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Fall-Induced Injuries and Deaths Among Older Adults
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).
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