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  • Regional and temporal trends of falls and injurious falls among Chinese older adults: results from China Health and Retirement Longitudinal Study, 2011–2018

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Original research
Regional and temporal trends of falls and injurious falls among Chinese older adults: results from China Health and Retirement Longitudinal Study, 2011–2018
  1. Yang Liu1,2,
  2. John Alimamy Kabba3,4,
  3. Sen Xu2,3,4,
  4. Hanxin Gu1,
  5. Xiaoming Su5,
  6. Yuanli Liu1,
  7. Hao Yu2
  1. 1 School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
  2. 2 Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA
  3. 3 Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University School of Pharmacy, Xi'an, Shaanxi, China
  4. 4 Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
  5. 5 Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Xicheng, Beijing, China
  1. Correspondence to Dr Hao Yu, Department of Population Medicine, Harvard Medical School, Boston, MA 02115, USA; hao_yu{at}hphci.harvard.edu; Professor Yuanli Liu; liuyuanli_pumc{at}163.com

Abstract

Objective This study aimed to investigate temporal trends and regional differences of both falls and injurious falls among Chinese older adults and identify the associated risk factors.

Methods We conducted a retrospective analysis using the 2011, 2013, 2015 and 2018 waves of China Health and Retirement Longitudinal Study. Our sample included 35 613 people aged 60 years or above. We analysed two binary outcome variables that were collected at each wave, including whether a respondent had any falls in the last 2 or 3 years, and if so, whether a respondent experienced any injurious falls that warranted seeking medical treatment. The explanatory variables included individual-level sociodemographic characteristics, physical function and health status. We conducted both descriptive and multivariate logistic analyses.

Results We found no significant trend for falls after adjusting for individual-level factors, while significant regional variations in falls existed with higher fall prevalence in the central and western areas, compared with the eastern area. We detected a significant descending trend of injurious falls between 2011 and 2018 and identified the northeastern region with the lowest rates of injurious falls during the study period. Our study also revealed significant risk factors for falls and injurious falls, such as chronic conditions and function limitations.

Conclusions Our results indicated no temporal trend of falls, a declined trend of injurious falls, and significant regional variations in the prevalence of falls and injurious falls in 2011–2018. These findings have important implications for prioritising areas and subpopulations to prevent falls and injuries among China’s elderly population.

  • fall
  • longitudinal
  • surveys
  • health disparities
  • older people

Data availability statement

Data are available in a public, open access repository. The CHARLS data are publicly available and have been cited in our manuscript as:[Dataset] 18 China Health and Retirement Longitudinal Study, 2018 CHARLS Wave 4. Updated on 6 March 2023. https://charls.charlsdata.com/pages/Data/2018-charls-wave4/en.html. Accepted on 30 March 2023[Dataset] 19. Zhao Y, Hu Y, Smith JP, Strauss J, Yang G. Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS). Int J Epidemiol. Feb 2014;43(1):61-8. doi:10.1093/ije/dys203.

https://doi.org/10.1136/ip-2022-044833

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    Data availability statement

    Data are available in a public, open access repository. The CHARLS data are publicly available and have been cited in our manuscript as:[Dataset] 18 China Health and Retirement Longitudinal Study, 2018 CHARLS Wave 4. Updated on 6 March 2023. https://charls.charlsdata.com/pages/Data/2018-charls-wave4/en.html. Accepted on 30 March 2023[Dataset] 19. Zhao Y, Hu Y, Smith JP, Strauss J, Yang G. Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS). Int J Epidemiol. Feb 2014;43(1):61-8. doi:10.1093/ije/dys203.

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    Footnotes

    • Contributors YangL and HY contributed with the design, interpretation of results and drafting of the manuscript. YangL, HG and XS did the statistical analysis. JAK, SX and YuanliL edited and revised of the manuscript. YangL was responsible for the overall content as the guarantor. All authors critically reviewed the manuscript and approved the final report.

    • Funding This work was supported by research grants from the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (grant number 2021-I2M-1-046).

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.