Archives of Gerontology and Geriatrics 73 (2017) 294–299

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Archives of Gerontology and Geriatrics

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Fall prevalence, time trend and its related risk factors among elderly people MARK
in China
⁎
Hong Wua, Peng Ouyangb,
a
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
b
School of Management, Harbin Institute of Technology, Harbin, China

A R T I C L E I N F O A B S T R A C T

Keywords: Objectives: To study the fall prevalence, time trends and related risk factors among elderly people in the Chinese
Fall prevalence mainland from 2011 to 2013.
Time trends Methods: Our data were from China Health and Retirement Longitudinal Study in 2011 and 2013. The popu-
Elderly people lation sample included people aged 60 years and over. Whether the person had experienced fall accident in the
Risk factors
last two years was used to measure fall incidence. The time trend and age groups were investigated through the
chi-square test. The related risk factors were examined based on the binary logistic regression model.
Results: In 2011, 19.64% (95% CI, 18.66%, 20.67%) of elderly people experienced fall incidents and in 2013,
19.28% (95% CI, 18.46%, 20.13%) of elderly people experienced fall incidents. However, no significant dif-
ference was seen in the fall prevalence between 2011 and 2013. The fall prevalence among elderly people aged
66–70 declined significantly while that among people aged over 80 showed an increasing time trend. The fall
prevalence was affected significantly by factors including age (66–70), gender, marital status, self-rated health,
quantity of chronic diseases, quantity of disability items, activities of daily living and physical functioning.
Conclusions: It is revealed the fall prevalence showed no increment from 2011 to 2013 but at a high level. More
efforts should be made to reduce the fall prevalence, and special attention should be paid to the elderly people
aged over 80 and older.

1. Introduction
A fall is an accidental event that occurs when a person loses his
balance and his center of gravity causes him to descend to the floor or
other lower surface (Ungar et al., 2013). According to the World Health
Organization’s estimation, there are nearly 424,000 fatal fall incidents
each year, which has become a common, challenging and dangerous
public health problem. Falls can cause many severe consequences such
as mobility restriction (Kosorok, Omenn, Diehr, Koepsell, & Patrick,
1992), the ability decline in conducting activities such as dressing,
bathing, shopping or housekeeping (Tinetti & Williams, 1998) and loss
of confidence (Sherrington & Tiedemann, 2015). Furthermore, falls can
cause serious injuries including head trauma, laceration
(Rubenstein & Josephson, 2002), fractures of the hip, spine, upper arm,
forearm and bones of the pelvis, hand and ankle (Stevens & Olson,
2000). Falls deliver high burden to health care utilization, long-term
pain and functional impairment (Hartholt et al., 2011). In the USA,
estimates demonstrate that falls result in $19 billion annual cost
(Stevens, Corso, Finkelstein, & Miller, 2006). Fall is somewhat delicate
for elderly people since it happens more regularly to them because of
their aging frailty.
China is challenged on a rapid aging speed. As indicated by 2010
censuses, the number of people aged 60 years and over exceeds 177
million (National Bureau of Statistics, 2010). It’s expected that by 2050
the aging population of China will achieve an incredible level as many
developed countries nowadays (Zhao, Smith, & Strauss, 2014). Fall and
its affiliated injuries place high pressures on both the national health
care and medical cost (Wang, Chen, & Song, 2010). Prior studies about
fall research in China mainly concentrate on the circumstances (Pi, Hu,
Zhang, Peng, & Nie, 2015), the incidence and prevalence (Jiang et al.,
2015), epidemiology, risk factors and clinical strategies for fall or its
affiliated injuries (Wang et al., 2010). However, previous studies don’t
provide comprehensive depiction of demographic and health char-
acteristics about fall due to absence of representative national data.
Meanwhile, nearly all of these studies exclude time trend. Time trend is
critical because it provides dynamic information about fall prevalence
to enable present better preventive project help design care policies on
elderly people and allocate the health resources to fall prevention.

