Epidemiological studies of falls among the elderly: a review
WU Shujun1, ZHU Siyi1, ZOU Zuquan2, GAO Yuan1, FANG Ting1
1. School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang 315211, China; 2. Beilun District Center for Disease Control and Prevention, Ningbo, Zhejiang 315801, China
Abstract：Falls are the leading cause of accidental injury deaths among the elderly. Currently, the incidence and disease burden of falls among the elderly remain high. By understanding the influencing factors of falls among the elderly and formulating targeted preventive measures, the risk of falls can be effectively reduced. Studies have found that falls among the elderly are results of the interaction of multiple factors. When formulating fall prevention strategies, attention should be paid to fall risk assessment and stratification, fall prevention exercise support and health education, living environment improvement, and primary healthcare service enhancement. Reviewing publications pertaining to the epidemiological studies of falls from January 2004 to January 2024, this article summarizes the epidemiological characteristics, risk factors, prevention and control strategies of falls among the elderly, aiming to provide the reference for prevention and control.
[1] World Health Organization.Falls[EB/OL].[2024-06-12].https://www.who.int/news-room/fact-sheets/detail/falls. [2] 张艳,付文,徐珏,等.2006—2018年杭州市老年人跌倒死亡趋势分析[J].预防医学,2020,32(9):878-881. [3] JAMES S L,LUCCHESI L R,BISIGNANO C,et al.The global burden of falls:global,regional and national estimates of morbidity and mortality from the Global Burden of Disease Study 2017[J]. Inj Prev,2020,26(Suppl.1):3-11. [4] YE P P,ER Y L,WANG H D,et al.Burden of falls among people aged 60 years and older in mainland China,1990-2019:findings from the Global Burden of Disease Study 2019[J].Lancet Public Health,2021,6(12):907-918. [5] World Health Organization.Step safely:strategies for preventing and managing falls across the life-course[EB/OL].[2024-06-12].https://www.who.int/publications/i/item/978924002191-4. [6] 刘洋. 我国社区老年人跌倒状况及居家环境影响因素研究[D].北京:北京协和医学院,2023. [7] ANG G C,LOW S L,HOW C H.Approach to falls among the elderly in the community[J].Singap Med J,2020,61(3):116-121. [8] ABBAFATI C,ABBAS K M,ABBASI M,et al.Global burden of 369 diseases and injuries in 204 countries and territories,1990-2019:a systematic analysis for the Global Burden of Disease Study 2019[J].Lancet,2020,396(10258):1204-1222. [9] PENG K,TIAN M,ANDERSEN M,et al.Incidence,risk factors and economic burden of fall-related injuries in older Chinese people:a systematic review[J].Inj Prev,2019,25(1):4-12. [10] RIVAN N F M,SINGH D K A,SHAHAR S,et al.Cognitive frailty is a robust predictor of falls,injuries,and disability among community-dwelling older adults[J].BMC Geriatr,2021,21(1):1-13. [11] QIN Z,BACCAGLINI L.Distribution,determinants,and prevention of falls among the elderly in the 2011-2012 California Health Interview Survey[J].Public Health Rep,2016,131(2):331-339. [12] ZHAO X G,YU J B,HU F,et al.Association of body mass index and waist circumference with falls in Chinese older adults[J].Geriatr Nurs,2022,44:245-250. [13] RAVINDRAN R M,KUTTY V R.Risk factors for fall-related injuries leading to hospitalization among community-dwelling older persons:a hospital-based case-control study in Thiruvananthapuram,Kerala,India[J].Asia Pac J Public Health,2016,28(Suppl.1):70-76. [14] LIN X Z,MENG R L,PENG D D,et al.Cross-sectional study on prevalence and risk factors for falls among the elderly in communities of Guangdong province,China[J].BMJ Open,2022,12(11):1-6. [15] 张家佳,陈小玉,廖娟,等. 