• P Kannus, J Parkkari, S Koskinen, S Niemi, M Palvanen, M Järvinen, and I Vuori.
• Accident & Trauma Research Center and the Tampere Research Center of Sports Medicine, President Urho Kaleva Kekkonen Institute for Health Promotion Research, Finland. klpeka@uta.fi
• JAMA. 1999 May 26;281(20):1895-9.

ContextAlthough various fall-induced injuries and deaths among older adults are increasing, little is known about the epidemiology of these events.ObjectiveTo determine the trends in the number and incidence of fall-induced injuries and deaths of older adults in a well-defined white population.Design And SettingSecular trend analysis of the population of Finland, using the Finnish National Hospital Discharge Register and the Official Cause-of-Death Statistics of Finland.ParticipantsAll persons aged 50 years or older who were admitted to hospitals in Finland for primary treatment of a first fall-induced injury from the years of 1970 to 1995, and for comparison, all fall-induced deaths in the same age group from the years 1971 to 1995.Main Outcome MeasureThe number and the age-specific and age-adjusted incidence rate (per 100000 persons) of fall-induced injuries and deaths in each year of the study.ResultsFor the study period, both the total and population-adjusted number (per 100000 persons) of Finns aged 50 years or older with fall-induced injury increased substantially. Total fall-induced injuries increased from 5622 in 1970 to 21 574 in 1995, a 284% increase, and the rate increased from 494 to 1398 per 100000 persons, a 183% increase. The age-adjusted incidence also increased in both women (from 648 in 1970 to 1469 in 1995, a 127% increase) and men (from 434 in 1970 to 972 in 1995, a 124% increase). Moreover, the number of deaths due to falls in the overall population increased from 441 in 1971 to 793 in 1995, an 80% increase, and the rate increased from 38 in 1971 to 51 in 1995, a 34% increase. However, after age adjustment the incidence of fall-induced death did not show a clear upward trend.ConclusionsIn a well-defined white population, the number of older persons with fall-induced injuries is increasing at a rate that cannot be explained simply by demographic changes. Preventive measures should be adopted to control the increasing burden of these injuries. Fortunately, the age-adjusted incidence of the fall-induced deaths shows no increasing trend over time.

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