Trends in falls among older adults before and during the COVID-19 pandemic in Ontario, Canada: A retrospective observational study.

Ashini Weerasinghe, Justin Thielman, Ye Li, Varsha B Doguparty, Alexia Medeiros, Sue Keller-Olaman, Sarah Carsley, Sarah A Richmond
Author Information
  1. Ashini Weerasinghe: Public Health Ontario, 661 University Ave, Suite 1701, Toronto, ON , M5G 1M1, Canada. ashini.weerasinghe@oahpp.ca.
  2. Justin Thielman: Public Health Ontario, 661 University Ave, Suite 1701, Toronto, ON , M5G 1M1, Canada.
  3. Ye Li: Public Health Ontario, 661 University Ave, Suite 1701, Toronto, ON , M5G 1M1, Canada.
  4. Varsha B Doguparty: Public Health Ontario, 661 University Ave, Suite 1701, Toronto, ON , M5G 1M1, Canada.
  5. Alexia Medeiros: Public Health Ontario, 661 University Ave, Suite 1701, Toronto, ON , M5G 1M1, Canada.
  6. Sue Keller-Olaman: Public Health Ontario, 661 University Ave, Suite 1701, Toronto, ON , M5G 1M1, Canada.
  7. Sarah Carsley: Public Health Ontario, 661 University Ave, Suite 1701, Toronto, ON , M5G 1M1, Canada.
  8. Sarah A Richmond: Public Health Ontario, 661 University Ave, Suite 1701, Toronto, ON , M5G 1M1, Canada.

Abstract

BACKGROUND: The public health measures associated with the COVID-19 pandemic may have indirectly impacted other health outcomes, such as falls among older adults. The purpose of this study was to examine trends in fall-related hospitalizations and emergency department visits among older adults before and during the COVID-19 pandemic in Ontario, Canada.
METHODS: We obtained fall-related hospitalizations (N = 301,945) and emergency department visit (N = 1,150,829) data from the Canadian Institute for Health Information databases from 2015 to 2022 for adults ages 65 and older in Ontario. Fall-related injuries were obtained using International Classification of Diseases, 10th edition, Canada codes. An interrupted time series analysis was used to model the change in weekly fall-related hospitalizations and emergency department visits before (January 6, 2015-March 16, 2020) and during (March 17, 2020-December 26, 2022) the pandemic.
RESULTS: After adjusting for seasonality and population changes, an 8% decrease in fall-related hospitalizations [Relative Rate (RR) = 0.92, 95% Confidence Interval (CI): 0.85, 1.00] and a 23% decrease in fall-related emergency department visits (RR = 0.77, 95%CI: 0.59, 1.00) were observed immediately following the onset of the pandemic, followed by increasing trends during the pandemic for both outcomes.
CONCLUSIONS: Following an abrupt decrease in hospitalizations and emergency department visits immediately following the onset of the pandemic, fall-related hospitalizations and emergency department visits have been increasing steadily and are approaching pre-pandemic levels. Further research exploring the factors contributing to these trends may inform future policies for public health emergencies that balance limiting the spread of disease among this population while supporting the physical, psychological, and social needs of this vulnerable group.

Keywords

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MeSH Term

Humans
COVID-19
Accidental Falls
Ontario
Aged
Retrospective Studies
Hospitalization
Male
Female
Emergency Service, Hospital
Aged, 80 and over
Pandemics

Word Cloud

Created with Highcharts 10.0.0pandemicfall-relatedhospitalizationsemergencydepartmentvisitsadultsCOVID-19amongolderhealthtrendsOntariodecreasepublicmayoutcomesfallsstudyCanadaobtained2022seriespopulation01immediatelyfollowingonsetincreasingBACKGROUND:measuresassociatedindirectlyimpactedpurposeexamineMETHODS:N = 301945visitN = 1150829dataCanadianInstituteHealthInformationdatabases2015ages65Fall-relatedinjuriesusingInternationalClassificationDiseases10theditioncodesinterruptedtimeanalysisusedmodelchangeweeklyJanuary62015-March162020March172020-December26RESULTS:adjustingseasonalitychanges8%[RelativeRateRR = 09295%ConfidenceIntervalCI:8500]23%RR = 07795%CI:5900observedfollowedCONCLUSIONS:Followingabruptsteadilyapproachingpre-pandemiclevelsresearchexploringfactorscontributinginformfuturepoliciesemergenciesbalancelimitingspreaddiseasesupportingphysicalpsychologicalsocialneedsvulnerablegroupTrendsCanada: AretrospectiveobservationalEDFallsHospitalizationOlderTime

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