Global Trends
Table 1
Incident cases,death cases and DALYs of falls for both sexes and all age between 1990 and 2021 by GBD regions
Location | Incident Cases all age | Death Cases all age | DALYs all age |
| 1990 | 2021 | 1990 | 2021 | 1990 | 2021 |
Global | 155954194.50(136202890.97-179718954.72) | 215566471.55(195267829.98-238982230.14) | 407767.80(357240.37-450139.65) | 802802.57(681873.54-874337.68) | 29408340.80(24558088.21-35187652.10) | 43804122.62(35938837.24-52811147.34) |
Andean Latin America | 659413.53(571438.96-765366.23) | 1393528.80(1238555.62-1573854.79) | 1789.54(1578.54-2057.15) | 3878.22(3106.98-4698.44) | 129249.23(110200.75-151241.88) | 253204.78(207671.26-310781.52) |
Australasia | 1237056.15(1048956.74-1470394.35) | 2179050.00(1949663.40-2457998.76) | 1163.83(1049.51-1237.25) | 5144.18(4282.46-5646.46) | 133451.05(96577.36-177369.72) | 303091.26(232538.54-389512.43) |
Caribbean | 536342.84(471207.93-620429.65) | 897677.01(818367.70-989722.74) | 2255.96(2109.65-2373.05) | 5651.81(4981.54-6258.37) | 105280.39(89854.83-123710.74) | 200756.90(170384.75-237412.20) |
Central Asia | 2363458.89(2116320.35-2626771.31) | 2384289.66(2143532.11-2651368.19) | 3736.59(3533.07-3913.49) | 3229.63(2878.12-3595.83) | 405783.51(347905.88-477894.49) | 380631.40(310934.87-468164.36) |
Central Europe | 7249154.34(6554577.96-8013853.24) | 5791945.86(5336054.45-6316125.58) | 18708.26(17885.71-19366.25) | 16036.36(14520.79-17152.01) | 1283759.79(1047555.68-1564509.90) | 1078481.87(841661.00-1344160.51) |
Central Latin America | 6680891.63(5634229.17-7905612.42) | 6537780.03(5715234.61-7581210.24) | 10276.03(10014.68-10483.71) | 13106.50(11765.96-14448.44) | 931910.60(774937.36-1116779.15) | 1043910.91(833958.59-1282357.70) |
Central Sub-Saharan Africa | 439156.54(366528.01-526079.77) | 1187242.13(994837.94-1402477.04) | 2162.76(1692.34-2899.87) | 4751.67(3439.73-6836.62) | 127887.96(99646.25-178301.31) | 269093.18(211937.04-352053.69) |
East Asia | 25222205.08(21549079.00-29735971.94) | 40322894.13(36270313.80-44856386.39) | 75591.31(64284.51-99592.15) | 146150.56(95163.53-187800.58) | 5984238.98(4952395.34-7436381.55) | 8488967.66(6536064.85-10672804.83) |
Eastern Europe | 13295015.73(11420526.85-15524879.48) | 10654142.98(9484661.93-12013114.35) | 15570.84(15239.87-15836.49) | 17601.26(16272.88-18827.18) | 2087621.58(1645135.61-2625405.10) | 1897353.18(1482154.61-2447510.74) |
Eastern Sub-Saharan Africa | 1643295.23(1342263.68-1993808.90) | 3642715.78(3056341.25-4345605.25) | 11204.89(8863.19-13045.53) | 21218.12(17892.72-24921.30) | 559382.55(439869.61-669004.60) | 1010808.33(851549.18-1182108.53) |
