Circumstances and C ontributing C auses of F all D eaths among P ersons A ged 65 and O lder: U nited S tates, 2010

OBJECTIVES: To determine whether the increasing fall death rate among people aged 65 and older is due in part to temporal changes in recording the underlying cause of death. DESIGN: Analyses of multiple cause of death data using the online Centers for Disease Control and Prevention Wide-ranging ON-line Data for Epidemiologic Research system, which uses the National Center for Health Statistics' Multiple Cause of Death data set. SETTING: United States, 1999 to 2010. PARTICIPANTS: People aged 65 and older with a fall listed on their death record as the underlying or a contributing cause of death. MEASUREMENTS: Circumstances and contributing causes off all deaths--records listing International Classification of Diseases, Tenth Revision, codes W00 to W19 as the underlying cause of death--and underlying causes for records with falls as a contributing cause were examined. Joinpoint regression analysis was used to assess trends in the proportion of fall and fall-associated deaths to total deaths for 1999 to 2010. RESULTS: In 2010, there were 21,649 fall deaths and 5,402 fall-associated deaths among people aged 65 and older; 48.7% of fall deaths involved a head injury. Approximately half the fall death records included diseases of the circulatory system as contributing causes. From 1999 to 2010, there was a trend toward more-specific reporting of falls circumstances, although total deaths remained unchanged. The proportion of fall deaths to total deaths increased 114.3%, and that of fall-associated deaths to total deaths increased 43.1%. CONCLUSION: The reasons behind the increasing older adult fall death rate deserve further investigation. Possible contributing factors include changing trends in underlying chronic diseases and better reporting of falls as the underlying cause of death.