Abstract
BackgroundAn aging society incurs great losses due to fall-related injuries and mortalities. The foreseeable increased burden of fall-related injury among older people requires a regular nationwide study on the fall epidemic and prevention strategies.MethodsThe fall epidemic was examined using data from three consecutive waves of the National Health Interview Survey (2005, 2009, and 2013). Common explanatory variables across these surveys included sociodemographic factors (age, sex, and difficulty in performing activities of daily living (ADL) or instrumental ADL), biological factors (vision, comorbidities, urinary incontinence, and depressive symptoms), and behavioral risk factors (sleeping pill use, and frequency of exercise). After the univariate and bivariate analyses, the prevalence of falls was investigated using multiple linear regression models adjusted for age group, sex, and year of survey. A multivariate logistic regression model for falls with adjustments for these common explanatory variables was established across three waves of surveys. The effect of fall prevention programs was examined with the effect size in terms of age-specific and sex-specific prevalence of falls and fall-related hospitalization rates during 2005 and 2009.ResultsFor each survey, there were consecutively 2722; 2900; and 3200 respondents with a mean age of 75.1, 75.6, and 76.4 years, respectively. The multiple linear regression model yielded a negative association between the prevalence of falls and year of survey. Several sociodemographic and biological factors, including female sex, difficulty in performing one basic ADL, difficulty in performing two or more instrumental ADLs, unclear vision, comorbidities, urinary incontinence, and depressive symptoms, were significantly associated with falls. In contrast to the universal positive effect on the prevalence of falls among older adults, the effect size of fall-related hospitalization rates revealed a 2% relative risk reduction only for those aged 65–74 years, but deteriorated for those aged 75–84 (− 10.9%).ConclusionAlthough the decline in fall prevalence over time supports existing fall intervention strategies in Taiwan, the differential prevention effect and identification of risk factors in older people suggest the necessity of adjusting fall prevention programs.
Highlights
IntroductionThe foreseeable increased burden of fall-related injury among older people requires a regular nationwide study on the fall epidemic and prevention strategies
An aging society incurs great losses due to fall-related injuries and mortalities
The proportion of two or more comorbidities escalated from 31.2, 32.5, to 39.1%. Those characteristics that decreased by survey included the proportions for unclear vision, irregular exercise, and depressive symptoms
Summary
The foreseeable increased burden of fall-related injury among older people requires a regular nationwide study on the fall epidemic and prevention strategies. As the burden of fall-related injury increased annually by 21.1% between 1990 and 2013, falls among older people have become a global health concern. Falls have created tremendous costs in high-income countries [3,4,5,6], but the increased rate of fall-related injuries has gradually affected the health and ability of older individuals in low- and middle-income countries to perform daily tasks. Given the multifactorial etiology of falls [7], the prevalence and risk factors of falls or fall-related injuries vary by age of the target population, country, outcomes, and covariates measured, etc. For the need of setting up a sound evidence base of fall prevention policy, increasing number of countries include fall-related issues in national surveys
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