High-income Asia Pacific | 8056281.18(7055970.32-9229966.75) | 7357241.69(6680230.86-8115924.33) | 8360.67(7597.91-9120.52) | 21619.60(17682.07-24289.70) | 1029762.03(801797.80-1323498.67) | 1345484.02(1031164.48-1726656.15) |
High-income North America | 10740466.53(9305546.58-12412221.84) | 16454980.80(15002506.20-18172212.28) | 15802.35(14121.33-16628.02) | 58297.92(49792.25-62768.79) | 1386309.09(1059636.30-1774055.03) | 2819344.53(2264787.53-3553753.15) |
North Africa and Middle East | 6937401.26(5994765.53-8108164.93) | 14287405.88(12707681.56-16185936.50) | 15051.38(12020.81-18835.86) | 23404.40(20141.65-27599.18) | 1286127.23(1003703.04-1613947.70) | 2165157.97(1782266.43-2689369.59) |
Oceania | 80710.04(68473.94-95165.83) | 227214.27(203624.00-253155.76) | 217.99(154.93-286.53) | 559.74(340.14-793.62) | 16279.84(13237.60-19722.69) | 43751.23(33852.64-56534.76) |
South Asia | 26869032.34(23060972.54-31292692.14) | 46081178.50(41202495.68-51175978.31) | 117025.83(86891.66-136673.77) | 262196.12(214422.73-292785.23) | 6647830.31(5325568.89-7775440.36) | 11646796.33(9746015.99-13595118.33) |
Southeast Asia | 6821008.52(5931736.33-7898107.39) | 11390038.97(10294207.50-12554639.56) | 30963.58(25789.24-35324.95) | 58275.74(46640.11-66398.62) | 1769006.38(1487576.16-2074530.12) | 2970331.99(2526497.96-3453428.07) |
Southern Latin America | 1611714.06(1400211.43-1859286.73) | 2344702.45(2057696.32-2706862.07) | 2421.85(2283.20-2526.53) | 3533.93(3156.92-3754.09) | 213430.97(169783.87-263748.01) | 314359.45(239250.62-403213.10) |
Southern Sub-Saharan Africa | 509592.70(418245.27-624247.55) | 682101.91(577909.12-814158.44) | 1092.78(912.58-1266.07) | 1732.73(1486.09-2171.29) | 83638.97(71077.23-99915.43) | 127179.32(105890.68-156400.44) |
Tropical Latin America | 7561716.99(6429709.81-8988741.06) | 8098424.18(7167874.57-9190557.01) | 7876.03(7543.03-8101.87) | 21920.21(19620.16-23307.51) | 950783.71(765052.00-1177535.76) | 1412652.35(1138856.77-1735970.69) |
Western Europe | 25639286.59(23113206.40-28724157.74) | 28768356.47(26336964.83-31465406.53) | 54532.19(49614.14-57205.47) | 91136.83(76595.25-98623.40) | 3689428.08(2862716.27-4658615.70) | 4826638.70(3763475.69-6100831.54) |
Western Sub-Saharan Africa | 1800994.33(1477408.09-2188032.42) | 4883560.07(4091365.39-5745329.62) | 11963.14(10186.52-14452.87) | 23357.03(19090.60-27588.21) | 587178.55(490296.22-701366.91) | 1206127.25(1004749.85-1411991.98) |
The number of fall-related incident cases, deaths, and DALYs globally in 2021 were 215,566,471.55 (95%UI, 195,267,829.98–238,982,230.14), 802,802.57 (95%UI, 681,873.54–874,337.68), and 43,804,122.62 (95%UI, 35,938,837.24-52,811,147.34) respectively, all showing a significant increase compared to 1990.(Table 1 and Fig. 1)
