Fall-related mortality trends in older Japanese adults aged ≥65 years: A nationwide observational study

Hideharu Hagiya, Toshihiro Koyama, Yoshito Zamami, Yasuhisa Tatebe, Tomoko Funahashi, Kazuaki Shinomiya, Yoshihisa Kitamura, Shiro Hinotsu, Toshiaki Sendo, Hiromi Rakugi, Mitsunobu R. Kano

Research output: Contribution to journalArticle

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.

Original languageEnglish
Article numbere033462
JournalBMJ Open
Volume9
Issue number12
DOIs
Publication statusPublished - Dec 11 2019

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Observational Studies
Mortality
Population
Japan
Public Health
Delivery of Health Care
Health

Keywords

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

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Fall-related mortality trends in older Japanese adults aged ≥65 years : A nationwide observational study. / Hagiya, Hideharu; Koyama, Toshihiro; Zamami, Yoshito; Tatebe, Yasuhisa; Funahashi, Tomoko; Shinomiya, Kazuaki; Kitamura, Yoshihisa; Hinotsu, Shiro; Sendo, Toshiaki; Rakugi, Hiromi; Kano, Mitsunobu R.

In: BMJ Open, Vol. 9, No. 12, e033462, 11.12.2019.

Research output: Contribution to journalArticle

Hagiya, H, Koyama, T, Zamami, Y, Tatebe, Y, Funahashi, T, Shinomiya, K, Kitamura, Y, Hinotsu, S, Sendo, T, Rakugi, H & Kano, MR 2019, 'Fall-related mortality trends in older Japanese adults aged ≥65 years: A nationwide observational study', BMJ Open, vol. 9, no. 12, e033462. https://doi.org/10.1136/bmjopen-2019-033462
Hagiya, Hideharu ; Koyama, Toshihiro ; Zamami, Yoshito ; Tatebe, Yasuhisa ; Funahashi, Tomoko ; Shinomiya, Kazuaki ; Kitamura, Yoshihisa ; Hinotsu, Shiro ; Sendo, Toshiaki ; Rakugi, Hiromi ; Kano, Mitsunobu R. / Fall-related mortality trends in older Japanese adults aged ≥65 years : A nationwide observational study. In: BMJ Open. 2019 ; Vol. 9, No. 12.
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AU - Funahashi, Tomoko

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AU - Kitamura, Yoshihisa

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AB - 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.

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