Trend of fall prevalence and projection of fall-related health care burden in the elderly in Taiwan

Objectives: The study aims to identify the trend of fall prevalence and project future fall-related health care burden in the elderly in Taiwan. Methods: The age- and sex-specific prevalence rates of falls were derived from the 1999, 2003 and 2007 Taiwan Longitudinal Study on Ageing (TLSA), and adjusted for the elderly population of year 2000. The age- and sex-specific incidence rates of hip fracture in the elderly during 2003-2025 were extrapolated, based on the rates generated from the 1996-2002 National Health Insurance Data, and multiplied with the corresponding end-of-the-year population projected to obtain future fall-induced health care burden estimates under different scenarios. These estimates of year 2003 and 2007 were cross-checked. Results: The adjusted prevalence of falls increased from 18.7% in 1999 to 20.1% in 2007. From 2002 to 2025, although the elderly population increase only 2.4 times, the total number of fall-induced hip fractures will increase by 5.3, 4.8, 2.7, and 1.5 folds respectively under exponential increase, linear increase, status quo, and linear decrease scenarios. Cross-check favored a linear increase scenario during 2003-2007. Conclusions: The prevalence of falls increased in the elderly in Taiwan during 1999-2007. The fall-related health care burden is projected to increase 1.5-5.3 times from 2002 to 2025. It suggests that prevention of falls and fall injury take priority of policy planning in an ageing society.