Abbreviations: BMI, body mass index; ADL, activities of daily living; IADL, instrumental activities of daily living; PF, physical function
⁎
Corresponding author at: Harbin Institute of Technology, 92 West Dazhi Street, Nan Gang District, Harbin, China.
E-mail address: ouyp@hit.edu.cn (P. Ouyang).

http://dx.doi.org/10.1016/j.archger.2017.08.009
Received 4 October 2016; Received in revised form 21 August 2017; Accepted 26 August 2017
Available online 01 September 2017
0167-4943/ © 2017 Elsevier B.V. All rights reserved.
H. Wu, P. Ouyang
Considering the serious health outcomes of fall, the intensive health
care, limited financial budget, enormous number of elderly population
and the rapid aging speed in China, more comprehensive researches
about fall are necessary and urgent, especially on time trend. In this
research we aim to: (1) estimate the time trend of fall prevalence over
the period 2011–2013; (2) examine the fall incidence among the elderly
in the Chinese mainland based on different age groups; (3) distinguish
the risk factors of fall incidence.
2. Methods
2.1. Study design and population
Data in this study originated from the China Health and Retirement
Longitudinal Study (CHARLS) 2011 (n = 17,500) (Zhao et al., 2012)
and 2013 (n = 18605) (Chen, Smith, Strauss, Wang, & Zhao, 2015).
CHARLS adopts a multi-stage stratified PPS sampling, which provides a
representative sample of national population. The individuals in
CHARLS will be followed up every two years. CHARLS aims to gather
high-quality data on demographic, family structure or transfer, health
status and functioning, biomarkers, health care and insurance, retire-
ment and pension, income and consumption, assets, and community-
level information. More details of CHARLS information can be found on
the official website. For our study and concerning the Chinese aging
policies, we included people who were 60 years and older.
The variables used in this paper were coded according to a series of
questions. Fall was assessed from the following question: have you
fallen down in the last two years? If the answer is “no”, the value of the
variable is coded as “0” following the answer is “yes” with the variable
set as “1”.
Socio-demographic characteristics include age, gender, marital
status, registered residence, educational level, annual household in-
come, insurance. We classified age into five groups: 60–65 years, 66–70
years, 71–75 years, 76–80 years and over 80. For marital status, we had
two levels: married or unmarried. We considered the marital status
answer “separated”, “divorced”, “widowed” or “never married” as un-
married. And we treated “cohabit” as married. Registered residence
implied whether a man lived in rural or urban areas. Registered re-
sidence could be changed only if a person completed a series of official
transfer procedures. Here we focused on the individual’s current re-
gistered residence status: rural or urban. Concerning the educational
level, we sorted the individual who did not complete primary school to
illiteracy group. We assigned the older-style private school to primary
school. Annual household income was figured based on the summary of
the following six sections: (1) wage and salary income, (2) individual
transfer income, (3) agricultural income, (4) self-employment income,
(5) governmental transfer income, and (6) capital income. China mainly
had nine types of insurance: (1) urban employ medical insurance; (2)
urban resident medical insurance; (3) new cooperative medical in-
surance; (4) urban and rural resident medical insurance; (5) govern-
ment medical insurance; (6) medical aid; (7) private medical insurance
bought by respondent’s union; (8) private medical insurance bought by
individual and (9) other medical insurance. When the respondent said
he held any one of the insurance above, we coded the insurance vari-
able as “1”, otherwise it would be set as “0”.
We evaluated self-rated health from the accompanying two ques-
tions: (1) how would you rate your health status? Would you say your
health is very good, good, fair, poor or very poor? (2) Would you say
your health is excellent, very good, good, fair or poor? All respondents
would be solicited to answer one of the two questions as indicated by
the predefined rule. The answer: very good, good, or excellent was
assigned with “1” while fair, poor or very poor was set as “0”. We
figured the BMI index based on the body weight and height of the
physical examination data. We sorted the BMI into three levels: (1)
BMI < 25, (2) BMI > = 25 and BMI < = 30, and (3) BMI > 30.
