This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (108)  • Contact me when this article is cited  Related Content  • Related letter  • Related articles  • Similar articles in JAMA  Topic Collections  • Aging/ Geriatrics  • Alert me on articles by topic  Social Bookmarking   What's this?

Pekka Kannus, MD, PhD; Jari Parkkari, MD, PhD; Seppo Koskinen, MD, PhD; Seppo Niemi; Mika Palvanen, MD; Markku Järvinen, MD, PhD; Ilkka Vuori, MD, PhD

JAMA. 1999;281:1895-1899.

Context  Although various fall-induced injuries and deaths among older adults are increasing, little is known about the epidemiology of these events.

Objective  To determine the trends in the number and incidence of fall-induced injuries and deaths of older adults in a well-defined white population.

Design and Setting  Secular trend analysis of the population of Finland, using the Finnish National Hospital Discharge Register and the Official Cause-of-Death Statistics of Finland.

Participants  All persons aged 50 years or older who were admitted to hospitals in Finland for primary treatment of a first fall-induced injury from the years of 1970 to 1995, and for comparison, all fall-induced deaths in the same age group from the years 1971 to 1995.

Main Outcome Measure  The number and the age-specific and age-adjusted incidence rate (per 100,000 persons) of fall-induced injuries and deaths in each year of the study.

Results  For the study period, both the total and population-adjusted number (per 100,000 persons) of Finns aged 50 years or older with fall-induced injury increased substantially. Total fall-induced injuries increased from 5622 in 1970 to 21,574 in 1995, a 284% increase, and the rate increased from 494 to 1398 per 100,000 persons, a 183% increase. The age-adjusted incidence also increased in both women (from 648 in 1970 to 1469 in 1995, a 127% increase) and men (from 434 in 1970 to 972 in 1995, a 124% increase). Moreover, the number of deaths due to falls in the overall population increased from 441 in 1971 to 793 in 1995, an 80% increase, and the rate increased from 38 in 1971 to 51 in 1995, a 34% increase. However, after age adjustment the incidence of fall-induced death did not show a clear upward trend.

Conclusions  In a well-defined white population, the number of older persons with fall-induced injuries is increasing at a rate that cannot be explained simply by demographic changes. Preventive measures should be adopted to control the increasing burden of these injuries. Fortunately, the age-adjusted incidence of the fall-induced deaths shows no increasing trend over time.

Author Affiliations: Accident & Trauma Research Center and the Tampere Research Center of Sports Medicine, President Urho Kaleva Kekkonen Institute for Health Promotion Research, Tampere, Finland (Drs Kannus, Parkkari, Palvanen, and Vuori and Mr Niemi); National Public Health Institute, Helsinki, Finland (Dr Koskinen); and the Medical School and the Department of Surgery, Tampere University and University Hospital, Tampere, Finland (Dr Järvinen).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTER

Time Trends in Severe Head Injuries Among Elderly Finns
Pekka Kannus, Mika Palvanen, and Seppo Niemi
JAMA. 2001;286(6):673-674.
EXTRACT | FULL TEXT  

RELATED ARTICLES

May 26, 1999
JAMA. 1999;281(20):1959-1960.
EXTRACT | FULL TEXT  

Falling and the elderly
JAMA. 1999;281(20):1962.
PDF  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Community-based intervention to optimise falls risk management: a randomised controlled trial
Ciaschini et al.
Age Ageing 2009;38:724-730.
ABSTRACT | FULL TEXT  

Disorders of Balance and Vestibular Function in US Adults: Data From the National Health and Nutrition Examination Survey, 2001-2004
Agrawal et al.
Arch Intern Med 2009;169:938-944.
ABSTRACT | FULL TEXT  

Accessibility of radiology equipment for patients with mobility disabilities.
Story et al.
Human Factors: The Journal of the Human Factors and Ergonomics Society 2008;50:801-810.
ABSTRACT  

