Circumstances and Contributing Causes of Fall Deaths among Persons Aged 65 and Older: United States, 2010

Journal of the American Geriatrics Society (Impact Factor: 4.57). 03/2014; 62(3). DOI: 10.1111/jgs.12702


To determine whether the increasing fall death rate among people aged 65 and older is due in part to temporal changes in recording the underlying cause of death. DesignAnalyses of multiple cause of death data using the online Centers for Disease Control and Prevention Wide-ranging ON-line Data for Epidemiologic Research system, which uses the National Center for Health Statistics' Multiple Cause of Death data set. SettingUnited States, 1999 to 2010. ParticipantsPeople aged 65 and older with a fall listed on their death record as the underlying or a contributing cause of death. MeasurementsCircumstances and contributing causes off all deaths—records listing International Classification of Diseases, Tenth Revision, codes W00 to W19 as the underlying cause of death—and underlying causes for records with falls as a contributing cause were examined. Joinpoint regression analysis was used to assess trends in the proportion of fall and fall-associated deaths to total deaths for 1999 to 2010. ResultsIn 2010, there were 21,649 fall deaths and 5,402 fall-associated deaths among people aged 65 and older; 48.7% of fall deaths involved a head injury. Approximately half the fall death records included diseases of the circulatory system as contributing causes. From 1999 to 2010, there was a trend toward more-specific reporting of falls circumstances, although total deaths remained unchanged. The proportion of fall deaths to total deaths increased 114.3%, and that of fall-associated deaths to total deaths increased 43.1%. Conclusion
The reasons behind the increasing older adult fall death rate deserve further investigation. Possible contributing factors include changing trends in underlying chronic diseases and better reporting of falls as the underlying cause of death.

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    ABSTRACT: Background We aimed to examine changes in the specificity of data recording and assess the impact on cause-specific injury mortality during 1999–2010. Methods A longitudinal study was designed to analyze injury mortality data of 1999-2010. Mortality rates for unspecified injury and for cause-specific injury were obtained using CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS™). The proportion of unspecified injury was used to measure the specificity of injury data recording. We used the proportionate method to adjust data specificity and compared changes in cause-specific mortality before and after adjustment. Results Between 1999 and 2010, the age-adjusted mortality from unspecified injuries decreased from 3.4 to 2.5 per 100,000 persons for all ages. The proportion of unspecified unintentional injury decreased from 18.9% to 10.9% for the elderly ages 65+. The proportion of unspecified homicide significantly increased for all age groups except ages 25–44 years. After adjustment, increases in age-adjusted mortality rates from falls, poisoning and drowning were less (77 vs. 61%, 66 vs. 51%, and 9 vs. 0%) and decreases in injuries from motor vehicle crashes, suffocation, fire/burn, and natural/environmental disasters were greater (-30 vs. -37%, -17 vs. -24%, -23 vs. -24%, and -46 vs. -51%), respectively. The adjustment resulted in reversed changes in homicide by firearm (-1 vs. 5%) and cut/pierce (-5 vs. 2%), greater increases in homicide by suffocation (9 vs. 16%) for ages 45–64 years, and smaller decreases in all other age- and cause-specific homicide groups. Conclusions During 1999–2010, the specificity of data recording changed significantly for homicide rates and elderly unintentional injury mortality and the changes altered trends in cause-specific injury mortality.
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    ABSTRACT: With the rapid growth of the aging U.S. population, the incidence of falls and fall-related injuries is expected to rise. We examined incidence and characteristics of fall-related hospitalizations (falls) among Texans aged 50 and older, by geography and across time. We calculated fall-related hospitalization incidence rates (65 and older), identified fall 'hot spots,' and examined availability of fall-prevention programming. The incidence of fall-related hospitalizations for older adults increased by nearly 20% from 2007 to 2011. There were clusters of 'hot spot' counties throughout the state, many of which lack fall prevention programs. Increased efforts are needed to identify older adults at elevated risk for falling and develop referral systems for promoting evidence-based fall prevention programs at multiple levels accounting for geographic settings. Geospatial investigations can inform strategic planning efforts to develop clinical-community partnerships to offer fall prevention programming in high risk areas. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.
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