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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


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. 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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