Incidence, risk factors and economic burden of fall-related injuries in older Chinese people: a systematic review

Objective China's population is ageing and fall-related injury in older Chinese people is a growing public health concern. This review aims to synthesise existing evidence on the incidence, risk factors and economic burden of fall-related injury among older Chinese people to inform health service planning. Methods A systematic search of literature on falls and injury among older people living in China was performed in six electronic databases including both English and Chinese databases. Results were combined using narrative synthesis due to the heterogeneity of included studies. Results A total of 93 studies from Mainland China, Taiwan and Hong Kong were included in this review. Most of these studies were descriptive; 82 reported the incidence of fall-related injury among older Chinese people, 7 studies examined the risk factors for fall-related injury and 22 studies described the economic burden of fall-related injury. The incidence of fall-related injury reported among older Chinese people ranged from 0.6% to 19.5%. Risk factors significantly associated with fall-related injury among older Chinese included older age, female sex, walking aid use, living environments, chronic disease, medication usage, visual impairment and a fall direction other than forward. The cost of fall-related injury among older Chinese people ranged from US$16 to US$3812 per person per fall. Conclusion Falls-related injuries are a significant public health issue for older Chinese people. Further studies using prospective design to identify risk factors and the economic burden of fall-related injuries are needed.