Leilei Duan: Elderly Falls Prevention in China

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Elderly Falls Prevention in China

Dr. Leilei Duan

Director, Division of Injury Prevention

National Center for Chronic and Noncommunicable Disease

Control and Prevention, China CDC

2016. 9 Finland



Overview of the talk

• Situation of older adults injury

• Elderly falls prevention

• Next step



Situation of older adults injury


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2.00

4.00

6.00

8.00

10.00

12.00

Pro

po

rtio

n (%

)

Source: National Bureau of Statistic of the People’s Republic of China

Trend of population proportion of the elderly aged ≥65 in China ,1995-2015

4.30%

Situation — Aging in China

16.1%

10.5%

≥65 years : 140 million

≥60 years : 220 million

Proportion of elderly aged ≥60 and ≥65 of China, 2015



Death rate of injuries among the elderly aged ≥65 : 157.21 /100,000

Mortality of injuries by causes among the elderly aged ≥65, 2014

Source: Data Sets of Death Surveillance of China ,2014

Situation - Older adults fatal injuries

50.02

35.27

30.3

18.19

8.98 8.75

3.66 0.64 0.02

0

10

20

30

40

50

60

Falls Road TrafficInjuries

Self-harm OtherUnintentional

Injuries

Drowning Poisoning Burn Assault OtherIntentional

Injuries

Rat

e p

er 1

00 0

00 p

op

ula

tio

n



Falls

32.1%

RTIs

22.6%

Self-harm

19.4%

11.7%

5.8%

5.6%

2.4% 0.4%

Falls

Road Traffic Injuries

Self-harm

Other Unintentional Injuries

Drowning

Poisoning

Burn

Assault

Other Intentional Injuries

Distribution of injury deaths by causes among the elderly aged ≥65, 2014


Situation - Older adults fatal injuries

Falls is the first leading cause of injury deaths among the elderly aged ≥65.



Distribution of injuries by causes among the elderly aged ≥65, 2015

Source: National Injury Surveillance System (NISS), 2015

Situation - Older adults nonfatal injuries

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Male

Female

Total

Proportion (%)

Falls

RTIs

Blunt object

Sharp object

Animal Bite

Poisoning

Burning

Suffocation

Firearm

Drowning

Others

Unknowm


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50

100

150

200

250

300

350

65-69 70-74 75-79 80-84 ≥85

Rat

e p

er

10

0 0

00

po

pu

lati

on

Age Group

Male

Female

Death rate: 50.02/100,000

Proportion: 31.82% of all fatal injuries

Death rate caused by falls among the elderly aged ≥65 by age and sex group, 2014


Situation - Older adults fatal falls



Source: National Injury Surveillance System (NISS), 2015

Situation - Older adults nonfatal falls

Home 52.3%

Fracture

24.0%

Head, 25.8%

36.6%

Place Nature

Severity M & S

Body part



Data source: GBD 2013 (aged ≧70 years)

DALYs:

735,423 person year

DALY rates:

930 /100,000

Change of DALYs

(1993—2013):

8.53%

Source: Global Burden of Disease, 2013

Situation - DALYs of older adults falls

DALY rates of falls by province, ≥70 years, China, GBD 2013



1990 rank 2013 rank

24. Falls

18. Falls

Change of the rank of DALY Rates among population aged ≥70 between 1990 and 2013, China

Source: Global Burden of Disease, 2013

Situation - DALYs of older adults falls



Elderly falls prevention



• Disease Surveillance Points System (DSPs）

• Nation Injury Surveillance System (NISS)

• Chronic disease risk factor surveillance in China

• Other falls-specific surveys

Data collection

Distribution of surveillance sites of NISS

Distribution of surveillance sites of DSPs

Distribution of surveillance sites of Chronic disease risk factor

surveillance



Community-based elderly falls intervention programs

Hebei

Zhejiang

Shenzhen

Dalian

Henan

Beijing

Shanghai

Integrated intervention



Community-based

elderly falls

prevention

Health

Communication

Exercises

Environment

modification

Capacity

building

Medication

management

Evaluation

Policy

promotion

Integrated intervention strategies



• Technical Guide:

– Technical Guide on elderly falls intervention,2008

• Mass media:

– National social advocacy activity on elderly falls prevention, the Double Ninth Festival of 2014

– Elderly falls prevention Public Service Advertising

• Core information:

– Health Literacy of Chinese Residents (2015 version)

Advocacy and health communication



National Action Plan for Disability Prevention in China (2016-2020)

The main actions: (2) Reducing the disability caused by injuries Reducing the disability caused by child injuries and elderly falls.......Removing the risk factors in environment to prevent falls and raising the awareness of falls prevention among elderly and their caregivers …

Policy



The project supported by the Ministry of Science and Technology

Community-based integrated intervention project on elderly falls

Research



Research

八段锦 Ba Duan Jin



What is Ba Duan Jin ?

Ba Duan Jin Movements

Ba Duan Jin is an ancient

practice that can be traced back

to 1000 years ago.

It consists of eight movements,

like a shorter version of Tai Chi.

Research



Why Ba Duan Jin ?

Tai Chi

• Can Improve balance and

reduce falls

• History of hundreds of years

• Support by Chinese traditional

medicine theory

• Complicated

• …

Ba Duan Jin

• Impacts on balance

improvement and falls reduction

is unknown

• History of moret than 1000 of

years

• Support by Chinese traditional

medicine theory

• Simple: Easy to learn

• …

Research



Research Hypothesis：

Research

Study on the Impacts of BaDuanJin Exercise on Balance Function among Older Adults



Literature review

Pilot study

Plan development

Training

Recruitment

Baseline survey

Intervention (exercise)

Data collection

Evaluation

……

Expert Discussion Pilot study

Training Ba Duan Jin Training

Research



Literature review

Pilot study

Plan development

Training

Recruitment

Baseline survey

Intervention (exercise)

Data collection

Evaluation

……

Balance evaluation

Intervention

Balance evaluation

Ba Duan Jin Team

Research

Ba Duan Jin Training



Ba Duan Jin Bracelet

Prof. Yubin Zhao

Research

Project Logo 3D gyroscope



• Function of the bracelet

Research

Record

Evaluate

Measure

Exposure dose measurement



Ba Duan Jin Curves

Research





Research

• “HEALTH” is the project theme

• “BADUANJIN－“八段锦”

• “Propping up the Sky”

• Two “八”

• Color



Research

Pu Dong, Shanghai City

Research teams

Ci Xi, Zhejiang Province

Shi Jiazhuang, Hebei Province

Guang zhou, Guangdong Province

Nan Shan, Shenzhen City

NCNCD，China CDC



What is in progress? Ba Duan Jin training and exercise

The 6-month intervention will finish next year.

Research



• Data collection and data utilization

• Strategy development

• Intervention

• Policy development

• Research

• Cooperation

…

Next Step



SAVING LIVES

Dr. Leilei Duan Director，Division of Injury Prevention,

National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC

[email protected]

Thanks!

Health & Medicine

Leilei Duan: Elderly Falls Prevention in China