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Fall-Related Injuries Amongst Elderly in Sweden: Still an Emerging Risk?
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.ORCID iD: 0000-0002-6928-0683
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In Sweden, injuries due to falls are the most common cause of injury-related hospitalization and injury-related death amongst elderly. Also, during the 20th century, increasing trends in fall-related injuries have been observed in many high-income countries. Whilst fall-related injury trends have been reported from national studies in other comparable countries, no studies from Sweden using national data have been published, despite this issue sometimes being pointed out as one of the most important emerging societal risks both in Sweden and elsewhere. With large individual and societal costs, as well as prognosticated continued increases in high-income countries, the aim of this thesis is to update the knowledge on the trends of fall-related injuries amongst elderly in Sweden and to determine whether the issue is still to be considered an emerging risk.

National injury morbidity and mortality data from Sweden can show that with regards to all hospitalized fall-related injuries as well as hip fractures, the risk is decreasing. However, diverging trends are observed in age- and sex-specific groups, with younger elderly now having considerably lower rates of fall-related injuries, whilst older elderly are increasingly hospitalized due to minor fall-related injuries. Also, amongst older elderly, increasing hip fracture mortality trends are observed. With regards to sex-specific groups, although fall-related injuries in general are more common amongst women, the injury trends for women are generally decreasing at a quicker rate than for men. Also, contradictorily to almost all fall-related injury morbidity, hip fracture mortality risk is higher amongst men.

This thesis can show a change in trend in fall-related injuries amongst elderly in Sweden since the turn of the century, apart from amongst older elderly and with regards to hip fracture mortality. The implications on prognoses needs to be studied further as do the underlying causes behind this shift in trend.

Abstract [en]

BAKSIDESTEXT

Injuries due to falls are the most common cause of injury-related hospitalization and injury-related death amongst elderly. During the 20th century, although increasing trends in fall-related injuries have been reported from other high-income countries, no studies from Sweden using national data have been published, despite this issue being pointed out as one of the most important emerging societal risks in Sweden.

National injury morbidity and mortality data from Sweden can show that in terms of hospitalized fall-related injuries as well as hip fractures, the risk is decreasing. However, diverging trends are observed in age- and sex-specific groups, with younger elderly now having considerably lower rates of fall-related injuries, whilst older elderly are increasingly hospitalized due to minor fall-related injuries. Also, amongst older elderly, increasing hip fracture mortality trends are observed.

This thesis can show a change in trend in fall-related injuries amongst elderly in Sweden since the turn of the century, apart from amongst older elderly and with regards to hip fracture mortality. The implications on future prognoses needs to be studied further as do the underlying causes behind this shift in trend.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2014. , p. 79
Series
Karlstad University Studies, ISSN 1403-8099 ; 2014:20
Keyword [en]
Elderly, Epidemiology, Falls, Injury, Trends
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Risk and Environmental Studies
Identifiers
URN: urn:nbn:se:kau:diva-31727ISBN: 978-91-7063-551-9 (print)OAI: oai:DiVA.org:kau-31727DiVA, id: diva2:705822
Public defence
2014-05-08, Frödingsalen, 1B364, Karlstad, 13:00 (English)
Opponent
Supervisors
Available from: 2014-04-17 Created: 2014-03-17 Last updated: 2018-05-22Bibliographically approved
List of papers
1. Trends in hip fracture incidence rates among elderly in Sweden 1987-2009
Open this publication in new window or tab >>Trends in hip fracture incidence rates among elderly in Sweden 1987-2009
2013 (English)In: Journal of Public Health, ISSN 1741-3842, E-ISSN 1741-3850, Vol. 35, no 1, p. 125-131Article in journal (Refereed) Published
Abstract [en]

Background Previous trend studies have shown large increases in hip fracture incidence rates among the elderly. International research, however, suggests a levelling off, or decline, of hip fracture incidence rates, although for Sweden this remains to be studied.

Methods Data were obtained regarding hip fractures among individuals 65 years and above from 1987 to 2009. Analysis was performed in three steps. First, age- and sex-specific trends in hip fracture rates per 100 000 and the mean age when sustaining a hip fracture were analysed. Secondly, the annual percentage change was used to compare time periods that helped to quantify changes in secular trends. Finally, linear and Poisson regression models were used to examine the trend data and observed rates.

Results The absolute number of hip fractures among the elderly in Sweden has largely remained constant between 1987 and 2009, while incidence rates have decreased for all age- and sex-specific groups, with the largest changes in the younger age groups and among women. The mean age of sustaining a hip fracture has increased for both men and women.

Conclusions This study supports other international studies in showing a decrease in hip fracture incidence rates among the elderly, especially since the mid-1990s.

