Article Text

The global burden of falls: global, regional and national estimates of morbidity and mortality from the Global Burden of Disease Study 2017
  1. Spencer L James1,
  2. Lydia R Lucchesi1,
  3. Catherine Bisignano1,
  4. Chris D Castle1,
  5. Zachary V Dingels1,
  6. Jack T Fox1,
  7. Erin B Hamilton1,
  8. Nathaniel J Henry1,
  9. Kris J Krohn1,
  10. Zichen Liu1,
  11. Darrah McCracken1,
  12. Molly R Nixon1,
  13. Nicholas L S Roberts1,
  14. Dillon O Sylte1,
  15. Jose C Adsuar2,
  16. Amit Arora3,4,
  17. Andrew M Briggs5,6,
  18. Daniel Collado-Mateo7,8,
  19. Cyrus Cooper9,10,
  20. Lalit Dandona1,11,
  21. Rakhi Dandona1,11,
  22. Christian Lycke Ellingsen12,13,
  23. Seyed-Mohammad Fereshtehnejad14,15,
  24. Tiffany K Gill16,
  25. Juanita A Haagsma17,
  26. Delia Hendrie18,
  27. Mikk Jürisson19,
  28. G Anil Kumar11,
  29. Alan D Lopez1,20,
  30. Tomasz Miazgowski21,
  31. Ted R Miller18,22,
  32. GK Mini23,24,
  33. Erkin M Mirrakhimov25,26,
  34. Efat Mohamadi27,
  35. Pedro R Olivares28,
  36. Fakher Rahim29,30,
  37. Lidia Sanchez Riera31,32,
  38. Santos Villafaina7,
  39. Yuichiro Yano33,
  40. Simon I Hay1,34,
  41. Stephen S Lim1,34,
  42. Ali H Mokdad1,34,
  43. Mohsen Naghavi1,34,
  44. Christopher J L Murray1,34
  1. 1 Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
  2. 2 Sport Science Department, University of Extremadura, Badajoz, Spain
  3. 3 School of Science and Health, Western Sydney University, Sydney, NSW, Australia
  4. 4 Oral Health Services, Sydney Local Health District, Sydney, NSW, Australia
  5. 5 School of Physiotherapy and Exercise Science, Curtin University, Bentley, WA, Australia
  6. 6 Ageing and Life Course, World Health Organization (WHO), Geneva, Switzerland
  7. 7 Sport Science Department, University of Extremadura, Cáceres, Spain
  8. 8 Faculty of Education, Autonomous University of Chile, Talca, Chile
  9. 9 Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
  10. 10 Department of Rheumatology, University of Oxford, Oxford, United Kingdom
  11. 11 Public Health Foundation of India, Gurugram, India
  12. 12 Department of Pathology, Stavanger University Hospital, Stavanger, Norway
  13. 13 Norwegian Institute of Public Health, Oslo, Norway
  14. 14 Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
  15. 15 Division of Neurology, University of Ottawa, Ottawa, ON, Canada
  16. 16 Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
  17. 17 Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
  18. 18 School of Public health, Curtin University, Perth, Western Australia, Australia
  19. 19 Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
  20. 20 University of Melbourne, Melbourne, QLD, Australia
  21. 21 Department of Hypertension, Pomeranian Medical University, Szczecin, Poland
  22. 22 Pacific Institute for Research and Evaluation, Calverton, Maryland, USA
  23. 23 Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
  24. 24 Global Institute of Public Health (GIPH), Ananthapuri Hospitals and Research Centre, Trivandrum, India
  25. 25 Faculty of General Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
  26. 26 Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
  27. 27 Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran
  28. 28 Institute of Physical Activity and Health, Autonomous University of Chile, Talca, Chile
  29. 29 Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  30. 30 Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  31. 31 Department of Rheumatology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
  32. 32 Institute of Bone and Joint Research, University of Sydney, Syndey, NSW, Australia
  33. 33 Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
  34. 34 Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
  1. Correspondence to Dr Spencer L James, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98121, USA; spencj{at}uw.edu

Abstract

Background Falls can lead to severe health loss including death. Past research has shown that falls are an important cause of death and disability worldwide. The Global Burden of Disease Study 2017 (GBD 2017) provides a comprehensive assessment of morbidity and mortality from falls.

Methods Estimates for mortality, years of life lost (YLLs), incidence, prevalence, years lived with disability (YLDs) and disability-adjusted life years (DALYs) were produced for 195 countries and territories from 1990 to 2017 for all ages using the GBD 2017 framework. Distributions of the bodily injury (eg, hip fracture) were estimated using hospital records.

Results Globally, the age-standardised incidence of falls was 2238 (1990–2532) per 100 000 in 2017, representing a decline of 3.7% (7.4 to 0.3) from 1990 to 2017. Age-standardised prevalence was 5186 (4622–5849) per 100 000 in 2017, representing a decline of 6.5% (7.6 to 5.4) from 1990 to 2017. Age-standardised mortality rate was 9.2 (8.5–9.8) per 100 000 which equated to 695 771 (644 927–741 720) deaths in 2017. Globally, falls resulted in 16 688 088 (15 101 897–17 636 830) YLLs, 19 252 699 (13 725 429–26 140 433) YLDs and 35 940 787 (30 185 695–42 903 289) DALYs across all ages. The most common injury sustained by fall victims is fracture of patella, tibia or fibula, or ankle. Globally, age-specific YLD rates increased with age.

Conclusions This study shows that the burden of falls is substantial. Investing in further research, fall prevention strategies and access to care is critical.

  • fall
  • epidemiology
  • burden of disease
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Footnotes

  • Funding This study was supported by the Bill and Melinda Gates Foundation (OPP1152504).

  • Competing interests SJ reports grants from Sanofi Pasteur outside the submitted work; AB reports personal fees from World Health Organization outside the submitted work; CC reports personal fees from Amgen, personal fees from Danone, personal fees from Eli Lilly, personal fees from GlaxoSmithKline, personal fees from Kyowa Kirin, personal fees from Medtronic, personal fees from Merck, personal fees from Nestle, personal fees from Novartis, personal fees from Pfizer, personal fees from Roche, personal fees from Servier, personal fees from Shire, personal fees from Takeda, and personal fees from UCB outside the submitted work.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available.

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