In 2021, the ASIR, ASMR, and ASDR for falls were 2701.95 (95%UI, 2444.45-3000.38), 9.94 (95%UI, 8.43–10.84), and 531.26 (95%UI, 436.95-639.12) respectively. All of them showed a decrease compared to 1990. The EAPC for ASIR, ASMR, and ASDR were − 0.49 (95%UI, -0.54-0.43), -0.29 (95%UI, -0.34-0.23), and − 0.69 (95%UI, -0.72-0.65) respectively. Based on the region, in 2021, the highest ASIR, ASMR, and ASDR were observed in Australasia 6948.34 (95%UI, 5892.64-8323.04), Eastern Sub-Saharan Africa 14.98 (95%UI, 12.76–17.67), and South Asia 764.79 (95%UI, 641.92-881.29); while the lowest ASIR, ASMR, and ASDR were found in Southern Sub-Saharan Africa 836.03 (95%UI, 716.78-987.41), Southern Sub-Saharan Africa3.04 (95%UI, 2.61–3.81), and Southern Sub-Saharan Africa177.32 (95%UI, 148.37-217.08) respectively. The regions with the largest increases in ASIR, ASMR, and ASDR were Oceania (EAPC, 0.82, 95%UI, 0.72–0.92), High-income North America (EAPC, 1.66, 95%UI, 1.42–1.91), and Australasia (EAPC, 0.51, 95%UI, 0.33–0.69); while the most significant decreases in ASIR, ASMR, and ASDR were Tropical Latin America (EAPC, -1.06, 95%UI, -1.39-0.73), Central Latin America (EAPC, -2.66, 95%UI, -2.84-2.49), and Central Latin America (EAPC, -1.47, 95%UI, -1.72-1.21).(Table 2 and Fig. 2)
Table 2
The ASIR, ASMR and ASDR of falls for both sexes between 1990 and 2021, and their EPACs from 1990 to 2021, by GBD regions
Location | ASIR(95%UI) | EPACs, %, 1990–2021 | ASMR(95%UI) | EPACs, %, 1990–2021 | ASDR(95%UI) | EPACs, %, 1990–2021 |
1990 | 2021 | 1990 | 2021 | 1990 | 2021 |
Global | 3002.32(2665.33-3411.42) | 2701.95(2444.45-3000.38) | -0.49(-0.54–0.43) | 10.90(9.68–11.81) | 9.94(8.43–10.84) | -0.29(-0.34–0.23) | 643.11(539.51-767.64) | 531.26(436.95-639.12) | -0.29(-0.34–0.23) |
Andean Latin America | 1621.54(1437.11-1832.57) | 2074.64(1845.98-2338.84) | 0.70(0.58–0.82) | 7.41(6.55–8.46) | 6.51(5.22–7.85) | -0.32(-0.39–0.25) | 425.48(364.45-501.69) | 395.53(324.25-485.36) | -0.32(-0.39–0.25) |
Australasia | 6385.14(5338.38-7744.90) | 6948.34(5892.64-8323.04) | 0.30(0.06–0.54) | 5.54(4.95–5.91) | 8.16(6.89–8.91) | 0.84(0.40–1.28) | 611.70(443.56-813.49) | 680.93(504.99-900.87) | 0.84(0.40–1.28) |
Caribbean | 1564.46(1399.88-1775.80) | 1832.92(1653.89-2038.73) | 0.40(0.28–0.52) | 9.74(9.09–10.22) | 10.14(8.98–11.18) | 0.60(0.37–0.84) | 368.03(317.79-428.98) | 381.27(322.73-451.59) | 0.60(0.37–0.84) |
Central Asia | 3137.78(2838.07-3463.78) | 2494.81(2237.43-2781.29) | -0.78(-0.85–0.71) | 5.98(5.72–6.24) | 3.69(3.30–4.08) | -1.34(-1.49–1.19) | 619.46(524.35-738.73) | 402.55(328.95-495.82) | -1.34(-1.49–1.19) |
Central Europe | 5795.85(5216.97-6453.44) | 4899.20(4362.28-5540.09) | -0.66(-0.76–0.55) | 15.02(14.22–15.59) | 7.56(6.91–8.06) | -2.05(-2.23–1.87) | 952.50(780.89-1155.45) | 632.92(490.26-802.01) | -2.05(-2.23–1.87) |
