Background In China, fall is a leading cause of injury death among the elderly, of which the prevalence rate of osteoporosis is estimated about 36%, but the mortality of fall attributed to low bone mineral density (LBMD) in the elderly still remains unclear.

Objective This study aims to highlight the disparity of the LBMD-attributable mortality of fall in the elderly aged 60 and over by gender and province in China from 1990 to 2015.

Methods Descriptive analysis is used to depict the current status and trend of the LBMD-attributable mortality of fall and the corresponding percent accounting for the total mortality of fall based on Global Burden Disease 2015. Annual percent change is used to indicate the change of the trend.

Findings In 2015, 64.95% of fall mortality, about 19.78 per 100,000, could be attributed to LBMD in the elderly aged 60 and over. The corresponding percent of females was much higher than that in males, about 84.58% and 47.92% respectively. Among 33 provinces, the mortality of fall attributed to LBMD varied widely from 3.93 to 75.66 (per 100,000) with a range of percent from 53.28% to 80.04%. From 1990 to 2015, there was no significant change in the LBMD-attributable mortality of fall in females, but an increasing trend in males. No significant difference of percent was found between two genders. 16 provinces saw an increasing trend of percent in both genders during this period, especially in Fujian Province.

Conclusion LBMD ranks the first attributable risk factor of fall mortality, which imposes a much higher burden on elderly women than elderly men. More efforts of fall and LBMD prevention should be put on elderly women in some provinces.

Policy implications Region and population-specific policy pertaining on fall and LBMD prevention in the elderly should be adopted in China.