Regarding the chronic disease status, we ascertained quantity of the
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Archives of Gerontology and Geriatrics 73 (2017) 294–299
chronic diseases diagnosed by a doctor for each respondent. The
question was: have you been diagnosed with [disease listed below, read
one by one] by a doctor? There were 14 sorts of chronic disease in the
answer list: (1) hypertension, (2) dyslipidemia, (3) diabetes or high
blood sugar, (4) cancer or malignant tumor, (5) chronic lung diseases,
(6) liver disease, (7) heart disease, (8) stroke, (9) kidney disease, (10)
stomach or other digestive disease, (11) emotional, nervous, or psy-
chiatric problems, (12) memory-related disease, (13) arthritis or rheu-
matism and (14) asthma. Once the respondent had one type of above
chronic diseases, the variable value would plus one. The maximum
value for chronic status was 14, and the base was 0. The disability
coding guideline was similar to the chronic disease status. We com-
puted the disability variable based on this question: do you have one of
the following disabilities? Five answers: (1) physical disabilities; (2)
brain damage/mental retardation; (3) vision problem; (4) hearing
problem and (5) speech impediment were provided. The maximum
value of the disability variable was 5 with the minimum one as 0.
Activity of daily living (ADL) was surveyed by these questions: because
of health and memory problems, do you have any difficulty with
dressing, bathing or showering, eating such as cutting up your food,
getting into or out of bed, using the toilet, including getting up and
down, controlling urination and defecation? If the answer was “no, I
don’t have any difficulty”, at that point we would consider he had no
difficulty and coded it as “0”, otherwise if the answer was the following
ones: “I have difficulty but can still do it”, “yes, I have difficulty and
need help” or “I can’t do it”, it would be coded as “0” as for such answer
we considered he had difficulty regardless of what the difficulty level
was. We computed the aggregate of the above each item as the value of
ADL. Instrumental activity of daily living (IADL) was similar to ADL
with the difference existing in the inquiry items. The inquiry items for
IADL were: doing household chores, preparing hot meals, shopping for
groceries, making phone calls, taking medications, managing money.
Physical functioning’s (PF) count complied with the same rule as ADL
or IADL but had more items. The items were used to assess PF including
running or jogging about 1 km, walking 1 km, walking 100 m, getting
up from a chair after sitting for a long time, climbing several flights of
stairs without rest, stooping, kneeling or crouching, reaching or ex-
tending your arms above the shoulders, lifting or carrying over 5 kg
such as a heavy bag of groceries, picking up a small coin from a table.
2.2. Statistical analysis
All of our work was performed through R language programming (R
Core Team, 2016). First, we conducted the descriptive statistics analysis
of the variables in 2011 and 2013 survey data. Then we compared the
fall incident prevalence and time trend through the chi-square test for
the period 2011–2013 according to the classified age groups. The an-
nual fall incident prevalence was also calculated and compared with
this period. A binary logistic regression model was used to identify the
related risk factors. We estimated the coefficients and odds ratios with
95% confidence interval for the logistic regression model.
3. Results
Table 1 demonstrated the variable distribution according to study of
the elderly in this research. In 2011, there were 6114 elderly people in
the study, and in 2013, 8683 elderly people were incorporated. Over
the period 2011–2013, the mean age increased a little but notably
(2011: 68.2 ± 6.7; 2013: 68.5 ± 7.12; p < 0.01). More in detail for
age groups, we found the number of elderly people in age group 66–70
and over 80 increased significantly while other age groups did not. The
gender proportion kept stable in this period and so did the marital
status. There was a little higher proportion of female elderly people
than male and for the marital status, married elderly people were three
times more than unmarried elderly people. However, the registered
residence percentage changed significantly. We found that elderly
H. Wu, P. Ouyang Archives of Gerontology and Geriatrics 73 (2017) 294–299

Table 1
Distribution according to study of elderly people included in the China Health and Retirement Longitudinal Study in 2011 and 2013.

