Fall-related injuries among Canadian seniors, 2005-2013: an analysis of the Canadian Community Health Survey.

INTRODUCTION We describe the epidemiology and trends of fall-related injuries among Canadian seniors aged 65 years and older by sex and age, as well as the circumstances and consequences of their injuries. METHODS We analyzed nationally representative data from the 2005, 2009/2010 and 2013 samples of the Canadian Community Health Survey to calculate the number and rates of fall-related injuries for each survey year. Where possible, we combined data from two or more samples to estimate the proportion of fall-related injuries by type of injury, part of body injured, type of activity and type of treatment. RESULTS The rate of fall-related injuries among seniors increased from 49.4 to 58.8 per 1000 population between 2005 and 2013, during which the number of fall-related injuries increased by 54% overall. Women had consistently higher rates than men across all survey years, while rates increased with advancing age. The upward trend in fall-related injury rates was more prominent among women and younger age groups. The most common type of injury was broken or fractured bones (37%), and the shoulder or upper arm (16%) was the most commonly injured body part. Many fall-related injuries occurred while walking on a surface other than snow or ice (45%). Over 70% of seniors seeking treatment for their injuries visited a hospital emergency department. CONCLUSION Given the increase in both the number and rates of fall-related injuries over time, there is a need to continue monitoring trends and injury patterns associated with falls.

[1]  B. Clarke,et al.  Low bone mineral density and fracture burden in postmenopausal women , 2008 .

[2]  W. Tamborlane,et al.  Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. , 2002, The New England journal of medicine.

[3]  R. Mitchell,et al.  Conflicting trends in fall-related injury hospitalisations among older people: variations by injury type , 2011, Osteoporosis International.

[4]  M. Tremblay,et al.  Canadian childhood obesity estimates based on WHO, IOTF and CDC cut-points. , 2010, International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity.

[5]  J. O'Loughlin,et al.  Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. , 1993, American journal of epidemiology.

[6]  S. Sen,et al.  Epidemiology of falls and osteoporotic fractures: a systematic review , 2012, ClinicoEconomics and outcomes research : CEOR.

[7]  Eva Negri,et al.  Risk Factors for Falls in Community-dwelling Older People: A Systematic Review and Meta-analysis , 2010, Epidemiology.

[8]  Eva Negri,et al.  Risk factors for falls in older people in nursing homes and hospitals. A systematic review and meta-analysis. , 2013, Archives of gerontology and geriatrics.

[9]  Peter Patka,et al.  Increase in fall-related hospitalizations in the United States, 2001-2008. , 2011, The Journal of trauma.

[10]  R. Sturm,et al.  The obesity epidemic and changes in self‐report biases in BMI , 2013, Obesity.

[11]  J. Stevens,et al.  Gender differences for non-fatal unintentional fall related injuries among older adults , 2005, Injury Prevention.

[12]  Suzanne G. Leveille,et al.  Sex differences in circumstances and consequences of outdoor and indoor falls in older adults in the MOBILIZE Boston cohort study , 2013, BMC Geriatrics.

[13]  C. Stephen,et al.  Identifying the impediments and enablers of ecohealth for a case study on health and environmental sanitation in Hà Nam, Vietnam , 2014, Infectious Diseases of Poverty.

[14]  R. Mitchell,et al.  The cost of fall-related injuries among older people in NSW, 2006-07. , 2011, New South Wales public health bulletin.

[15]  Peter Patka,et al.  Trends in fall-related hospital admissions in older persons in the Netherlands. , 2010, Archives of internal medicine.

[16]  P. Kannus,et al.  Declining age-adjusted incidence of fall-induced injuries among elderly Finns. , 2012, Age and ageing.

[17]  L. Bouter,et al.  Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. , 2001, Journal of clinical epidemiology.

[18]  H. MacMillan,et al.  Relationship between child abuse exposure and reported contact with child protection organizations: results from the Canadian Community Health Survey. , 2015, Child abuse & neglect.

[19]  Jeannine S. Schiller,et al.  Fall injury episodes among noninstitutionalized older adults: United States, 2001-2003. , 2007, Advance data.

[20]  S. Cummings,et al.  Forgetting Falls , 1988, Journal of the American Geriatrics Society.

[21]  P. Scuffham,et al.  Incidence and costs of unintentional falls in older people in the United Kingdom , 2003, Journal of epidemiology and community health.

[22]  E. Barrett-Connor,et al.  Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. , 2001, JAMA.

[23]  Chelsea A. Heuer,et al.  The Stigma of Obesity: A Review and Update , 2009, Obesity.

[24]  G. McVey,et al.  Health Promotion and Chronic Disease Prevention in Canada Research , Policy and Practice , 2015 .

[25]  J. Smit,et al.  Consequences of falling in older men and women and risk factors for health service use and functional decline. , 2004, Age and ageing.

