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      Prevalence and risk factors of falls among community-dwelling older people: results from three consecutive waves of the national health interview survey in Taiwan

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          Abstract

          Background

          An aging society incurs great losses due to fall-related injuries and mortalities. The foreseeable increased burden of fall-related injury among older people requires a regular nationwide study on the fall epidemic and prevention strategies.

          Methods

          The fall epidemic was examined using data from three consecutive waves of the National Health Interview Survey (2005, 2009, and 2013). Common explanatory variables across these surveys included sociodemographic factors (age, sex, and difficulty in performing activities of daily living (ADL) or instrumental ADL), biological factors (vision, comorbidities, urinary incontinence, and depressive symptoms), and behavioral risk factors (sleeping pill use, and frequency of exercise). After the univariate and bivariate analyses, the prevalence of falls was investigated using multiple linear regression models adjusted for age group, sex, and year of survey. A multivariate logistic regression model for falls with adjustments for these common explanatory variables was established across three waves of surveys. The effect of fall prevention programs was examined with the effect size in terms of age-specific and sex-specific prevalence of falls and fall-related hospitalization rates during 2005 and 2009.

          Results

          For each survey, there were consecutively 2722; 2900; and 3200 respondents with a mean age of 75.1, 75.6, and 76.4 years, respectively. The multiple linear regression model yielded a negative association between the prevalence of falls and year of survey. Several sociodemographic and biological factors, including female sex, difficulty in performing one basic ADL, difficulty in performing two or more instrumental ADLs, unclear vision, comorbidities, urinary incontinence, and depressive symptoms, were significantly associated with falls. In contrast to the universal positive effect on the prevalence of falls among older adults, the effect size of fall-related hospitalization rates revealed a 2% relative risk reduction only for those aged 65–74 years, but deteriorated for those aged 75–84 (− 10.9%).

          Conclusion

          Although the decline in fall prevalence over time supports existing fall intervention strategies in Taiwan, the differential prevention effect and identification of risk factors in older people suggest the necessity of adjusting fall prevention programs.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12877-020-01922-z.

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          Most cited references 46

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          Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons.

            (2010)
          The following article is a summary of the American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons (2010). This article provides additional discussion of the guideline process and the differences between the current guideline and the 2001 version and includes the guidelines' recommendations, algorithm, and acknowledgments. The complete guideline is published on the American Geriatrics Society's Web site (http://www.americangeriatrics.org/health_care_professionals/clinical_practice/clinical_guidelines_recommendations/2010/). © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.
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            Screening for Depression in Well Older Adults: Evaluation of a Short Form of the CES-D

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              The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013

              Background The Global Burden of Diseases (GBD), Injuries, and Risk Factors study used the disability-adjusted life year (DALY) to quantify the burden of diseases, injuries, and risk factors. This paper provides an overview of injury estimates from the 2013 update of GBD, with detailed information on incidence, mortality, DALYs and rates of change from 1990 to 2013 for 26 causes of injury, globally, by region and by country. Methods Injury mortality was estimated using the extensive GBD mortality database, corrections for ill-defined cause of death and the cause of death ensemble modelling tool. Morbidity estimation was based on inpatient and outpatient data sets, 26 cause-of-injury and 47 nature-of-injury categories, and seven follow-up studies with patient-reported long-term outcome measures. Results In 2013, 973 million (uncertainty interval (UI) 942 to 993) people sustained injuries that warranted some type of healthcare and 4.8 million (UI 4.5 to 5.1) people died from injuries. Between 1990 and 2013 the global age-standardised injury DALY rate decreased by 31% (UI 26% to 35%). The rate of decline in DALY rates was significant for 22 cause-of-injury categories, including all the major injuries. Conclusions Injuries continue to be an important cause of morbidity and mortality in the developed and developing world. The decline in rates for almost all injuries is so prominent that it warrants a general statement that the world is becoming a safer place to live in. However, the patterns vary widely by cause, age, sex, region and time and there are still large improvements that need to be made.
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                Author and article information

                Contributors
                ywwang@hpa.gov.tw
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                9 December 2020
                9 December 2020
                2020
                : 20
                Affiliations
                [1 ]GRID grid.454740.6, Health Promotion Administration, , Ministry of Health and Welfare, ; Taipei, Taiwan
                [2 ]GRID grid.412040.3, ISNI 0000 0004 0639 0054, Department of Geriatrics and Gerontology, College of Medicine, , National Cheng-Kung University and Hospital, ; Tainan, Taiwan
                [3 ]GRID grid.412896.0, ISNI 0000 0000 9337 0481, Graduate Institute of Injury Prevention and Control, College of Public Health, , Taipei Medical University, ; Taipei, Taiwan
                [4 ]GRID grid.411824.a, ISNI 0000 0004 0622 7222, Hualien Tzu Chi Hospital, , Tzu Chi University and Hospital, ; Hualien, Taiwan
                Article
                1922
                10.1186/s12877-020-01922-z
                7724833
                33297968
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                Funding
                Funded by: Health Promotion Administration, Ministry of Health and Welfare (TW)
                Award ID: MOHW 107-HPA-H-315-000725
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Geriatric medicine

                prevalence, risk factors, fall prevention, elderly

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