Variables Categories China Health and Retirement Longitudinal Study p value

2011 N = 6114 2013 N = 8683

N % N %

Age (mean) [SD] (68.2) [6.7] (68.5) [7.12] < 0.01

Age group (years) 60–65 2697 44.11 3735 43.02 0.19
66–70 1484 24.27 1997 23.00 0.08
71–75 974 15.93 1393 16.04 0.87
76–80 617 10.09 914 10.53 0.41
81+ 342 5.59 644 7.42 < 0.01
Gender Female 3060 50.05 4350 50.10 0.97
Male 3054 49.95 4333 49.90 0.97
Marital status Married 4787 78.30 6839 78.76 0.51
Unmarried 1327 21.70 1844 21.24 0.51
Registered residence Rural 4822 78.87 6613 76.16 < 0.01
Urban 1292 21.13 2070 23.84 < 0.01
Education level Illiteracy 5050 82.60 6957 80.12 < 0.01
Primary school 712 11.65 1091 12.56 0.10
Middle school 245 4.01 469 5.40 < 0.01
High school and above 105 1.72 162 1.87 0.55
Annual household income (RMB) < 780 721 11.79 1809 20.83 < 0.01
780–5000 1461 23.90 2075 23.90 1.00
5001–25000 2301 37.63 1879 21.64 < 0.01
> 25000 1631 26.68 1848 21.28 < 0.01
Insurance No 395 6.46 339 3.90 < 0.01
Yes 5694 93.13 8252 95.04 < 0.01
Self-rated health Very good/good 1157 18.92 1810 20.85 < 0.01
Fair/bad/very bad 4955 81.04 6848 78.87 < 0.01
BMI (kg/m2) < 25 4354 71.21 4398 50.65 < 0.01
25–30 1312 21.46 1589 18.30 < 0.01
> 30 273 4.47 319 3.67 < 0.01
Quantity of chronic diseases (mean) [SD] (1.63) [1.47] (2.11) [1.70] < 0.01
Quantity of disability items (mean) [SD] (0.30) [0.60] (0.48) [0.77] < 0.01
ADL (mean) [SD] (0.66) [1.28] (0.68) [1.30] 0.56
IADL (mean) [SD] (0.65) [1.24] (0.94) [1.51] < 0.01
PF (mean) [SD] (2.48) [2.19] (2.62) [2.39] < 0.01

people who held rural registered residence decreased significantly Table 2

(2011: 78.87%; 2013: 76.16%; p < 0.01). On the contrary, the elderly Prevalence of fall by age group, in 2011 and 2013.
people who owned urban registered residence increased significantly
Age Prevalence of fall Trend (p value)
(2011: 21.13%; 2013: 23.84%; p < 0.01). Meanwhile the rate of el-
derly people with a higher education level improved. This may be due 2011 N = 6114 2013 N = 8683
to elderly people who had no studies decreased significantly and who
had completed their middle school study increased significantly. N %(95% CI) N %(95% CI)

