Epidemiological surveillance of falls among older adults.

Introduction: Falls among older adults (aged 65 and older) cause significant morbidity and mortality in all countries and represent a major public health problem. Methods: Epidemiological surveillance of falls relies on several data sources, each with its own objectives: the Baromètre Santé surveys, the Permanent Survey on Accidents in Daily Life (EPAC), the Medical Information Systems Program (PMSI), and a database compiled from death certificates. Results: According to the Health Barometer, in 2010, nearly one in 12 people aged 55 to 85 (7.8%) reported having experienced at least one accident in the past 12 months that resulted in a medical or hospital visit. Those who had experienced an accident primarily reported falls (56.5%). According to EPAC data, in 2010, 85% of emergency room visits due to accidents in daily life among those aged 65 and older were caused by a fall. This proportion increased with age: 71% among those aged 65 to 69, 78% among those aged 70 to 74, 85% among those aged 80 to 84, 93% among those aged 85 to 89, and 95% among those aged 90 and older. According to the PMSI, in 2014, 76,100 hospitalizations were due to a fracture of the upper end of the femur among people aged 65 and older, three times more common in women than in men. Nine out of ten of these fractures occurred as a result of a fall. Finally, according to data from death certificates, in 2013, in mainland France, 9,334 people aged 65 and older died as a result of an accidental fall (11.2 per 100,000), including 3,737 men (13.1 per 100,000) and 5,597 women (10.1 per 100,000). Mortality rates from falls increase with age. Discussion: Currently available surveys provide results that allow for overall epidemiological surveillance of falls but do not enable the development of targeted prevention strategies. In the future, OSCOUR-SurSaUD® data may partially address the need to track trends in emergency department visits due to falls. The ChuPADom survey on falls among older adults at home will establish profiles of fallers aged 65 and older based on their sociodemographic and economic characteristics, the presence of chronic diseases and/or multiple conditions, their mental health, (poly)pharmacy, independence prior to the fall, home care, extrinsic risk factors (living environment, objects involved in the fall, activity at the time of the fall, etc.), physical and psychological sequelae, as well as their quality of life one year after the fall.

Author(s): Thelot B, Lasbeur L, Pedrono G

Publishing year: 2017

Pages: 328-35

Weekly Epidemiological Bulletin, 2017, n° 16-17, p. 328-35

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