Falls and risk factors of falls for urban and rural community-dwelling older adults in China

Li Zhang,Liya Qiu,An Li,Zhihong Ding

doi:10.1186/s12877-019-1391-9

Abstract

BackgroundFalls among older people have become a public health concern due to serious health consequences. Despite abundant literature on falls in older people, little is known about the rural-urban differentials in falls among older people in China. This research fills the voids of prior literature by investigating falls and the associated risk factors among Chinese seniors, with a particular focus on the rural-urban differences.MethodsData are from the 2010 wave of Chinese Longitudinal Survey on Urban and Rural Elderly. The analysis includes 16,393 respondents aged 65 and over, with 8440 and 7953 of them living in urban and rural areas, respectively. Descriptive analyses are performed to examine incidence, locations, circumstances and consequences of falls in older people. Regression analysis is used to investigate the effects of risk factors on falls among older people in urban and rural China.ResultsThe incidence of falls is higher among rural than urban older people. In both settings, older people are more likely to fell outside of home. But common outdoor falls among rural and urban older people differ in terms of locations and circumstances. Urban older people are more likely to report falling on the road whereas their rural counterparts have experienced more falls in the yard. Falls occurring within homes or immediate home surroundings are also common; but few falls occurred in public areas. The rate of hospitalization of urban seniors after falling is higher than that of rural ones. Most risk factors of falls show similar than different effects on rural and urban elders’ risks of falling.ConclusionsIncidence, locations, circumstances and consequences of falls vary among Chinese rural and urban older people. But most risk factors for falls show similar effects on rural and urban elders’ odds of falling. Implications drawn from this research provide suggestions for the government and local agencies to develop suitable fall prevention strategies which may well be applicable to other countries.

Highlights

Falls among older people have become a public health concern due to serious health consequences
Drinkers are 1.1 times more likely to fall than non-drinkers among the urban subgroup. These results suggest that most risk factors of falls based on studying Western elders are applicable to urban older people based on studying the sample
The fall prevention strategies drawn from this research fall in line with some fall prevention schemes proposed by the World Health Organization (WHO) [36]

Summary

Introduction

Falls among older people have become a public health concern due to serious health consequences. Falls among older people have become a major public health problem in many countries. About one third of community-dwelling people aged 65 and over in the United States experience falls each year, with about 10.0% of falls resulting in serious injuries [3]. Older people who had a fall are more likely to experience serious complications, resulting in death within the same year 50.0% of the time [4]. Data from the 2014 National Injury Surveillance System (NISS) revealed that in China, for a total of 77,779 accidental injuries among people aged 60 and over, 52.8% of them were caused by falls [5]. Accidental injuries have become the fourth leading causes of death among Chinese older people; and falls are the major cause of elders’ accidental injuries in China [6].

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Discussion

Conclusion