Unintentional fall mortality by place, sex, and age group among older Chinese adults, 2010-21

Unintentional falls are known to be a leading cause of injury mortality among older Chinese adults, yet we lack data on the most recent trends in related mortality. To address this, we used the latest nationally representative data from China to examine trends in elderly unintentional fall mortality by place (urban/rural), sex (men/women), and age group (65-69, 70-74, 75-79, 80-84, and ≥85 years) from 2010 to 2021.

We retrieved mortality data from the Chinese Health Statistical Yearbook (2010-21) and population data from the Chinese Population Census (2010, 2020). Using line graphs, we examined mortality trends over time. We fitted a joinpoint regression model to detect periods experiencing significant changes and calculated the average and specific annual percentage change of mortality rates to quantify significant changes in the mortality of the elderly due to unintentional falls.

Between 2010 and 2021, the age-standardised mortality rate from unintentional falls increased from 45.7 to 67.8 per 100 000 population among Chinese adults aged 65 years and older. Subgroup analyses by sex and place showed similar changing patterns to the overall mortality trends. The joinpoint regression identified certain recent periods that saw significant increases in mortality among adults aged 65-69, 70-74, 75-79, and 80-84 years. During the study period, men and individuals living in rural areas generally had higher unintentional fall mortality rates than women and people living in urban areas (mortality rate ratios: 1.09-1.21 for men vs. women and 1.01-1.27 for rural areas vs. urban areas). Notably, the differences between urban and rural areas, and those between men and women, were consistent across the three younger age groups (65-69, 70-74, and 75-79 years) studied, but reduced in the two oldest age groups (80-84 and ≥85 years).

The age-standardised mortality rate from unintentional falls increased between 2010 and 2021 among Chinese adults aged 65 years or older, with wide variations across years. Unintentional fall mortality has recently increased among adults aged 65 to 84 years. Differences between urban and rural areas, as well as between men and women, deserve the attention of injury researchers and policymakers.