Changes in fall-related mortality in older adults in Quebec, 1981-2009.

INTRODUCTION Our purpose was to evaluate changes in fall-related mortality in adults aged 65 years and over in Quebec and to propose a case definition based on all the causes entered on Return of Death forms. METHODS The analysis covers deaths between 1981 and 2009 recorded in the Quebec vital statistics data. RESULTS While the number of fall-related deaths increased between 1981 and 2009, the adjusted falls-related mortality rate remained relatively stable. Since the early 2000s, this stability has masked opposing trends. The mortality rate associated with certified falls (W00-W19) has increased while the rate for presumed falls (exposure to an unspecified factor causing a fracture) has decreased. CONCLUSION For fall surveillance, analyses using indicators from the vital statistics data should include both certified falls and presumed falls. In addition, a possible shift in the coding of fall-related deaths toward secondary causes should be taken into account.