Accidents among adults aged 65+ in Poland: a growing challenge in the face of demographic ageing

Background

Unintentional injuries follow a bimodal age pattern, peaking in youth and again in older age. As Europe ages rapidly, the burden increasingly concentrates among adults aged 65 and older. Among the oldest age groups, accident frequency is driven mainly by multimorbidity, polypharmacy, and functional and sensory impairments. Since 2012, falls have been the leading cause of all fatal accidents, accounting for over 39% of accidental deaths.

Methods

We analysed national death registries (Statistics Poland), hospital morbidity data from the Nationwide General Hospital Morbidity Study (NGHMS, 2019–2023), and National Health Programme survey, with EU27 comparisons. A key limitation is incomplete documentation of accident circumstances in hospital records, with 26.8% of external cause codes missing in 2021–2023.

Results

Accident related mortality among adults aged 65 and older declined until 2019, then rose sharply in 2021 (23.7% year on year), surpassing the EU27 increase of approximately 7%, and remained elevated thereafter. Falls dominated: in 2023, there were 5,027 fall deaths, 78.6% occurring in this age group. Age standardised mortality reached 14.2 per 100,000 in men and 12.5 per 100,000 in women. Unspecified falls (ICD10 W19) accounted for 53.6% of fall deaths. NGHMS data identified falls as the leading hospitalisation category (56.2% of accident related discharges), with the highest rates among women aged 85 and older. Among adults ≥65, injuries most often occurred outdoors (39.9%) and at home (36.2%). The proportion of pedestrian injuries in public spaces rosed with age.

Conclusions

In an ageing population, injuries, especially falls, create a sustained and growing burden. Effective prevention requires coordinated, long term action integrating chronic disease care, polypharmacy review, geriatric assessment, and safer home and urban environments.

Key messages

• As Europe ages, unintentional injuries increasingly burden adults 65+, calling for prevention strategies beyond youth‑focused risk models.

• Preventing injuries in older adults means preventing premature morbidity: early management of chronic conditions, functional decline and polypharmacy is as crucial as fall prevention itself.