Country-Level Burden Profiles for Fall-Related Nursing Service Planning in Older Adults

Area of Science:

• Gerontology
• Public Health
• Epidemiology

Background:

• Falls represent a major cause of disability, mortality, and loss of independence in older adults.
• Existing evidence often focuses on the epidemiologic burden of falls, lacking comparative patterns for nursing management and service planning.

Purpose of the Study:

• To analyze the global burden of falls in adults aged 60 years and older using a novel country-level burden-profile framework.
• To identify distinct patterns of fall-related burden across countries to inform nursing management and service planning.

Main Methods:

• An ecological, age-sex-stratified study using Global Burden of Disease (GBD) 2023 data from 1990 to 2023 for 204 countries and territories.
• Analysis focused on adults aged 60+ years, examining incidence rate, years lived with disability (YLD) rate, YLDs per 1000 falls, deaths per 100,000 falls, YLD share of disability-adjusted life years (DALYs), and the share of YLDs from adults aged 85+ years.
• A burden-profile framework categorized countries into prevention-intensive, rehabilitation-intensive, mortality-intensive, long-term-care-intensive, and mixed profiles, with sensitivity analyses conducted.

Main Results:

• In 2023, the global fall incidence rate was 6600.3 per 100,000, with 69.5% of fall-related DALYs attributed to YLDs.
• The study identified five country-level burden profiles, with 'mixed-profile' being the largest group (90 countries).
• Significant variations in incidence, YLD burden, mortality, and the contribution of older adults (85+) to YLDs were observed across countries and between sexes.

Conclusions:

• Fall-related burden in older adults exhibits distinct country-level patterns related to prevention, rehabilitation, mortality, and long-term support needs.
• A burden structure beyond simple incidence is essential for understanding cross-national differences and guiding service planning.
• These ecological profiles offer a foundation for comparative nursing management reviews when integrated with local data on workforce, infrastructure, and service utilization.