Incidence of poisoning deaths in Finland in 1971-2005
Kivisto et al.
Hum Exp Toxicol 2008;27:567-573.
ABSTRACT  

Rising Incidence of Low-Trauma Fractures of the Calcaneus and Foot Among Finnish Older Adults
Kannus et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2008;63:642-645.
ABSTRACT | FULL TEXT  

Hip Protectors for Preventing Hip Fracture
Kannus and Parkkari
JAMA 2007;298:454-455.
FULL TEXT  

Tai Chi and Perceived Health Status in Older Adults Who Are Transitionally Frail: A Randomized Controlled Trial
Greenspan et al.
ptjournal 2007;87:525-535.
ABSTRACT | FULL TEXT  

Alarming Rise in the Number and Incidence of Fall-Induced Cervical Spine Injuries Among Older Adults
Kannus et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2007;62:180-183.
ABSTRACT | FULL TEXT  

The costs of fatal and non-fatal falls among older adults.
Stevens et al.
Inj. Prev. 2006;12:290-295.
ABSTRACT | FULL TEXT  

KANNUS RESPONDS
Kannus
AJPH 2005;95:1306-1306.
FULL TEXT  

Gender differences for non-fatal unintentional fall related injuries among older adults
Stevens and Sogolow
Inj. Prev. 2005;11:115-119.
ABSTRACT | FULL TEXT  

Fall-Induced Deaths Among Elderly People
Kannus et al.
AJPH 2005;95:422-424.
ABSTRACT | FULL TEXT  

Osteoporotic Fractures of the Distal Humerus in Elderly Women
Palvanen et al.
ANN INTERN MED 2003;139:W-61-W-61.
FULL TEXT  

Injury-Related Deaths Among Finnish Children, 1971-2001
Parkkari et al.
JAMA 2003;289:702-703.
FULL TEXT  

Population based study of hospitalised fall related injuries in older people
Peel et al.
Inj. Prev. 2002;8:280-283.
ABSTRACT | FULL TEXT  

Brain Injury Resulting From Falls Among Elderly Persons
Stevens et al.
JAMA 2001;286:2665-2666.
FULL TEXT  

Fall Risk Assessment Measures: An Analytic Review
Perell et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2001;56:M761-766.
ABSTRACT | FULL TEXT  

Carotid sinus syndrome: a modifiable risk factor for nonaccidental falls in older adults (SAFE PACE)
Kenny et al.
J Am Coll Cardiol 2001;38:1491-1496.
ABSTRACT | FULL TEXT  

Prevention of falls and subsequent injuries in elderly people: a long way to go in both research and practice
Kannus and Khan
CMAJ 2001;165:587-588.
FULL TEXT  

Time Trends in Severe Head Injuries Among Elderly Finns
Kannus et al.
JAMA 2001;286:673-674.
FULL TEXT  

Economic evaluation of a community based exercise programme to prevent falls
Robertson et al.
J. Epidemiol. Community Health 2001;55:600-606.
ABSTRACT | FULL TEXT  

Lower standing systolic blood pressure as a predictor of falls in the elderly: a community-based prospective study
Kario et al.
J Am Coll Cardiol 2001;38:246-252.
ABSTRACT | FULL TEXT  

Etiology and modification of gait instability in older adults: a randomized controlled trial of exercise
Hausdorff et al.
J. Appl. Physiol. 2001;90:2117-2129.
ABSTRACT | FULL TEXT  

Physical activity to prevent falls in older people: time to intervene in high risk groups using falls as an outcome
Khan et al.
Br. J. Sports. Med. 2001;35:144-145.
FULL TEXT  

Recent advances: Geriatric
BMJ 2001;322:86-89.
FULL TEXT  

Prevention of Hip Fracture in Elderly People with Use of a Hip Protector
Kannus et al.
NEJM 2000;343:1506-1513.
ABSTRACT | FULL TEXT  

Falls Increasing in the Elderly
JWatch Emergency Med. 1999;1999:20-20.
FULL TEXT