Central Latin America | 3787.87(3292.40-4371.25) | 2619.23(2268.83-3048.38) | -0.50(-0.87–0.12) | 11.21(10.77–11.49) | 5.39(4.83–5.94) | -2.66(-2.84–2.49) | 739.07(616.69-881.47) | 407.33(326.88-499.56) | -2.66(-2.84–2.49) |
Central Sub-Saharan Africa | 823.88(720.46–944.50) | 925.33(822.82-1040.59) | 0.35(0.29–0.41) | 10.77(8.48–14.40) | 10.47(7.79–15.07) | -0.10(-0.12–0.08) | 359.98(298.11–456.00) | 338.17(266.62-439.86) | -0.10(-0.12–0.08) |
East Asia | 2102.23(1822.14-2437.27) | 2684.49(2397.55-3026.86) | 0.16(-0.48-0.80) | 9.97(8.66–12.88) | 8.53(5.55–10.87) | -0.36(-0.52–0.19) | 567.38(474.88-701.55) | 474.93(370.29-590.15) | -0.36(-0.52–0.19) |
Eastern Europe | 5998.08(5128.72-6996.26) | 5454.36(4793.43-6226.10) | -0.60(-0.91–0.30) | 6.46(6.31–6.57) | 5.94(5.49–6.35) | 0.06(-0.46-0.57) | 840.84(667.83-1051.74) | 703.59(551.83-893.54) | 0.06(-0.46-0.57) |
Eastern Sub-Saharan Africa | 871.79(752.17-1013.23) | 911.83(808.30-1036.99) | 0.04(-0.02-0.10) | 16.98(14.39–20.11) | 14.98(12.76–17.67) | -0.32(-0.38–0.26) | 482.33(411.15-556.01) | 416.24(357.93-481.36) | -0.32(-0.38–0.26) |
High-income Asia Pacific | 4722.25(4133.60-5431.04) | 3752.20(3252.59-4347.47) | -0.90(-1.07–0.74) | 4.65(4.19–5.08) | 3.81(3.29–4.26) | -0.99(-1.10–0.89) | 540.97(424.08-691.49) | 402.24(301.96-522.97) | -0.99(-1.10–0.89) |
High-income North America | 3716.20(3208.65-4334.91) | 3463.19(3123.47-3846.19) | -0.34(-0.56–0.12) | 4.49(4.03–4.72) | 8.22(7.12–8.81) | 1.66(1.42–1.91) | 424.21(323.43-544.24) | 469.10(373.94-590.43) | 1.66(1.42–1.91) |
North Africa and Middle East | 1911.76(1692.69-2192.14) | 2281.67(2042.45-2564.66) | 0.57(0.49–0.64) | 7.70(6.34–9.33) | 5.66(4.85–6.73) | -0.83(-0.88–0.79) | 451.24(363.13-550.58) | 385.59(318.79-475.02) | -0.83(-0.88–0.79) |
Oceania | 1306.18(1155.34-1487.04) | 1763.16(1608.26-1932.31) | 0.82(0.72–0.92) | 7.87(5.45–10.64) | 7.88(4.79–11.33) | 0.08(0.06–0.10) | 362.45(287.90-445.32) | 421.59(321.10-541.97) | 0.08(0.06–0.10) |
South Asia | 2668.60(2329.30-3031.08) | 2629.42(2361.36-2905.47) | -0.18(-0.25–0.12) | 22.84(17.54–26.92) | 21.19(17.33–23.80) | -0.05(-0.14-0.05) | 874.03(721.10-1009.70) | 764.79(641.92-881.29) | -0.05(-0.14-0.05) |
Southeast Asia | 1520.23(1348.13-1715.19) | 1675.71(1517.45-1840.21) | 0.20(0.16–0.24) | 12.60(9.55–14.81) | 10.37(7.96–11.80) | -0.53(-0.61–0.45) | 513.71(443.59-590.23) | 449.44(381.75-521.47) | -0.53(-0.61–0.45) |
Southern Latin America | 3234.16(2826.44-3712.09) | 3567.47(3097.41-4179.78) | 0.35(0.08–0.61) | 5.84(5.44–6.11) | 4.00(3.60–4.24) | -1.43(-1.67–1.18) | 456.61(364.63-563.99) | 398.94(302.60-515.75) | -1.43(-1.67–1.18) |
