Epidemiology and clinical consequences of falls among older adults in Shandong, China: a retrospective cohort study (2015–2021)

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Abstract
Purpose This study aimed to characterise the epidemiology, clinical presentation, and temporal trends of falls among adults aged ≥60 years in Shandong Province, China. Methods We evaluated incidence rates, temporal trends and demographic patterns among 631 001 older adults between 1 January 2015 and 31 December 2021. Annual percentage changes (APCs) were estimated using logarithmic linear regression, while Poisson regression models calculated incidence rate ratios to assess risk factors. Results During the study period, 5314 fall cases were recorded, yielding an overall incidence of 196.64 per 100 000 person-years with a significant upward trend. Females demonstrated 1.78 times higher risk than males, while adults ≥85 years faced twice the risk of those aged 60–64 years. Geographically, Weihai recorded the highest incidence (446.80/100 000 person-years), while Dezhou exhibited the most rapid increase (APC=42.13%). Seasonal analysis revealed peak incidence in summer (1394, 26.23%), with significant differences in seasonal distribution by sex and age groups. Gender-specific injury patterns emerged: males experienced more head (488, 50.36%) and neck trauma (77, 53.85%) and females showed higher fracture rates (2892, 68.11%). Conclusions Our findings reveal a growing incidence of falls among older adults, exacerbated by demographic ageing and geographic disparities. Urgent interventions are needed, particularly for high-risk groups including women, the oldest old (≥85 years) and residents of coastal areas.
Funding Information
  • National Natural Science Foundation of China (81803337, 81872719)
  • Natural Science Foundation of Shandong Province (ZR2023MH313)

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