Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017.

Abstract Introduction: Falls in older age adults are an important public health problem in the Western European region. Insight into differences in fall rates between countries can serve as important input for identifying and evaluating prevention strategies. The objectives of this study were to provide an overview of the Global Burden of Disease (GBD) 2017 figures on mortality, incidence, and DALYs due to falls in older adults of 22 countries of the Western European region, and to examine changes over a 27 year-period. Methods: We performed a secondary database descriptive study using the GBD 2017 results on falls in older adults aged 70 years and older in 22 countries from 1990 to 2017. Results: In 2017 in the Western European region 1380 per 100,000 (uncertainty interval (UI) 11,837- 16,113) older adults sought medical treatment for fall-related injury, ranging from 7,594 per 100,000 (UI 6,326-9,032) in Greece to 19,796 per 100,000 (UI 15,536-24,233) in Norway. Since 1990, falls DALY showed little change for the whole region, but patterns varied widely between countries. Some countries (e.g. Belgium and Netherlands) have lost their favorable positions due to an increasing fall-related burden of disease since 1990. Conclusions: From 1990 to 2017 there was considerable variation in falls incidence, mortality, DALY rates and its composites in the 22 countries of the Western European region. It may be useful to assess which falls prevention measures have been taken in countries that showed continuous low or decreasing incidence, death and DALY rates despite ageing of the population. Keywords: Aging, Accidental falls, Global burden of disease, Population Health, Disability-adjusted Life Years (DALYs)