Wu Yu, Su Binbin, Gao Jiatong, Zhong Panliang, Zheng Xiaoying
Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
Inj Prev. 2024 Jul 13. doi: 10.1136/ip-2023-045225.
Falls in older age pose a major public health concern, with unclear urban-rural patterns of falls mortality in China. This study examines the trends of late-life falls mortality in urban and rural China over a 35-year period.
Falls mortality data were sourced from China's National Health Commission. Joinpoint regression analysis was used to examine changes in trends and age-period-cohort modelling to estimate age, period and cohort effects on fall-related mortality from 1987 to 2021. Net drift, local drift, longitudinal age curves and period relative risks were also calculated.
The age-standardised falls mortality in older age showed a long-term trend of initial decline prior to 2003, followed by a steep increase thereafter, with notable distinctions between urban and rural patterns. The rise in rural populations, particularly among older males, was more conspicuous. In rural areas, the decline in falls mortality diminished with age, contrary to the urban trend. Falls mortality increased with age in both urban and rural older populations, peaking in the group aged 85-89. The period effect curves of falls mortality in urban and rural areas both approximated a U-shaped pattern while there were minor variations in early cohorts.
China has experienced a consistent rise in late-life falls mortality in recent years. Notably, there are significant urban-rural disparities in age, period and cohort effects of fall-related mortality among older adults. Rural residents, males and older age groups have potential higher fatal-falls risk. Targeted strategies should be implemented to prevent late-life falls.
老年人跌倒问题是一个重大的公共卫生问题，中国城乡跌倒死亡率模式尚不清楚。本研究调查了中国城乡35年间老年人跌倒死亡率的趋势。
跌倒死亡率数据来源于中国国家卫生健康委员会。采用Joinpoint回归分析来研究趋势变化，并使用年龄-时期-队列模型来估计1987年至2021年期间年龄、时期和队列对跌倒相关死亡率的影响。还计算了净漂移、局部漂移、纵向年龄曲线和时期相对风险。
老年人年龄标准化跌倒死亡率在2003年之前呈长期下降趋势，之后急剧上升，城乡模式存在显著差异。农村人口的上升更为明显，尤其是老年男性。在农村地区，跌倒死亡率的下降幅度随年龄增长而减小，这与城市趋势相反。城乡老年人口的跌倒死亡率均随年龄增长而上升，在85-89岁年龄组达到峰值。城乡跌倒死亡率的时期效应曲线均近似U形模式，早期队列存在细微差异。
近年来，中国老年人跌倒死亡率持续上升。值得注意的是，老年人跌倒相关死亡率的年龄、时期和队列效应在城乡之间存在显著差异。农村居民、男性和老年人群体的致命跌倒风险可能更高。应实施有针对性的策略来预防老年人跌倒。
