关键词: 跌倒, 中老年, 疾病负担, 趋势, 影响因素

Abstract: Objective To analyze the temporal trends in the disease burden of falls among the Chinese population aged 55 years and older from 1990 to 2021 and to forecast the burden from 2022 to 2030, providing a reference for public health strategy formulation and medical resource allocation. Methods Leveraging the Global Burden of Disease Study 2021 database, data on the burden of falls in the Chinese population aged ≥55 years were extracted. Joinpoint regression analysis was employed to examine temporal trends and identify inflection points in the disease burden. A decomposition analysis was conducted to assess the respective contributions of population aging, population growth, and epidemiological changes. Furthermore, an Autoregressive Integrated Moving Average (ARIMA) model was utilized to project the disease burden for the period of 2022-2030. Results Between 1990 and 2021, the absolute number of fall incidents in the Chinese population aged ≥55 years increased from 3.03 million to 13.45 million, fatalities rose from 31 000 to 107 500, and Disability-Adjusted Life Years (DALYs) increased from 1.46 million to 4.43 million person-years. In both 1990 and 2021, age-standardized incidence rates, age-standardized mortality rates, and age-standardized DALY rates were higher in males than in females. The Joinpoint regression analysis indicated a significant upward trend in the age-standardized incidence rate of falls from 1990 to 2021 (AAPC=0.96%, P<0.05). Conversely, a significant downward trend was observed for both the age-standardized mortality rate (AAPC=-0.47%, P<0.05) and the age-standardized DALY rate (AAPC=-0.52%, P<0.05). The overall trends in the disease burden of falls for both males and females were consistent with those of the total population. Decomposition analysis revealed that epidemiological changes were the primary driver of the increase in fall incidents, contributing 57.03%. Population aging was the core factor in the growth of fall-related fatalities, with a contribution of 86.41%. The ARIMA model forecasts a continued increase in the number of fall incidents, deaths, and DALYs in this demographic through 2030. Conclusion From 1990 to 2021, the absolute burden of falls among the population aged ≥55 years in China demonstrated an increasing trend with notable sex-based disparities. Epidemiological shifts were the central impetus for the rise in fall incidents, whereas population aging predominantly drove the increase in fall-related mortality. It is anticipated that the absolute burden of falls among middle-aged and older adults in China may continue to intensify in the future.

Key words: Falls, Middle-aged and elderly, Disease burden, Trends, Influencing factors