重庆市老年慢性病共病患者跌倒调查[J]. 预防医学,2023,35(12):1062-1066. [16] MARTINEZ M,DE LEON P L,KEELEY D.Bayesian classification of falls risk[J].Gait Posture,2019,67:99-103. [17] KUANG T M,TSAI S Y,HSU W M,et al.Visual impairment and falls in the elderly:the Shihpai Eye Study[J].J Chin Med Assoc,2008,71(9):467-472. [18] PHELAN E A,RITCHEY K.Fall prevention in community-dwelling older adults[J].Ann Intern Med,2018,169(11):81-96. [19] ZANINOTTO P,HUANG Y T,DI GESSA G,et al.Polypharmacy is a risk factor for hospital admission due to a fall:evidence from the English Longitudinal Study of Ageing[J].BMC Public Health,2020,20(1):1-7. [20] SHARIF S I,AL-HARBI A B,AL-SHIHABI A M,et al.Falls in the elderly:assessment of prevalence and risk factors[J].Pharm Pract(Granada),2018,16(3):1-7. [21] 林伟权,刘慧,利耀辉,等.2014—2018年广州市60岁及以上老年人跌倒/坠落伤害流行病学特征[J].中华疾病控制杂志,2020,24(3):269-273. [22] HACIDURSUNOĞLU ERBAŞ D,ÇINAR F,ETI ASLAN F.Elderly patients and falls:a systematic review and meta-analysis[J].Aging Clin Exp Res,2021,33(11):2953-2966. [23] XU Q M,OU X M,LI J F.The risk of falls among the aging population:a systematic review and meta-analysis[J].Front Public Health,2022,10:1-8. [24] 沈颖卓,陈洁,刘芳,等.海曙区老年人跌倒死亡特征分析[J].预防医学,2023,35(11):985-988. [25] LUEBBERT S,CHRISTENSEN W,FINKEL C,et al.Falls in senior adults:demographics,cost,risk stratification,and evaluation[J]. Mo Med,2022,119(2):158-163. [26] 李芳,郁晓琴,许瑞,等.兰州市社区独居老人慢性病及意外伤害发生情况调查[J].护理研究,2019,33(18):3267-3269. [27] 张家佳,陈小玉,卿雪莲.我国空巢老人跌倒发生率的Meta分析[J].预防医学,2023,35(10):844-848,855. [28] 施小明. 新形势下我国老年人口面临的主要公共卫生挑战[J].中华医学杂志,2021,101(44):3613-3619. [29] MONTERO-ODASSO M,VAN DER VELDE N,MARTIN F C,et al.World guidelines for falls prevention and management for older adults:a global initiative[J].Age Ageing,2022,51(9):1-36. [30] 杨志健,姜树军.老年人跌倒风险评估及预防的研究进展[J].北京医学,2022,44(12):1125-1128. [31] PALUMBO P,KLENK J,CATTELANI L,et al.Predictive performance of a fall risk assessment tool for community-dwelling older people(FRAT-up)in 4 European cohorts[J].J Am Med Dir Assoc,2016,17(12):1106-1113. [32] LIU-AMBROSE T,DAVIS J C,BEST J R,et al.Effect of a home-based exercise program on subsequent falls among community-dwelling high-risk older adults after a fall:a randomized clinical trial[J].JAMA,2019,321(21):2092-2100. [33] SHERRINGTON C,TIEDEMANN A,FAIRHALL N,et al.Exercise to prevent falls in older adults:an updated meta-analysis and best practice recommendations[J].N S W Public Health Bull,2011,22(3/4):78-83. [34] 中华人民共和国中央人民政府.健康中国行动(2019—2030年) [EB/OL][2024-06-12].https://www.gov.cn/xinwen/2019-07/15/content_5409694.htm. [35] 姚玉华,凌利民,姚文,等.健康教育及环境评估对预防老年跌倒的效果观察[J].中国健康教育,2020,36(2):142-146. [36] 马京华,薛娜娜,纪敬敏,等.多元化健康教育对老年骨质疏松骨折患者生活质量的影响[J].中国老年学杂志,2015,35(6):1667-1669. [37] 汪春华,黎莉.分阶段视频教育在老年患者预防跌倒中的效果[J].中国临床护理,2021,13(9):574-576,581. [38] 邓学文,周海滨,雷林,等.深圳市社区老年预防跌倒健康教育效果评价[J].中国健康教育,2018,34(2):174-176,179. [39] 朱欢欢,卢璇,王婷婷,等.医疗机构老年人预防跌倒环境管理的最佳证据总结[J].军事护理,2023,40(3):23-26. [40] 陈卫民,张奇.中国基层医疗服务发展对老年人健康的影响[J].人口学刊,2024,46(2):93-107. [41] YE P P,PENG J Y,JIN Y,et al.Using a participatory design to develop an implementation framework for integrating falls prevention for older people within the Chinese primary health care system[J].BMC Geriatr,2024,24(1):1-12.