Southern Sub-Saharan Africa | 950.06(800.09-1131.53) | 836.03(716.78-987.41) | -0.57(-0.69–0.45) | 3.75(3.00-4.45) | 3.04(2.61–3.81) | -0.51(-0.67–0.34) | 214.67(181.42-257.86) | 177.32(148.37-217.08) | -0.51(-0.67–0.34) |
Tropical Latin America | 4656.75(4001.34-5486.59) | 3605.64(3161.32-4128.06) | -1.06(-1.39–0.73) | 8.47(7.89–8.78) | 8.99(8.02–9.57) | 0.39(0.21–0.56) | 758.48(610.24-932.81) | 565.45(456.57–693.60) | 0.39(0.21–0.56) |
Western Europe | 6629.07(5827.54-7580.89) | 6210.49(5390.14-7183.26) | -0.20(-0.33–0.07) | 9.91(9.02–10.40) | 7.83(6.75–8.37) | -1.10(-1.34–0.86) | 754.89(582.06-956.34) | 654.17(491.79-844.34) | -1.10(-1.34–0.86) |
Western Sub-Saharan Africa | 955.18(825.40-1107.84) | 1064.25(946.20-1196.98) | | 14.71(12.38–17.78) | 13.39(11.37–15.81) | -0.12(-0.17–0.06) | 452.03(392.73-529.65) | 407.45(341.07-472.83) | -0.12(-0.17–0.06) |
Among the 204 countries globally, during the period of 1990–2021, the countries with the largest increases in falls ASIR from 1990 to 2021 were Viet Nam 1.79 (95%UI, 1.65–1.92), Bhutan 1.78 (95%UI, 1.62–1.94), Mongolia 1.53 (95%UI, 1.40–1.66), while the countries with the most significant decreases were Armenia − 3.08 (95%UI, -3.53-2.63), Latvia − 2.31 (95%UI, -2.53-2.09), Kyrgyzstan − 2.13 (95%UI, -2.29-1.98).
For fall ASMR, the countries with the largest increases were Belize 1.78 (95%UI, 1.42–2.15), United States of America 1.75 (95%UI, 1.50–2.01), Antigua and Barbuda 1.58 (95%UI, 1.31–1.86), and the countries with the most significant decreases were Hungary − 3.66 (95%UI, -4.03-3.29), Czechia − 3.41 (95%UI, -3.62-3.21), Mexico − 2.96 (95%UI, -3.16-2.77) .
The countries with the largest increase in falls ASDR are Netherlands 1.08 (95%UI, 0.62–1.54), Mauritius 1.07 (95%UI, 0.66–1.47), and Saint Vincent and the Grenadines 0.73 (95%UI, 0.66–0.80). The countries with the largest decrease in falls ASDR are Armenia − 3.31 (95%UI, -3.81-2.80), Latvia − 2.94 (95%UI, -3.24-2.65), and Hungary − 2.89 (95%UI, -3.03-2.74).(Figure2 and Table S1).
Burden of Falls by SDI
Globally, from 1990 to 2021, falls ASIR is positively correlated with SDI, while ASMR and ASDR are generally negatively correlated with SDI. ASIR and ASDR are lower than expected at higher SDI levels and higher than expected at lower SDI levels, while ASMR is consistently higher than expected. Regionally, falls ASIR, ASMR, and ASDR in South Asia are higher than expected based on SDI, while in Oceania, Southern Sub-Saharan Africa, Central Sub-Saharan Africa, and Andean Latin America, falls ASIR, ASMR, and ASDR are lower than expected based on SDI.(Figure 5)
In 2021, globally across 204 countries, those with higher SDI tended to have higher ASIR, while ASMR and ASDR were lower in countries with middle SDI or high middle SDI.(Figure 6)