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Fall-related mortality trends in older Japanese adults aged ≥65 years: a nationwide observational study
  1. Hideharu Hagiya1,
  2. Toshihiro Koyama2,
  3. Yoshito Zamami3,
  4. Yasuhisa Tatebe4,
  5. Tomoko Funahashi5,
  6. Kazuaki Shinomiya6,
  7. Yoshihisa Kitamura4,
  8. Shiro Hinotsu7,
  9. Toshiaki Sendo4,
  10. Hiromi Rakugi1,
  11. Mitsunobu R Kano5,8
  1. 1 Department of General Internal Medicine, Osaka University Hospital, Suita, Japan
  2. 2 Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
  3. 3 Department of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School, Tokushima, Japan
  4. 4 Department of Pharmacy, Okayama University Hospital, Okayama, Japan
  5. 5 Department of Pharmaceutical Biomedicine, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
  6. 6 Department of Pharmaceutical Care and Clinical Pharmacy, Faculty of Pharmaceutical Sciences Tokushima Bunri University, Tokushima, Japan
  7. 7 Department of Biostatistics, Sapporo Medical University, Sapporo, Japan
  8. 8 Department of Geriatric Medicine, University of Tokyo, Tokyo, Japan
  1. Correspondence to Dr Toshihiro Koyama; koyama-oka{at}umin.ac.jp

Abstract

Objectives Fall-related mortality among older adults is a major public health issue, especially for ageing societies. This study aimed to investigate current trends in fall-related mortality in Japan using nationwide population-based data covering 1997–2016.

Design We analysed fall-related deaths among older persons aged ≥65 years using the data provided by the Japanese Ministry of Health, Labour and Welfare.

Results The crude and age-standardised mortality rates were calculated per 100 000 persons by stratifying by age (65–74, 75–84 and ≥85 years) and sex. To identify trend changes, a joinpoint regression model was applied by estimating change points and annual percentage change (APC). The total number of fall-related deaths in Japan increased from 5872 in 1997 to 8030 in 2016, of which 78.8% involved persons aged ≥65 years. The younger population (65–74 years) showed continuous and faster-decreasing trends for both men and women. Average APC among men aged ≥75 years did not decrease. Among middle-aged and older women (75–84 and ≥85 years) decreasing trends were observed. Furthermore, the age-adjusted mortality rate of men was approximately twice that of women, and it showed a faster decrease for women.

Conclusions Although Japanese healthcare has shown improvement in preventing fall-related deaths over the last two decades, the crude mortality for those aged over 85 years remains high, indicating difficulty in reducing fall-related deaths in the super-aged population. Further investigations to uncover causal factors for falls in older populations are required.

  • geriatric medicine
  • health & safety
  • health policy
  • adult intensive & critical care
  • public health
  • epidemiology

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Twitter @KoyamaJapan2018

  • Contributors HH contributed to the acquisition, statistical analysis, and interpretation of the data, as well as the drafting and revision of the manuscript. TK contributed to the conception and study design, the acquisition, statistical analysis, and interpretation of the data, and the revision of the manuscript. MRK and HR contributed to the interpretation of the data and the revision of the manuscript. SH, YZ, YT, TF, KS, YK and TS contributed to the interpretation of the data and the critical review of the manuscript. All authors approved the final version of the manuscript.

  • Funding This study was supported by the Japan Society for the Promotion of Science KAKENHI (19K10533) (Tokyo, Japan).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The complete data set is available in Supplementary Table 1.