European Geriatric Medicine (2018) 9:371–375
Continuously declining incidence of fall injuries in older adults:
nationwide statistics from Finland between 1970 and 2016
· Jari Parkkari
· Seppo Niemi
· Harri Sievänen
Received: 5 February 2018 / Accepted: 24 March 2018 / Published online: 24 April 2018
© European Geriatric Medicine Society 2018
Background Fall-induced injuries of older adults are a major public health issue.
Methods We assessed the current trends in the number and age-adjusted incidence (per 100,000 persons) of fall-induced
injuries among older adults in Finland by taking into account all persons 80 years of age or older who were admitted to
Finnish hospitals for primary treatment of a ﬁrst annual fall injury between 1970 and 2016.
Results The number of hospital-treated fall injuries in older Finns increased considerably during the study period: in women,
from 927 (1970) to 11,791 (2016), and in men from 212 (1970) to 4275 (2016). In both genders, the age-adjusted incidence
(per 100,000 persons) of these injuries increased until the late 1990s but decreased thereafter, the incidence being 2754
(women) and 1475 (men) in 1970, and 5843 (women) and 4115 (men) in 2016. Even with the currently declining injury
incidence, the absolute number of these injuries is expected to increase (about 40% by the year 2030), because the popula-
tion at risk is constantly expanding.
Conclusions The rise in the age-adjusted incidence of hospital-treated fall injuries of 80 years and older Finnish persons
from the 1970s to the late 1990s has been followed by declining injury rates. Despite this, we have to eﬀectively continue
implementation of all feasible fall prevention actions.
Keywords Aging · Fall-induced injuries · Older adults · Time trends · Hospitalization
Falls of older people are a major cause of morbidity and
mortality and thus a major public health problem in contem-
porary societies with aging populations [1–3]. Fall-induced
injuries can reduce the quality of life of the older adults con-
siderably, since very easily they lead to long-standing pain,
functional impairment, disability, and hospitalization [2–4].
They also have a strong impact on health care costs .
Previously, we reported that the number and incidence
of hospital-treated fall injuries of persons 80 years of age or
older increased in Finland from the early 1970s to the late
1990s and started to stabilize and decline thereafter [6, 7].
We have now followed the population to the end of 2016 to
reveal most recent changes.
Materials and methods
The data on the hospital-treated fall injuries were obtained
from the Finnish National Hospital Discharge Register
(NHDR). This statutory computer-based register is the old-
est nationwide discharge register in the world (in operation
since 1967). The Register is continuously updated and moni-
tored for quality by the Department of Registers and Sta-
tistics, National Institute for Health and Welfare, Helsinki,
Finland and provides reportedly reliable data for hospital-
treated injuries in Finland [1, 8–12]. The register has been
shown to cover acute injuries in the population adequately
(annual coverage of injuries is 90% or over) and record them
* Pekka Kannus
Injury and Osteoporosis Research Center, UKK
Institute for Health Promotion Research, P.O. Box 30,
33501 Tampere, Finland
Medical School, University of Tampere, Tampere, Finland
Department of Orthopedics and Trauma Surgery, Tampere
University Hospital, Tampere, Finland
Tampere Research Center of Sports Medicine, UKK Institute
for Health Promotion Research, Tampere, Finland