Background: In 2010 falls accounted for over 77% and 85% of years lived with disability (YLDs) resulting from unintentional injuries excluding traffic accidents, in adults aged 50-69, and 70 and over. The global burden of YLDs due to falls in adults aged 50-69 was 66% in developing countries compared with 34% in developed countries in 2010. This gap is expected to widen as a consequence of rapid population ageing in developing countries, where over 70% of the world’s older population currently lives, and as a result of effective falls prevention strategies being implemented in higher-income countries. Developing countries urgently need sound epidemiological data to develop and integrate falls prevention into their public health policy frameworks.

Methods: The study uses household and individual data collected from the Study on global AGEing and adult health (SAGE) in adults aged 50 years and older in six low- and middle-income countries (LMIC). The objectives are to identify the annual prevalence of fall-related injury and investigate and compare risk factors associated with fall-related injury. Multivariate logistic regressions were separately conducted within biological, behavioral, environmental and socioeconomic domains included in the falls prevention framework for older adults developed by the World Health Organization. Statistically significant factors associated with fall-related injury were tested across the domains using stepwise regression.

Results: Of the 34,138 survey participants, self-reported fall-related injury prevalence in the previous 12 months was 4%, although this varied by country. The prevalence of fall-related injury was higher among women. Risk factors significantly associated with an increased risk of fall-related injury are depression (p<0.01), arthritis (p<0.1), grip strength (p<0.05), insufficient intake of fruits and vegetables (p<0.05), severe or extreme sleep problems (p<0.05), water source outside the home (p<0.05) and completed secondary education (p<0.05).

Conclusions: There is now, more than ever, a need to re-focus public health priorities for falls prevention in older age in LMIC where populations are rapidly ageing. This study provides a much needed platform for further investigation into fall-related injury in LMIC.