[26]  Julie K. Gammack,et al.  Falls, osteoporosis, and hip fractures. , 2011, The Medical clinics of North America.

[27]  Lehana Thabane,et al.  Relation between fractures and mortality: results from the Canadian Multicentre Osteoporosis Study , 2009, Canadian Medical Association Journal.

[28]  K. Shojania,et al.  Elements of informed consent and decision quality were poorly correlated in informed consent documents. , 2015, Journal of clinical epidemiology.

[29]  T. Murphy,et al.  Original Contribution Association of Injurious Falls with Disability Outcomes and Nursing Home Admissions in Community-living Older Persons , 2022 .

[30]  J. Geweke,et al.  Recent hospitalization and the risk of hip fracture among older Americans. , 2009, The journals of gerontology. Series A, Biological sciences and medical sciences.

[31]  S. Cummings,et al.  BMD at Multiple Sites and Risk of Fracture of Multiple Types: Long‐Term Results From the Study of Osteoporotic Fractures , 2003, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[32]  A. MacFarlane,et al.  Genetic modifiers of folate, vitamin B-12, and homocysteine status in a cross-sectional study of the Canadian population. , 2015, The American journal of clinical nutrition.

[33]  Tiffany Gill,et al.  A Population-Based Survey of Factors Relating to the Prevalence of Falls in Older People , 2005, Gerontology.

[34]  J. Stewart,et al.  Validity of Self-report Screening for Overweight and Obesity , 2008, Canadian journal of public health = Revue canadienne de sante publique.

[35]  Peter Patka,et al.  Costs of falls in an ageing population: a nationwide study from the Netherlands (2007-2009). , 2012, Injury.

[36]  A. Gauthier,et al.  Are Canadian Seniors Becoming More Active? Empirical Evidence Based on Time-Use Data* , 2005, Canadian Journal on Aging / La Revue canadienne du vieillissement.

[37]  M. Carroll,et al.  Trends of elevated blood pressure among children and adolescents: data from the National Health and Nutrition Examination Survey1988-2006. , 2009, American journal of hypertension.

[38]  M. Tremblay,et al.  Obesity estimates for children based on parent-reported versus direct measures. , 2011, Health reports.

[39]  Understanding seniors' risk of falling and their perception of risk , 2014 .

[40]  S. Caprio,et al.  High normal fasting glucose level in obese youth: a marker for insulin resistance and beta cell dysregulation , 2010, Diabetologia.

[41]  Steven Thomas,et al.  Combining cycles of the Canadian Community Health Survey. , 2009, Health reports.

[42]  V. Chang,et al.  Risk factors for falls among seniors: implications of gender. , 2015, American journal of epidemiology.

[43]  R. McClure,et al.  Population based study of hospitalised fall related injuries in older people , 2002, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[44]  C. Craig,et al.  Tracking of obesity and physical activity from childhood to adulthood: the Physical Activity Longitudinal Study. , 2009, International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity.

[45]  Chuansi Gao,et al.  A systems perspective of slip and fall accidents on icy and snowy surfaces , 2004, Ergonomics.

[46]  M. Tinetti,et al.  Risk factors for falls among elderly persons living in the community. , 1988, The New England journal of medicine.

[47]  Jeffrey M. Hausdorff,et al.  Risk factors for falls among older adults: a review of the literature. , 2013, Maturitas.

[48]  J. Gerberding,et al.  Fatalities and injuries from falls among older adults--United States, 1993-2003 and 2001-2005. , 2006, MMWR. Morbidity and mortality weekly report.

[49]  Hasanat Alamgir,et al.  Trends in fall-related injuries among older adults treated in emergency departments in the USA , 2014, Injury Prevention.

[50]  M. Tremblay,et al.  Canadian Health Measures Survey: rationale, background and overview. , 2007, Health reports.

[51]  Anya Okhmatovskaia,et al.  Validation of population-based disease simulation models: a review of concepts and methods , 2010, BMC public health.

[52]  Chris Todd,et al.  What are the main risk factors for falls amongst older people and what are the most effective interventions to prevent these falls? How should interventions to prevent falls be implemented? , 2004 .

[53]  S. Dzakpasu,et al.  Interventions in labour and birth and satisfaction with care: The Canadian Maternity Experiences Survey Findings , 2015 .

[54]  A. Scott,et al.  On Chi-Squared Tests for Multiway Contingency Tables with Cell Proportions Estimated from Survey Data , 1984 .

[55]  E. Finkelstein,et al.  The costs of fatal and non-fatal falls among older adults , 2006, Injury Prevention.

[56]  Clare Eileen Bradley,et al.  Trends in hospitalisations due to falls by older people, Australia 1999-00 to 2010-11 , 2013 .

[57]  M. Tinetti,et al.  The patient who falls: "It's always a trade-off". , 2010, JAMA.