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Objective Underlying cause of death (UCD) statistics highly depend on data reporting practices.This study quantified overall and specific unintentional injury mortality attributed to changes in data reporting for Americans aged 65 years and older from 1999 to 2015.Methods We used data from the U.S.Centers for Disease Control and Prevention WONDER online databases to develop an attribution model and to calculate injury mortality attributed to data reporting changes in cause specificity and selection of UCD from multiple cause of death (MCD).Results From 1999 through 2015,the proportion of MCD cause-specific unintentional injury mortality increased from 0.74 to 0.84;proportions of UCD/MCD mortality for overall and cause-specific unintentional injury rose substantially in all categories except motor vehicle crash.Ageadjusted UCD-based mortality attributed to data reporting changes increased distinctly between 1999 and 2015;the increase for overall unintentional injury,falls,motor vehicle crash,suffocation,poisoning,and fire/bum was 23.19,12.78,1.99,2.55,1.44 and 0.33 per 100,000 persons,respectively.Percent change in mortality between 1999 and 2015 differed greatly between reported and expected mortality--overall unintentional injury,16% vs.-9%;falls,106% vs.62%;motor vehicle crashes,-31% vs.-40%;suffocation,-17% vs.-43%;poisoning,118% vs.47%;fire/burn,-29% vs.-39%.Conclusion Data reporting changes have altered trends in overall and causespecific unintentional injury mortality for older Americans.