However, elderly people had a lower annual household income in 2013 60–65 479 7.83 (7.18, 8.54) 635 7.31 (6.78, 7.89) 0.25
as the proportion of elderly people who earned less than 780 increased 66–70 315 5.15 (4.62, 5.74) 367 4.23 (3.82, 4.68) < 0.01***
significantly (2011: 11.79%; 2013: 20.83%; p < 0.01) and the extent 71–75 191 3.12 (2.71, 3.60) 305 3.51 (3.14, 3.93) 0.21
earning between 5001 and 25000 or above decreased significantly. At 76–80 142 2.32 (1.97, 2.74) 193 2.22 (1.93, 2.56) 0.73
81+ 74 1.21 (0.96, 1.53) 174 2.00 (1.72, 2.33) < 0.01***
the same time, elderly people enjoyed more basic health medical in-
Total 1201 19.64 (18.66, 1674 19.28 (18.46, 0.60
surance as the basic health medical insurance coverage expanded sig- 20.67) 20.13)
nificantly in this period.
The self-rated health and BMI exhibited a significantly worse con- Note: *p < 0.1; **p < 0.05; ***p < 0.01.
dition in 2011 than in 2013. Most functional variables about elder
people’s activity abilities became worse from 2011 to 2013 except for showed a significant reduction in 2013 compared with that in
ADL. The quantity of chronic diseases diagnosed by doctors and dis- 2011(2011: 5.15%; 2013, 4.23%; p < 0.01), while for elderly people
ability items increased significantly. IADL and PF varied similarly as aged over 80 the prevalence of fall incidents displayed a significant
chronic disease and disability items. Only the ADL variable kept stable. increment (2011: 1.21%; 2013: 2.00%; p < 0.01).
In general, elder people’s activity abilities were becoming worse during Table 3 shows the associated factors with fall incidents among elder
this period. people, with odds ratio and corresponding 95% confidence interval.
The prevalence of fall incidents was shown in Table 2. The fall in- Given the upper 95% CI of OR was 0.98, the 2013 cohorts were at lower
cident prevalence declined overall but not significantly (2011: 19.64%; risk of falling than those of 2011 after adjustment for a wide range of
2013: 19.28%; p = 0.60). In detail, the fall prevalence for elderly socio-demographic and health variables (OR 0.87, 95% CI 0.78–0.98).
people aged 60–65 (2011: 7.83%; 2013, 7.31%; p = 0.25), 71–75 Registered residence, educational level, annual household income, in-
(2011: 3.12%; 2013: 3.51%; p = 0.21) and 76–80 (2011: 2.32%; 2013: surance, BMI and IADL were not significantly associated with fall in-
2.22%; p = 73) stayed stable. The prevalence of fall incidents among cidents. Self-rated health was the only risk factor that was negatively
elderly people aged 66–70 and over 80 showed a controversial varia- related to fall event. Compared with an individual in fair/bad/very bad
tion. The prevalence of fall incidents among elderly people aged 66–70 health status, when elderly people rated his health as very good/good,

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Table 3
Binary logistic regression model for fall among Chinese elderly people in China Health and Retirement Longitudinal Study in 2011 and 2013.

Variable Categories Fall

Coefficients OR (95%CI)

Age group (years) 60–65 1

66–70 0.123* 1.13 (0.99, 1.29)
71–75 0.046 1.05 (0.90, 1.22)
76–80 0.043 1.04 (0.87, 1.25)
81+ 0.141 1.15 (0.91, 1.45)
Gender Male 1
Female 0.359*** 1.43 (1.28, 1.60)
Marital status Unmarried 1
Married 0.105* 1.11 (0.97, 1.27)
Registered residence Rural 1
Urban −0.033 0.97 (0.83, 1.12)
Education level Illiteracy 1
Primary school 0.078 1.08 (0.90, 1.29)
Middle school −0.081 0.92 (0.67, 1.25)
High school and above −0.202 0.82 (0.47, 1.36)
Annual household income (RMB) < 780 1
780–5000 −0.032 0.97 (0.83, 1.13)
5001–25000 −0.067 0.94 (0.80, 1.09)
> 25000 −0.026 0.97 (0.82, 1.16)
Insurance No 1
Yes 0.112 1.12 (0.88, 1.44)
Self-rated health Fair/bad/very bad 1
Very good/good −0.268*** 0.76 (0.64, 0.90)
BMI (kg/m2) < 25 1
25–30 0.010 1.01 (0.89, 1.14)
> 30 −0.136 0.87 (0.69, 1.10)
Quantity of chronic diseases 0.081*** 1.08 (1.05, 1.12)
Quantity of disability items 0.162*** 1.18 (1.09, 1.27)
ADL 0.131*** 1.14 (1.08, 1.20)
IADL 0.025 1.03 (0.98, 1.08)
PF 0.091*** 1.09 (1.06, 1.13)
CHARLS 2011 1
2013 −0.142** 0.87 (0.78, 0.98)

