Incidence and mortality of falls amongst older people in primary care in the United Kingdom

Abstract

Background: Despite the role of primary care in the falls care pathway, there are almost no data on the extent of falls seen in general practices. Aim: To quantify the incidence and mortality of falls amongst older people in primary care in the UK. Methods: Cohort study of people aged ≥60 years and registered in a UK practice contributing data to The Health Improvement Network primary care database (THIN) throughout 2003-06. Analysis of crude incidence and estimation of incidence rate ratios using negative binomial regression, and survival using Cox regression. Sensitivity analysis of criteria for distinguishing discrete fall events from follow-up appointments. Results: Amongst people aged ≥60 years the overall crude incidence rate of recorded falls was 3.58/100 person-years (95% CI 3.56-3.61). The rate of recurrent falls was 0.67/100 person-years (95% CI 0.66-0.68). The incidence rate of recorded falls and recurrent falls was higher in older age groups, in women and least advantaged social groups. Incidence of recorded falls was constant through the time period 2003-06. Mortality for recurrent fallers was about twice that of general population controls. Conclusions: These data suggest that more than 475000 fall events in older people are recorded in general practice each year in the UK, and are associated with increased mortality and relative deprivation. The underlying incidence rate has remained stable in recent years. © The Author 2009. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved.