department, Kaiser Permanente, Fontana, California, USA.
²³ School of Health Sciences, A.T. Still University, Mesa, Arizona, USA.
²⁴ School of Public Health Medicine, Bielefeld University, Bielefeld, Germany.
²⁵ Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain.
²⁶ Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain.
²⁷ Department of Ophthalmology, Heidelberg University, Mannheim, Germany.
²⁸ Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China.
²⁹ Clinical Epidemiology Unit, Lund University, Lund, Sweden.
³⁰ CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain.
³¹ Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.
³² Department of General Surgery, Aintree University Hospital National Health Service (NHS) Foundation Trust, Liverpool, UK.
³³ Department of Surgery, University of Liverpool, Liverpool, UK.
³⁴ Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland.
³⁵ University of Helsinki, Helsinki, Finland.
³⁶ Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria.
³⁷ Institute of Public Health, Heidelberg University, Heidelberg, Germany.
³⁸ Department of Pediatircs, RD Gardi Medical College, Ujjain, India.
³⁹ College of Graduate Health Sciences, A.T. Still University, Mesa, Arizona, USA.
⁴⁰ Medichem, Barcelona, Spain.
⁴¹ Department of Primary Care and Public Health, Imperial College London, London, UK.
⁴² Academic Public Health, Public Health England, London, UK.
⁴³ WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK.
⁴⁴ University College London Hospitals, London, UK.
⁴⁵ Department of Rheumatology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
⁴⁶ Institute of Bone and Joint Research, University of Sydney, Sydney, New South Wales, Australia.
⁴⁷ Institute of Medical Epidemiology, Martin Luther University Halle-Wittenberg, Halle, Germany.
⁴⁸ UKK Institute, Tampere, Finland.

PMID: 32111726
PMCID: PMC7571349
DOI: 10.1136/injuryprev-2019-043347

Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017

Juanita A Haagsma et al. Inj Prev. 2020 Oct.

. 2020 Oct;26(Supp 1):i67-i74.

doi: 10.1136/injuryprev-2019-043347. Epub 2020 Feb 28.

Authors

Affiliations

¹ Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands j.haagsma@erasmusmc.nl.
² Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
³ Consumer Safety Institute, Amsterdam, The Netherlands.
⁴ Department of Public Health, Trnava University, Trnava, Slovakia.
⁵ Department of Public Health, Erasmus University, Rotterdam, The Netherlands.
⁶ Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.
⁷ Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
⁸ School of Health Sciences, Birmingham City University, Birmingham, UK.
⁹ Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany.
¹⁰ T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.
¹¹ General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
¹² School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia.
¹³ Ageing and Life Course, World Health Organization (WHO), Geneva, Switzerland.
¹⁴ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
¹⁵ Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
¹⁶ Department of Rheumatology, University of Oxford, Oxford, UK.
¹⁷ Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
¹⁸ Department of Pathology, Stavanger University Hospital, Stavanger, Norway.
¹⁹ Norwegian Institute of Public Health, Oslo, Norway.
²⁰ Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
²¹ Division of Neurology, University of Ottawa, Ottawa, Ontario, Canada.
²² Psychiatry Department, Kaiser Permanente, Fontana, California, USA.
²³ School of Health Sciences, A.T. Still University, Mesa, Arizona, USA.
²⁴ School of Public Health Medicine, Bielefeld University, Bielefeld, Germany.
²⁵ Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain.
²⁶ Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain.
²⁷ Department of Ophthalmology, Heidelberg University, Mannheim, Germany.
²⁸ Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China.
²⁹ Clinical Epidemiology Unit, Lund University, Lund, Sweden.
³⁰ CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain.
³¹ Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.
³² Department of General Surgery, Aintree University Hospital National Health Service (NHS) Foundation Trust, Liverpool, UK.
³³ Department of Surgery, University of Liverpool, Liverpool, UK.
³⁴ Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland.
³⁵ University of Helsinki, Helsinki, Finland.
³⁶ Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria.
³⁷ Institute of Public Health, Heidelberg University, Heidelberg, Germany.
³⁸ Department of Pediatircs, RD Gardi Medical College, Ujjain, India.
³⁹ College of Graduate Health Sciences, A.T. Still University, Mesa, Arizona, USA.
⁴⁰ Medichem, Barcelona, Spain.
⁴¹ Department of Primary Care and Public Health, Imperial College London, London, UK.
⁴² Academic Public Health, Public Health England, London, UK.
⁴³ WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK.
⁴⁴ University College London Hospitals, London, UK.
⁴⁵ Department of Rheumatology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
⁴⁶ Institute of Bone and Joint Research, University of Sydney, Sydney, New South Wales, Australia.
⁴⁷ Institute of Medical Epidemiology, Martin Luther University Halle-Wittenberg, Halle, Germany.
⁴⁸ UKK Institute, Tampere, Finland.

