National Centre for Epidemiology. "Carlos III" Institute of Health, Av Monforte de Lemos 5, 28029, Madrid, Spain.
CIBERNED (Consortium for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain.
BMC Geriatr. 2017 Nov 28;17(1):276. doi: 10.1186/s12877-017-0670-6.
Accidental falls in older people are a major public health problem but a relatively limited number of studies have analyzed the mortality trends from this cause. Effective public health interventions have been found to prevent the incidence of falls and their complications. Therefore, characterizing the mortality trends of falls for different subpopulations can help to identify their needs and contribute to develop more appropriate prevention programs for specific target groups.
This study was based on a longitudinal analysis of death rates from accidental falls (2000-2015) stratified by sex for the population ≥ 65 years and by age groups (65-74, 75-84, ≥85). A joinpoint regression model was used to identify trend inflection points. The Annual Percent Change (APC) was estimated for each trend.
Mortality rates per 100,000 person-years increased from 20.6 to 30.1 for men and 13.8 to 20.8 for women between 2000 and 2015. Men presented a relevant trend increase between 2008 and 2015 (APC [95% CI] 7.2% [5.3;9.2]) and women between 2008 and 2013 (7.9% [4.1;11.8]) There were no trend differences between sexes. For 65-74 years old men we found a relevant increase in the last period (2011-2015) (7.8% [1.0;15.1]). Those aged 75-84 years showed a trend increase between 2007 and 2015 (6.4% [4.4;8.4]) and men ≥85 years presented a remarkably high trend between 2008 and 2015 (9.0% [5.2;13]). There were no relevant differences between age groups. Women aged 65-74 had no relevant trend through the period. Those aged 75-84 presented an uniform trend increase for the whole period, 2000-2015, (3.4% [2.3;4.4]) and women ≥85 had and important trend increase between 2008 and 2013 (11.1% [5.3;17.2]), that has reached an stable level in the last 2 years. There were no relevant differences between the 75-84 and ≥85 age groups.
Recent mortality trends from accidental falls increased in men ≥65 years and women ≥75 years. These results recommend the implementation of specific preventive programs.
老年人意外跌倒是一个重大的公共卫生问题，但只有相对较少的研究分析了这一原因导致的死亡率趋势。已发现有效的公共卫生干预措施可预防跌倒及其并发症的发生。因此，描述不同亚人群跌倒死亡率趋势有助于确定他们的需求，并有助于为特定目标群体制定更合适的预防计划。
本研究基于对 2000 年至 2015 年（按性别对≥65 岁人群和按年龄组（65-74、75-84、≥85）进行分层）因意外跌倒导致的死亡率进行的纵向分析。使用连接点回归模型来确定趋势转折点。估计了每个趋势的年平均百分比变化（APC）。
2000 年至 2015 年间，男性每 100,000 人年的死亡率从 20.6 上升至 30.1，女性从 13.8 上升至 20.8。男性在 2008 年至 2015 年之间呈现出明显的上升趋势（APC[95%CI]7.2%[5.3;9.2]），女性在 2008 年至 2013 年之间呈现出 7.9%[4.1;11.8]的上升趋势。性别之间没有趋势差异。65-74 岁的男性在最后一个时期（2011-2015 年）发现了明显的增长（7.8%[1.0;15.1]）。75-84 岁年龄组的人在 2007 年至 2015 年之间呈现出上升趋势（6.4%[4.4;8.4]），85 岁以上的男性在 2008 年至 2015 年之间呈现出显著的上升趋势（9.0%[5.2;13]）。各年龄组之间没有明显差异。65-74 岁的女性在整个期间没有明显的趋势。75-84 岁的女性在整个期间呈现出均匀的上升趋势，2000-2015 年（3.4%[2.3;4.4]），85 岁以上的女性在 2008-2013 年之间出现了重要的上升趋势（11.1%[5.3;17.2]），在过去两年中达到了稳定水平。75-84 岁和≥85 岁年龄组之间没有明显差异。
最近≥65 岁男性和≥75 岁女性因意外跌倒导致的死亡率趋势有所上升。这些结果表明需要实施具体的预防计划。