Note: *p < 0.1; **p < 0.05; ***p < 0.01.

he was less likely to fall (OR 0.76, 95% CI 0.64–0.89). Female elderly
people had a higher chance of fall (OR 1.44, 95% CI 1.28–1.61). In
terms of age groups, only elderly people aged between 66 and 70 had
significantly higher likelihood of fall (OR 1.13, 95% CI 0.99–1.29).
Elderly people who are married were also more prone to experience fall
incidents (OR 1.12, 95% CI 0.98–1.27). More chronic diseases (OR
1.08, 95% CI 1.04–1.11) and disability items (OR 1.17, 95% CI
1.08–1.25) would bring about more fall incidents significantly. More
ADL difficulties (OR 1.15, 95% CI 1.09–1.21) and more physical func-
tion impairments (OR 1.10, 95% CI 1.06–1.13) would likewise cause
higher chance of fall event. The highest OR was found among elderly
people with more disability items who had 1.15 greater likelihood of
fall.
4. Discussion
Although China’s aging population increase quickly, fall has not
been completely studied in such a tremendous aging population, and
the dynamic research is absent. We fill a major gap by using the
CHARLS national longitudinal data to investigate the dynamic variation
in fall prevalence among China’s elderly people, which has never been
studied before. No obvious increment of fall incidents is found in our
research and elderly people aged over 80 are found to be at higher risk
of fall. The prevalence of fall incidents of our study is high, but different
from other researches in China (Pi et al., 2015). Pi et al. reported that
the fall incidents rate is 41.5% among elderly people in Beijing, which
is twice higher than ours (Pi et al., 2015). Xu et al. reported higher fall
prevalence among Chinese veterans with 34.2% (Xu et al., 2015),
however Yu et al. reported a lower fall incidence prevalence with only
18.0% in Beijing (Yu et al., 2009). The distinction in fall prevalence
between our research and other studies may be due to the difference in
place and the target population. Additionally, the fall prevalence in our
study is lower than that in Nottingham (UK) (Bath & Morgan, 1999)
with fall prevalence of 52.5% or US with 43.8% (Alamgir,
Muazzam, & Nasrullah, 2012). This difference may be associated with
different elderly people incorporation age, while in their studies in-
dividuals aged 65 years and older were included. The fall prevalence
varies with age groups. Our results distinguished from others by ex-
amining the time trend among different age groups while most fall-
related studies concentrated on the fall-related injury or fall-related cost
and cause. We found that time trend fluctuated significantly among
elderly people as the prevalence of people aged 66–70 experienced a
decline while the prevalence of elderly people aged over 80 showed an
increasing trend. This suggests that more attention should be paid to
elderly people of specific age group for fall prevention in light of the
fact that an advanced age was associated with morbidity, mortality and
injury pattern as a result of ground level fall (Bhattacharya, Maung,
Schuster, & Davis, 2016). The potential explanation for why the total
prevalence did not increase may be credited to the expansion of basic
insurance coverage or people’s registered residence transfers which
help them easily gain access to better health care. This needs to be
further studied.
Risk factors of fall included age, functional abilities, chronic con-
ditions (Stevens, 2005). Elderly people in China were becoming older
over the period 2011–2013 as their mean age increased 0.3 year while
careful consideration is needed to give to fall prevention since studies
showed that older age was associated with increasing fall risk
(Verghese, Holtzer, Lipton, & Wang, 2009) and elderly people may fall
harder when they were older (Bhattacharya et al., 2016). It seemed that
female people were more likely to fall than male people as some studies

