Falls in adults 65 years and older

Introduction

In older age groups, falls are a significant cause of morbidity and mortality. Nationally in 2019–20, 77% of injury hospitalisations in adults age 65 and older were due to falls. Hospitalisations due to falls were three times more common than all other injury types combined.¹

This section is focused on falls hospitalisations and deaths in older age groups. Fall injuries treated in other settings, or that went untreated, are not included. Results therefore underestimate the population-level impacts of falls injuries. Coding systems used for injuries are more complex than for other health conditions included in this report and have changed over time.

For data source technical specifications and for data comparability information please refer to the technical notes at the end of this section.

Hospitalisations

In 2020–21, the Queensland, age-standardised hospitalisations rate (ASR or standardised rate) for falls among those 65 years and over was 4,961.8 per 100,000 persons (Figure 1).²

Demographic differences

Hospitalisation rates varied by demographic characteristics. In 2020–21, the Queensland standardised hospitalisation rate for falls in adults 65 years and older was 1.4 times higher in females than males (5,661.6 compared to 4,137.8 per 100,000, respectively) (Figure 1).

• Females have consistently higher fall hospitalisation rates than males for all age groups (Figure 1). The highest age-specific rate was in females 85 years and older (17,361.0 per 100,000).
• Hospitalisation rates increase markedly with increasing age—the rate of hospitalisations in adults 85 years and older was 9.3 times higher than for those 65 to 69 years (16,075.8 compared to 1,737.0 per 100,000 persons, respectively).

Remoteness and socioeconomic differences

Regions within Queensland can be classified by remoteness³ and the area-based index of relative socioeconomic advantage and disadvantage.⁴

• Rates were higher in major cities but otherwise did not show a consistent relationship with remoteness or socioeconomic status (Figure 1).
• In 2020–21, the standardised hospitalisation rate for falls in adults 65 years and older was 24.7% higher in major cities compared to inner regional areas (5,325.6 compared to 4,269.9 per 100,000 persons, respectively).

Trends

Queensland standardised hospitalisation rates for falls in adults 65 years and older increased 2.3 times from 2002–03 to 2020–21 (Figure 2). The increase was higher in males (2.6 times) than in females (2.2 times).

• Increasing trends in rates were evident in both sexes and all age groups 65 years and older (Figure 2) with females having consistently higher hospitalisation rates than males in all age groups and at all comparative times points.

Mortality

In 2020, the Queensland standardised mortality rate for falls in adults 65 years and older was 68.7 per 100,000 persons (Figure 3).²

Demographic differences

In 2020, the Queensland standardised mortality rate for falls in adults 65 years and older was 51.2% higher in males than females (85.3 compared to 56.4 per 100,000, respectively).

Age-specific mortality rates for falls were consistently higher in males than females (Figure 3). The highest age-specific falls mortality rate was in males age 85 years and older (480.5 per 100,000). This contrasts with falls hospitalisation rates (Figure 1) which were consistently higher in females, suggesting that males experience more severe falls.

Mortality rates increased markedly with increasing age—the mortality rate in adults 85 years and older was 54.2 times higher than in adults 65 to 69 years (385.1 compared to 7.1 per 100,000 persons, respectively).

Trends

Queensland standardised mortality rates have increased since 2002 for males and females with rates being consistently higher for males (Figure 4). The increasing mortality rate in persons 65 years and older is largely driven by increasing rates in persons 85 years and older as younger age groups (65 to 84 years) have shown little to no increase in mortality rates since 2002 (Figure 4).

Additional information

Data and statistics

More information is available from Facts on falls - Queensland Stay On Your Feet.

Section technical notes

Where presented, ratios were calculated using higher precision estimates than in text. Ratios calculated using estimates in text may differ.

Rates are standardised to Australian standard population 2001 per 100,000 population.

For table data: “NA” indicates results that are unavailable or suppressed due to small sample size or not calculated.

Hospitalisations:

• Queensland Health Statistical Services Branch (SSB): ICD Code definition of falls hospitalisation data: Falls (excl. transfer) (PD - S00-T75, or T79. First external cause - W00 - W19. Not transfer from another hospital).
• Separation counts were restricted to Queensland residents and exclude separations flagged as unqualified newborns, organ donors or boarders and admissions to public psychiatric hospitals.
• Admission practices likely changed as a result of COVID-19. Trends that include 2020 or 2021 data should be assessed with caution.

Mortality:

• ICD Code definition of SSB falls mortality data: Falls (underlying) (Refer to Henley G & Harrison JE 2015. Trends in injury deaths, Australia: 1999–00 to 2009–10. AIHW).
• Source: Cause of Death Unit Record File, Australian Coordinating Registry.
• Death counts were restricted to Queensland residents. Deaths where age at the time of death is unknown were excluded.
• Year has been based on year of death. The number of deaths may change due to late death registrations.
• Deaths registered in 2019 and 2020 are subject to change. Deaths for 2020 are underestimated due to late death registrations, especially for First Nations population. Results should be interpreted with caution.
• AIHW mortality data: See AIHW: Henley G & Harrison JE 2019. Trends in injury deaths, 1999–00 to 2016–17, boxes 1.1, 1.2 and appendix A for notes on data limitations and methods. Data source: AIHW National Mortality Database.

References

1. Australian Institute of Health and Welfare. 2022. Falls in older Australians 2019–20: hospitalisations and deaths among people aged 65 and over. Accessed: 1 January 2023.
2. Queensland Health. 2020. Queensland hospital admitted patient data collection (QHAPDC). Accessed: 12 November 2022.
3. Hugo Centre for Migration and Population Research. 2018. Accessibility/remoteness index of Australia (ARIA). Accessibility/Remoteness Index of Australia (ARIA). Accessed: 1 October 2022.
4. Australian Bureau of Statistics. 2018. Socio-economic indexes for areas (SEIFA) 2016. 2033.0.55.001 - Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2016. Accessed: 1 October 2022.