Effects of age, period, and birth cohort on fall-related mortality in older adults in Brazil from 1980 to 2019

Abstract

Aim:This study aimed to estimate the effects of age, period, and birth cohort on fall-related mortality in older adults in Brazil and its geographic regions, by sex, from 1980 to 2019.Methods:We conducted an ecological time-series study using data on fall-related deaths in older people extracted from the official mortality information system. Poisson models were adjusted for each sex and geographic region to estimate age-period-cohort effects.Results:From 1980 to 2019, Brazil recorded 170,607 fall-related deaths in older adults, with 50.1% occurring in women. More than half of these deaths occurred in the 80 years or older age group (55.0%) and in the Southeast region (52.0%). We observed an increase in fall-related mortality rates (FMR) across all age groups and regions, regardless of sex. There was an increased risk of death in all periods after the reference period (2000 to 2004) in all geographic regions and for both sexes. We also observed a gradual increase in mortality risk for men born before 1914 and after 1935 compared to the reference cohort (1930 to 1944). In contrast, we found a protective effect across all birth cohorts for women.Conclusion:There was a consistent increase in fall-related mortality risk among older people in Brazil, posing a public health challenge. The findings highlight the urgent need for implementing public health policies promoting older adult health and preventing fall risks to improve the quality of life for this population.