297
H. Wu, P. Ouyang
concentrated on the fall incidents or fall related injuries to women
(Bergland & Wyller, 2004;; Hu, Xia, Jiang, Zhou, & Li, 2015;
Stevens & Olson, 2000). Verghese et al. showed that women’s fall risk
was higher (Verghese et al., 2009). Our results are in line with their
results. Elderly people’s physical conditions in China were deteriorating
due to the more and more chronic diseases, the disability items and the
troubles in IADL and physical functioning identifying and treating
symptoms of chronic diseases may help reduce the risk of falling
(Society, Society, Prevention, & Panel, 2001). Our results demonstrated
that more diagnosed chronic diseases were related to higher falling risk.
De Rekeneire et al. provided similar results to ours that people who fall
were more likely to have more chronic diseases (De Rekeneire et al.,
2003). These results are of vital implications for fall prevention. The
quantity of chronic diseases in our study was a significant risk factor of
fall, so it can be used as a feasible and effective signal for screening
elderly people with higher risk of fall. It is found that elderly people
who were in better self-rated health were less inclined to fall. This
might be because self-rated health status was significantly associated
with fear of falling (Howland et al., 1993). Additionally, it is found that
elderly people who had more disability items, ADL difficulties and
physical function difficulties were with a higher likelihood to fall.
While most of the previous studies focused on the fall induced in-
juries, the relationships between injuries and fall were seldom ex-
amined. Here we found that when elderly people had greater disability
items, they were at higher risk of fall. Masud et al. revealed that im-
paired ADL was a significant risk factor for fall (Masud & Morris, 2001).
Yokoya et al. suggested that fall risk was closely related to ADL cap-
ability (Yokoya, Demura, & Sato, 2007). Aside from ADL, Chang et al.
pointed out that physical function turned out to be closely related to the
fall in the elderly people (Chang & Kang, 2004). Our results are con-
sistent with their results. The relationship between BMI and fall in-
cidents remained unclear. Some prior examinations indicated that BMI
(overweight 25–29.9 kg/m2) was not related to fall (Ylitalo & Karvonen-
Gutierrez, 2016), while some studies suggested that obesity
(BMI ≥ 40 kg/m2) appeared to be associated with greater risk of fall
(Himes & Reynolds, 2012). Our results were consistent with both, but
no significance could be confirmed.
Strengths of our study included a large, representative sample based
on national individual data and the use of specified questionnaires. As
far as we know, this study is the first to focus on time trend for fall in
China. Our results may provide evidence for fall intervention or pre-
vention based on individual’s demographics and related health condi-
tions.
Limitations may exist in our study. First, the causal effects were not
got. Second, some information is missing that some individuals rejected
providing an answer which may lead to biased answers. Third, the
lifestyle, housing or some other environmental factors were not in-
cluded in our study which may be important risk factors. Last, the cost
and injuries induced by fall were not studied, which need to be studied
in the future.
5. Conclusion
The fall prevalence among elderly people in China kept stable
around 20% over the period of 2011–2013 with no significant variation
identified during this period while the prevalence of people aged over
80 had an increasing time trend, but the prevalence of fall among
people aged 66–70 displayed an opposite time trend. Self-rated health
was the only factor in our research that was negatively related to fall.
Other factors that were significantly associated with fall were gender,
chronic disease, disability items, ADL and PF. Our results can be used to
pick out people with high-risk level off all accidents and help develop
prevention program targeted at specific elderly population.
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Archives of Gerontology and Geriatrics 73 (2017) 294–299
Funding
This research did not receive any specific grant from funding
agencies in the public, commercial, or not-for-profit sectors.
Declarations of interest
None of the authors have any conflicts of interest to this paper.
Acknowledgements
We thank John M Starr for his hard and efficient work and his
constructive comments to this paper. We are grateful for the reviewer’s
hard and critical work.We also would like to thank the China Center for
Economic Research, the National School of Development of Peking
University for providing the CHARLS data.
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