Abstract
Falls are the leading cause of injury-related mortality among older adults in the US, but national data sources are limited in the ability to estimate incidence rates (IR) and determinants of fall mortality. Using longitudinal data from a nationally-representative sample, the goal of this study was to estimate the IR and determinants of fall mortality in the US. Nationally-representative data from the Health and Retirement Study (HRS) from 1999 to 2010 were merged with National Death Index (NDI) data. Older adults (age > 65) who participated in the HRS survey during the study period were included in the analytic sample (n=20,639). Fall deaths were determined using ICD-10 codes for underlying cause. We calculated weighted IRs and hazard ratios (HRs) using weighted cox proportional hazards models. In total, 113 fall-related deaths (weighted n=261,208) occurred in the study sample over 12 years and the annual IR of fall-related mortality in the sample was 45.63 fall deaths per 100,000. Factors related to greater likelihood of fall mortality included greater age (HR|age 75–85: 1.95, 95% CI: 1.15, 3.53; HR|age > 84: 4.48, 95% CI: 2.60, 7.72) and two or more previous non-fatal falls (HR: 1.82, 95% CI: 0.99, 3.37). Participants of black race were less likely to experience fall-related deaths (HR: 0.46, 95% CI: 0.21, 0.98). Results provide more accurate estimates of fall mortality IRs than widely used data sources and help identify factors related to fall mortality independent of falls. More research is needed to quantify fall-related mortality and inform fall mortality prevention.