Place, publisher, year, edition, pages
Oxford: Oxford University Press, 2013
Keyword
epidemiology, falls, hip fractures, injury, trend
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Risk and Environmental Studies
Identifiers
urn:nbn:se:kau:diva-13205 (URN)10.1093/pubmed/fds053 (DOI)000315645600020 ()22753444 (PubMedID)
Available from: 2012-05-04 Created: 2012-05-04 Last updated: 2018-05-22Bibliographically approved
2. Fall-related fracture trends among elderly in Sweden – exploring transitions among hospitalized cases
Open this publication in new window or tab >>Fall-related fracture trends among elderly in Sweden – exploring transitions among hospitalized cases
2013 (English)In: Journal of Safety Research, ISSN 0022-4375, E-ISSN 1879-1247, no 45, p. 141-145Article in journal (Refereed) Published
Abstract [en]

Problem

Fall-related injuries have been a cause of worry during the end of the 20th century with increasing trends among the elderly.

Method

Using data from the Swedish National Patient Register (NPR) based on hospital admissions, this study explores the trends in fall-related fractures between 1998 and 2010.

Results

The data shows a decreasing trend in fall-related fractures in all age- and sex-specific groups apart from men 80 years and above. While hip fracture incidence rates decreased in all age- and sex-specific groups, both central fractures and upper extremity fractures have increased in all age- and sex-specific groups apart from women 65–79 years. Lower extremity fractures have increased in the older age groups and decreased in the younger. Discussion: The differences found between the groups of fractures and by age- and sex-specific groups indicate a possible transition where more serious fractures are decreasing while less serious fractures increase among hospitalized cases.

Summary

Perhaps due to a focus on hip fracture prevention, this study shows that while the incidence rate of hospitalized hip fractures has decreased, other fall-related hospitalized fractures have increased.

Impact on industry

Potentially, this could be indicative of a healthier younger elderly, coupled with a frailer older elderly requiring more comprehensive healthcare also for less serious injuries. Further research is needed to confirm our results.

Place, publisher, year, edition, pages
Elsevier, 2013
Keyword
Hip fractures, injury, trend, falls, epidemiology
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-13202 (URN)10.1016/j.jsr.2012.10.014 (DOI)000320429600017 ()23708486 (PubMedID)
Available from: 2012-05-04 Created: 2012-05-04 Last updated: 2018-05-22Bibliographically approved
3. Hospitalized fall-related injury trends in Sweden between 2001 and 2010
Open this publication in new window or tab >>Hospitalized fall-related injury trends in Sweden between 2001 and 2010
2016 (English)In: International Journal of Injury Control and Safety Promotion, ISSN 1745-7300, E-ISSN 1745-7319, Vol. 23, no 3, p. 277-283Article in journal (Refereed) Published
Abstract [en]

Previous studies have indicated increasing trends of hospitalized fall-related injuries amongst elderly. Whether this is true also in Sweden is unknown though it is important to study considering the potential societal impact. Data were obtained regarding hospitalized injuries with falls as external cause among those aged 65 years and above with information on injury type, gender and age, on a yearly basis, from 2001 to 2010. Age- and sex-specific incidence rates were calculated (per 100,000 population) for all fall-related injuries, and for each injury type and trend lines were drawn. Linear regression analyses and percentage change were calculated for the types of fall-related injuries. A decreasing incidence was observed in the younger age groups (65-79 years) with greater decreases amongst women (women: -14.6%, men 65-79 years: -10.5%). However, increasing rates were observed in the older age group (80 years and above), with greater increases amongst men (women: 4.3%, men: 11.4%). Superficial injuries showed greater increases than fractures amongst those aged 80 years and above. This study indicates that older elderly in Sweden are increasingly being hospitalized for less serious injuries. This changing injury panorama is important to include in the future planning of both health care and fall-related prevention.

Keyword
elderly; epidemiology; falls; injury
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science; Risk and Environmental Studies
Identifiers
urn:nbn:se:kau:diva-13206 (URN)10.1080/17457300.2015.1032980 (DOI)000379757400007 ()25952682 (PubMedID)
Note

Titel i avhandlingen: Hospitalized fall-related injury trends among elderly in Sweden between 2001 and 2010

Available from: 2012-05-04 Created: 2012-05-04 Last updated: 2018-05-22Bibliographically approved
4. Increasing hip fracture mortality amongst elderly in Sweden - a new emerging risk?
Open this publication in new window or tab >>Increasing hip fracture mortality amongst elderly in Sweden - a new emerging risk?
(English)Article in journal (Refereed) Submitted
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:kau:diva-31724 (URN)
Available from: 2014-03-17 Created: 2014-03-17 Last updated: 2014-04-17Bibliographically approved

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