Fall-Related Mortality Among Older Adults in Türkiye and Selected Regional Countries: A Multinational Ecological Panel Study

Objective: This study aimed to describe observed annual variation, demographic patterns, coding specificity, and the robustness of cross-country comparisons of fall-related mortality among adults aged 65 years or older in Türkiye and nine selected regional countries.Material and Methods: Underlying-cause mortality records coded W00-W19 were obtained from the World Health Organization Mortality Database for 2009-2023 and linked to population denominators. Age-standardized mortality rates were calculated using grouped age categories and the WHO world standard population. Country comparisons used negative binomial models adjusted for age, sex, and calendar year; an analysis including X59 was performed to assess coding sensitivity. Georgia was retained descriptively but excluded from inferential analyses. W19 was summarized as a coding indicator.Results: A total of 90,395 W00-W19 deaths were included in the descriptive series. Mean age-standardized mortality varied approximately tenfold across countries. In the nine-country adjusted comparison, Slovenia and Croatia had higher W00-W19 mortality than Türkiye. Adding X59 altered some comparisons, notably Cyprus (IRR 0.49 to 1.48) and Moldova (0.28 to 0.62). Mortality was lower in women than in men (incidence rate ratio [IRR] 0.54, 95% confidence interval [CI] 0.41-0.72) and increased at ages 75-84 years (IRR 3.08, 95% CI 1.92-4.93) and 85 years or older (IRR 10.15, 95% CI 4.54-22.71), compared with ages 65-74 years.Conclusion: Older age and male sex were the most consistent demographic correlates. Some country comparisons were sensitive to inclusion of unspecified external-cause deaths; these findings support caution in interpreting international differences in fall-coded mortality.