leilei duan: elderly falls prevention in china
TRANSCRIPT
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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
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Overview of the talk
• Situation of older adults injury
• Elderly falls prevention
• Next step
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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
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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
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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
Source: Data Sets of Death Surveillance of China ,2014
Situation - Older adults fatal injuries
Falls is the first leading cause of injury deaths among the elderly aged ≥65.
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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
Source: Data Sets of Death Surveillance of China ,2014
Situation - Older adults fatal falls
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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
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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
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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
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Elderly falls prevention
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• 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
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Community-based elderly falls intervention programs
Hebei
Zhejiang
Shenzhen
Dalian
Henan
Beijing
Shanghai
Integrated intervention
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Community-based
elderly falls
prevention
Health
Communication
Exercises
Environment
modification
Capacity
building
Medication
management
Evaluation
Policy
promotion
Integrated intervention strategies
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• 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
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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
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The project supported by the Ministry of Science and Technology
Community-based integrated intervention project on elderly falls
Research
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Research
八 段 锦 Ba Duan Jin
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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
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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
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Research Hypothesis:
Research
Study on the Impacts of BaDuanJin Exercise on Balance Function among Older Adults
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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
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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
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Ba Duan Jin Bracelet
Prof. Yubin Zhao
Research
Project Logo 3D gyroscope
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• Function of the bracelet
Research
Record
Evaluate
Measure
Exposure dose measurement
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Ba Duan Jin Curves
Research
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Research
• “HEALTH” is the project theme
• “BADUANJIN-“八段锦”
• “Propping up the Sky”
• Two “八”
• Color
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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
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What is in progress? Ba Duan Jin training and exercise
The 6-month intervention will finish next year.
Research
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• Data collection and data utilization
• Strategy development
• Intervention
• Policy development
• Research
• Cooperation
…
Next Step
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SAVING LIVES
Dr. Leilei Duan Director,Division of Injury Prevention,
National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC
Thanks!