Graduate School of Public Health, St. Luke's International University, Tokyo, Japan; Department of Rehabilitation, St. Luke's International Hospital, Tokyo, Japan.
Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.
Injury. 2023 Dec;54(12):111138. doi: 10.1016/j.injury.2023.111138. Epub 2023 Oct 16.
Falls are a significant public health issue in aging societies. This study aimed to examine the temporal, seasonal, and spatial patterns in fall-related mortality in Japan, and to investigate the potential factors associated with fall-related mortality.
The number of unintentional fall-related deaths from 1979 to 2019 were obtained from Japanese vital statistics and crude and direct age-standardized mortality rates (DSR) were calculated. We also calculated the standardized mortality ratio (SMR) to determine seasonal and prefectural differences. In addition, spatial regression was conducted to examine the potential factors associated with fall-related mortality.
The DSR among those over 65 years old showed a decreasing trend from 1979, but remained unchanged from 1990 to 2019. Based on the spatial regression model, the factors significantly associated with SMRs were the proportion of the aged population (Coefficient: 0.049), the number of hospitals (0.118), the number of clinics (1.169), the number of hospital beds (-0.060), and the number of physiotherapists (-0.069) for men; and the proportion of aged single households (-0.060), the number of hospitals (0.132), the number of clinics (1.498), the number of hospital beds (-0.051), and the number of physicians (-0.308) for women.
Fall-related mortality among Japanese elderly people has remained unchanged in recent years. In addition, seasonal and spatial patterns were also observed, and it was found that demographic data and healthcare resources in the prefectures affected fall-related mortality rates. Appropriate prevention measures of fall-related deaths should be considered according to the region-specific characteristics and issues.
在老龄化社会中，跌倒已成为一个重大的公共卫生问题。本研究旨在探讨日本与跌倒相关的死亡率的时间、季节和空间变化模式，并调查与跌倒相关的死亡率相关的潜在因素。
从日本人口动态统计数据中获取了 1979 年至 2019 年与非故意跌倒相关的死亡人数，并计算了粗死亡率和直接年龄标准化死亡率（DSR）。我们还计算了标准化死亡比（SMR）以确定季节和县的差异。此外，进行空间回归以检验与跌倒相关的死亡率相关的潜在因素。
65 岁以上人群的 DSR 从 1979 年开始呈下降趋势，但从 1990 年到 2019 年保持不变。根据空间回归模型，与 SMR 显著相关的因素是老年人口比例（系数：0.049）、医院数量（0.118）、诊所数量（1.169）、医院床位数量（-0.060）和物理治疗师数量（-0.069）男性；以及老年单身家庭比例（-0.060）、医院数量（0.132）、诊所数量（1.498）、医院床位数量（-0.051）和医师数量（-0.308）女性。
近年来，日本老年人与跌倒相关的死亡率保持不变。此外，还观察到季节性和空间模式，发现县内的人口统计数据和医疗保健资源影响了与跌倒相关的死亡率。应根据特定地区的特点和问题，考虑采取适当的预防跌倒相关死亡的措施。
