Analysis of the disease burden of falls and influencing factors among the elderly from 1990 to 2023
- VernacularTitle:1990-2023年老年人跌倒疾病负担及相关影响因素分析
- Author:
Xufeng LONG
1
;
Liyu QIN
1
;
Hongya CAO
1
;
Keyuan LIANG
1
;
Mingmei HUANG
1
;
Xiandan LUO
1
;
Quanyuan HUANG
1
;
Hongliang ZHANG
1
Author Information
1. Dept. of Pharmacy,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021
- Publication Type:Journal Article
- Keywords:
falls;
global burden of disease;
older adults;
multimorbidity;
drug-related;
risk factor
- From:
China Pharmacy
2026;37(12):1631-1637
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To analyze trends in the burden of disease associated with falls from 1990 to 2023, identify risk factors for falls, and provide a reference for the development of measures to reduce the burden of disease associated with falls and the formulation of public health policies. METHODS Based on the data of 2023 from the Global Burden of Disease (GBD) database, the changes in fall-related prevalence, mortality, disability-adjusted life years (DALYs) and incidence in China and globally from 1990 to 2023 were analyzed, and the stratified analyses by gender, age and socio-demographic index (SDI) were conducted. The risk factors related to falls in 2023 were systematically analyzed, and the impact of multimorbidity and polypharmacy on the occurrence of falls by combining relevant literature evidence was explored. RESULTS & CONCLUSIONS Globally, the percentage changes in age-standardized rates of fall-related prevalence, mortality, DALYs and incidence from 1990 to 2023 were -2.4% (95%UI: -4.8% to -0.3%), -7.8% (95%UI: -20.5% to 10.9%), -10.6% (95%UI: -16.5% to -4.3%), and -4.6% (95%UI: -8.1% to -0.8%), respectively. However, in some regions, the percentage changes in age-standardized rates for these indicators were greater than 0 (e.g., prevalence, mortality and DALYs in Australasia, and incidence in Andean Latin America). In China, the percentage changes in age-standardized rates of fall-related mortality and DALYs from 1990 to 2023 were -18.3% (95%UI: -56.7% to 32.3%) and 1.9% (95%UI: -10.1% to 12.4%), while the percentage changes in age-standardized rates of prevalence and incidence were 25.9% (95%UI: 20.2% to 32.0%) and 35.7% (95%UI: 28.5% to 44.1%), respectively. Globally, in regions with high and medium-to-high SDI levels, the percentage changes in age-standardized rates of fall-related prevalence and incidence showed an upward trend, while DALYs showed a downward trend; however, the trend in mortality was unclear. In regions with a middle SDI level, the percentage changes in age-standardized rates of fall-related prevalence and incidence both showed an upward trend, while the trends in mortality and DALYs were unclear. In regions with low-to-medium SDI level, the percentage changes in age-standardized rate of fall-related prevalence, DALYs and incidence all showed a downward trend, while the trend in mortality was unclear; in regions with low SDI level, the trends for all above indicators were unclear. Correlation analyses of the burden of fall-related diseases in China and globally indicated that the risk of fall-related diseases was higher among younger and middle-to-older adult male populations, while women were concentrated in older age groups. Meanwhile, as the SDI levels increase, the percentage change in age-standardized rate of DALYs for fall-related diseases showed a clear upward trend, and this trend was more pronounced in high-SDI regions. Tobacco use, alcohol consumption, low bone density, and occupational risks were risk factors for falls, with low bone density and occupational risks contributing significantly (exceeding 20% in some regions); multimorbidity and polypharmacy could also significantly increase the risk of falls. It is recommended that clinical settings establish a list of fall-risk increasing drugs and a warning system, improve medication reviews, strengthen medication education and adherence management, foster multidisciplinary collaboration, and develop medication strategies for specific patient populations to reduce the incidence of falls and alleviate the burden of disease.