Comparing Estimates of Fall-Related Mortality Incidence Among Older Adults in the United States

Abstract Background Falls are the leading cause of injury-related mortality among older adults in the United States, but incidence and risk factors for fall-related mortality remain poorly understood. This study compared fall-related mortality incidence rate estimates from a nationally representativ...

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Bibliographic Details
Published in:	The journals of gerontology. Series A, Biological sciences and medical sciences Vol. 74; no. 9; pp. 1468 - 1474
Main Authors:	Lohman, Matthew C, Sonnega, Amanda J, Nicklett, Emily J, Estenson, Lillian, Leggett, Amanda N
Format:	Journal Article
Language:	English
Published:	US Oxford University Press 16-08-2019
Subjects:	Death Mortality Older people Risk assessment Risk factors The Journal of Gerontology: Medical Sciences United States > US Falls Epidemiology Mortality Risk factors
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Summary:	Abstract Background Falls are the leading cause of injury-related mortality among older adults in the United States, but incidence and risk factors for fall-related mortality remain poorly understood. This study compared fall-related mortality incidence rate estimates from a nationally representative cohort with those from a national vital record database and identified correlates of fall-related mortality. Methods Cause-of-death data from the National Death Index (NDI; 1999–2011) were linked with eight waves from the Health and Retirement Study (HRS), a representative cohort of U.S. older adults (N = 20,639). Weighted fall-related mortality incidence rates were calculated and compared with estimates from the Centers for Disease Control and Prevention (CDC) vital record data. Fall-related deaths were identified using International Classification of Diseases (Version 10) codes. Person-time at risk was calculated from HRS entry until death or censoring. Cox proportional hazards models were used to identify individual-level factors associated with fall-related deaths. Results The overall incidence rate of fall-related mortality was greater in HRS–NDI data (51.6 deaths per 100,000; 95% confidence interval: 42.04, 63.37) compared with CDC data (42.00 deaths per 100,000; 95% confidence interval: 41.80, 42.19). Estimated differences between the two data sources were greater for men and adults aged 85 years and older. Greater age, male gender, and self-reported fall history were identified as independent risk factors for fall-related mortality. Conclusion Incidence rates based on aggregate vital records may substantially underestimate the occurrence of and risk for fall-related mortality differentially in men, minorities, and relatively younger adults. Cohort-based estimates of individual fall-related mortality risk are important supplements to vital record estimates.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1079-5006 1758-535X
DOI:	10.1093/gerona/gly250