PMID: 32111726
PMCID: PMC7571349
DOI: 10.1136/injuryprev-2019-043347

Abstract

Introduction: Falls in older aged adults are an important public health problem. Insight into differences in fall-related injury rates between countries can serve as important input for identifying and evaluating prevention strategies. The objectives of this study were to compare Global Burden of Disease (GBD) 2017 estimates on incidence, mortality and disability-adjusted life years (DALYs) due to fall-related injury in older adults across 22 countries in the Western European region and to examine changes over a 28-year period.

Methods: We performed a secondary database descriptive study using the GBD 2017 results on age-standardised fall-related injury in older adults aged 70 years and older in 22 countries from 1990 to 2017.

Results: In 2017, in the Western European region, 13 840 per 100 000 (uncertainty interval (UI) 11 837-16 113) older adults sought medical treatment for fall-related injury, ranging from 7594 per 100 000 (UI 6326-9032) in Greece to 19 796 per 100 000 (UI 15 536-24 233) in Norway. Since 1990, fall-related injury DALY rates showed little change for the whole region, but patterns varied widely between countries. Some countries (eg, Belgium and Netherlands) have lost their favourable positions due to an increasing fall-related injury burden of disease since 1990.

Conclusions: From 1990 to 2017, there was considerable variation in fall-related injury incidence, mortality, DALY rates and its composites in the 22 countries in the Western European region. It may be useful to assess which fall prevention measures have been taken in countries that showed continuous low or decreasing incidence, death and DALY rates despite ageing of the population.

Keywords: burden of disease; disability; metanalysis; time series.

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Conflict of interest statement

Competing interests: Dr. Briggs reports grants from Australian National Health and Medical Research Council, outside the submitted work. Professor Cooper reports personal fees from Alliance for Better Bone Health, Amgen, Eli Lilly, GSK, Medtronic, Merck, Novartis, Pfizer, Roche, Servier, Takeda and UCB. Dr. Haro reports personal fees from Lundbeck and from Roche, and that the institution for which they work provides scientific work for Eli Lilly and Co. Dr. James reports grants from Sanofi Pasteur, outside the submitted work.

Figures

**Figure 1**
Age-standardised DALY rate (the 70+ DALY rates by country were age standardised within the 70+-year age group) of falls in older adults per 100 000 per country, 2017. DALY, disability-adjusted life year.

**Figure 2**
DALY rate (the 70+ DALY rates by country were age standardised within the 70+-year age group) of falls in older adults per 100 000 per country in the period from 1990 to 2017. (A) Countries with a decrease in DALY rate between 1990 and 2017. (B) Countries with an increase in DALY rate between 1990 and 2017. DALY, disability-adjusted life year.

**Figure 3**
YLD:DALY ratio of falls in older adults by country, 1990–2017. (A) Countries with a decrease or a small increase (<0.04) in YLD:DALY ratio between 1990 and 2017. (B) Countries with a medium increase (≥0.04 and<0.09) in YLD:DALY ratio between 1990 and 2017. (C) Countries with a large increase (≥0.09) in YLD:DALY ratio between 1990 and 2017. DALY, disability-adjusted life year; YLD, year lived with disability.

See this image and copyright information in PMC

References

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Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017

Affiliations

Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical