Declining incidence in fall-induced deaths of older adults: Finnish statistics during 1971–2015



Fall-induced deaths of elderly people are a major problem.

Aim and methods

Using the Official Cause-of-Death Statistics of Finland, we aimed to determine the current trends in the number and age-adjusted incidence (per 100,000 persons) of fall deaths among older Finns by taking into account 50 years or older persons who died because of a fall-induced injury in 1971–2015.


Among men, the number of fall-induced deaths increased considerably between 1971 and 2003 (from 162 in 1971 to 564 in 2003), while thereafter, this number has been relatively stable (579 deaths in 2015). Men’s age-adjusted incidence of fall deaths rose from 45.6 in 1971 to 69.5 in 1998, after which it stayed relatively stable until 2005 (69.9). Since 2005, this figure has shown a steady, deep decline (only 45.1 in 2015). Among women, the number of fall-induced deaths increased considerably between 1971 and 1998 (from 279 in 1971 to 563 in 1998), while thereafter, this number has been relatively stable (532 deaths in 2015). In sharp contrast to men, women’s age-adjusted incidence of fall-induced deaths has been declining since the early 1970s, the incidence being 82.6 in 1971 while only 33.0 in 2015. A steady, deep decline started in 1998.


Among 50 years or older Finns the number of fall-induced deaths increased considerably from the early 1970s until the late 1990s but stabilized thereafter. In the new millennium, the age-adjusted incidence of these deaths has started to decline in both sexes. Despite this we have to effectively continue the falls prevention efforts, because our elderly population will grow rapidly in the near future.

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  1. 1.

    Kannus P, Parkkari J, Koskinen S et al (1999) Fall-induced injuries and deaths among older adults. JAMA 281:1895–1899

    Article  PubMed  CAS  Google Scholar 

  2. 2.

    Korhonen N, Kannus P, Niemi S et al (2013) Fall-induced deaths among older adults: nationwide statistics in Finland between 1971 and 2009 and prediction for the future. Injury 44:867–871.

    Article  PubMed  Google Scholar 

  3. 3.

    Welmer AK, Rizzuto D, Laukka EJ et al (2017) Cognitive and physical function in relation to the risk of injurious falls in older adults: a population-based study. J Gerontol A Biol Sci Med Sci 72:669–675.

    PubMed  Article  Google Scholar 

  4. 4.

    Ferrucci L, Cooper R, Shardell M et al (2016) Age-related change in mobility: perspectives from life course epidemiology and geroscience. J Gerontol A Biol Sci Med Sci 71:1184–1194.

    Article  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Uusi-Rasi K, Patil R, Karinkanta S et al (2017) A 2-year follow-up after a 2-year RCT with vitamin D and exercise: effects on falls, injurious falls and physical functioning among older women. J Gerontol A Biol Sci Med Sci 72:1239–1245.

    Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Official Statistics of Finland (2016) Official cause-of death statistics, 1971–2015. Statistics Finland, Helsinki

    Google Scholar 

  7. 7.

    Kramarow E, Chen LH, Hedegaard H et al (2015) Deaths from unintentional injury among adults aged 65 and over: United States, 2000–2013. NCHS Data Brief 199:1–8

    Google Scholar 

  8. 8.

    Orces CH (2008) Trends in fall-related mortality among older adults in Texas. Tex Med 104:55–59

    PubMed  Google Scholar 

  9. 9.

    Dowling AM, Finch CF (2009) Baseline indicators for measuring progress in preventing falls injury in older people. Aust N Z J Public Health 33:413–417.

    Article  PubMed  Google Scholar 

  10. 10.

    Stevens JA, Rudd RA (2014) Circumstances and contributing causes of fall deaths among persons aged 65 and older: United States, 2010. J Am Geriatr Soc 62:470–475.

    Article  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Bäckström D, Larsen R, Steinvall I et al (2017) Deaths caused by injury among people of working age (18–64) are decreasing, while those among older people (64+) are increasing. Eur J Trauma Emerg Surg.

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Hartholt KA, Polinder S, van Beeck EF et al (2012) End of the spectacular decrease in fall-related mortality rate: men are catching up. Am J Public Health 102:207–211.

    Article  Google Scholar 

  13. 13.

    Official Statistics of Finland (2016) Structure of population and vital statistics: whole country and provinces, 1971–2015. Statistics Finland, Helsinki

    Google Scholar 

  14. 14.

    Official Statistics of Finland (2015) Population projection by municipalities, 2016–2030. Statistics Finland, Helsinki

    Google Scholar 

  15. 15.

    Kannus P, Niemi S, Parkkari J et al (2006) Nationwide decline in incidence of hip fracture. J Bone Miner Res 21:1836–1838.

    Article  PubMed  Google Scholar 

  16. 16.

    Deprey S (2009) Descriptive analysis of fatal falls of older adults in a Midwestern county in the year 2005. J Geriatr Phys Ther 32:67–72

    Article  PubMed  Google Scholar 

  17. 17.

    Korhonen N, Niemi S, Parkkari J et al (2013) Continuous decline in incidence of hip fracture: nationwide statistics from Finland between 1970 and 2010. Osteoporos Int 24:1599–1603.

    Article  PubMed  CAS  Google Scholar 

  18. 18.

    Deprey SM, Biedrzycki L, Klenz K (2017) Identifying characteristics and outcomes that are associated with fall-related fatalities: multi-year retrospective summary of fall deaths in older adults from 2005 to 2012. Inj Epidemiol 4:21.

    Article  PubMed  PubMed Central  Google Scholar 

  19. 19.

    Abrahamsen B, van Staa T, Ariely R et al (2009) Excess mortality following hip fracture: a systematic epidemiological review. Osteoporosis Int 20:1633–1650.

    Article  CAS  Google Scholar 

  20. 20.

    Hindmarsh DM, Hayen A, Finch CF et al (2009) Relative survival after hospitalisation for hip fracture in older people in New South Wales, Australia. Osteoporosis Int 20:221–229.

    Article  CAS  Google Scholar 

  21. 21.

    Kannegaard P, van der Mark S, Eiken P et al (2010) Excess mortality in men compared with women following a hip fracture. National analysis of comedications, comorbidity and survival. Age Ageing 39:203–209.

    Article  PubMed  Google Scholar 

  22. 22.

    Fleischman R, Adams A, Hedges J et al (2010) The optimum follow-up period for assessing mortality outcomes in injured older adults. J Am Geriatr Soc 58:1843–1849.

    Article  PubMed  PubMed Central  Google Scholar 

  23. 23.

    Haentjens P, Magaziner J, Colon-Emeric C et al (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152:380–390.

    Article  PubMed  PubMed Central  Google Scholar 

  24. 24.

    Chisholm K, Harruff R (2010) Elderly deaths due to ground-level falls. Am J Forensic Med Pathol 31:350–354.

    Article  PubMed  Google Scholar 

  25. 25.

    Coronado VG, Xu L, Basavaraju SV et al (2011) Surveillance for traumatic brain injury-related deaths—United States, 1997–2007. MMWR Surveill Summ 60:1–32

    PubMed  Google Scholar 

  26. 26.

    Thomas K, Stevens J, Sarmiento K et al (2008) Fall-related traumatic brain injury deaths and hospitalizations among older adults-Unites States, 2005. J Safety Res 39:269–272.

    Article  PubMed  CAS  Google Scholar 

  27. 27.

    Thierauf A, Preuβ J, Lignitz E et al (2010) Retrospective analysis of fatal falls. Forensic Sci Int 198:92–96.

    Article  PubMed  PubMed Central  Google Scholar 

  28. 28.

    Sorock G, Chen L, Gonzalgo S et al (2006) Alcohol-drinking history and fatal injury in older adults. Alcohol 40:193–199

    Article  PubMed  Google Scholar 

  29. 29.

    Immonen S, Valvanne J, Pitkälä KH (2011) Prevalence of at-risk drinking among older adults and associated sociodemographic and health-related factors. J Nutr Health Aging 15:789–794

    Article  PubMed  CAS  Google Scholar 

  30. 30.

    Davidson G, Hamlat C, Rivara F et al (2011) Long-term survival of adult trauma patients. JAMA 305:1001–1007.

    Article  PubMed  CAS  Google Scholar 

  31. 31.

    Sulander TT, Rahkonen OJ, Uutela AK (2003) Functional ability in the elderly Finnish population: time period differences and associations, 1985–99. Scand J Public Health 31:100–106

    Article  PubMed  Google Scholar 

  32. 32.

    Betz M, Kelly S, Fisher J (2008) Death certificate inaccuracy and underreporting of injury in elderly people. J Am Geriatr Soc 56:2267–2272

    Article  PubMed  Google Scholar 

  33. 33.

    Kharrazi RJ, Nash D, Mielenz TJ (2015) Increasing trend of fatal falls in older adults in the United States, 1992 to 2005: coding practice or reporting quality? J Am Geriatr Soc 63:1913–1917.

    Article  PubMed  Google Scholar 

  34. 34.

    Korhonen N, Niemi S, Palvanen M et al (2012) Declining age-adjusted incidence of fall-induced injuries among elderly Finns. Age Ageing 41:75–79.

    Article  PubMed  Google Scholar 

  35. 35.

    Karinkanta S, Piirtola M, Sievänen H et al (2010) Physical therapy approaches to reduce risk of falls and fractures among older adults. Nat Rev Endocrinol 6:396–407.

    Article  PubMed  Google Scholar 

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This work was financially supported by the Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital, Tampere, Finland (grant 9V015). The organization had no involvement in the (1) study design; (2) collection, analysis and interpretation of data; (3) writing of the manuscript; and (4) decision to submit the manuscript for publication.

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Correspondence to Pekka Kannus.

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All procedures performed in studies involving human subjects were in accordance with ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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As a register-based blinded analysis, the study did not have identifiable individual participants, and thus, informed consent was not obtained.

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Kannus, P., Niemi, S., Sievänen, H. et al. Declining incidence in fall-induced deaths of older adults: Finnish statistics during 1971–2015. Aging Clin Exp Res 30, 1111–1115 (2018).

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  • Fall-induced deaths
  • Elderly people
  • Secular trends