Global burden of low bone mineral density related fractures in pre- and post-menopausal women from 1990 to 2021, with projections to 2050.

UNLABELLED

This study is the first to estimate the global burden of low bone mineral density related fractures (LBMD-fractures) in women by menopausal status from 1990 to 2021, with projections to 2050. The global burden of LBMD-fractures remains substantial, particularly among post-menopausal women.

PURPOSE

To evaluate the global burden and spatiotemporal trends of low bone mineral density related fractures (LBMD-fractures) in pre- and post-menopausal women over the past 30 years, and provide projections to 2050.

METHODS

The counts and age-standardized rates (ASRs) of deaths and disability-adjusted life years (DALYs) caused by LBMD-fractures were estimated using data from Global Burden of Disease Study 2021. Temporal trends of ASRs from 1990 to 2021 were quantified using estimated annual percent changes. Health inequality and decomposition analyses were performed, and a Bayesian age-period-cohort model was applied to project LBMD-fractures burden among post-menopausal women to 2050.

RESULTS

In 2021, LBMD-fractures caused 1,358 deaths (95% uncertainty interval [UI]: 983 to 1,602) and 298,253 DALYs (95% UI: 220,588 to 397,894) among pre-menopausal women globally. For post-menopausal women, there were 189,025 deaths (95% UI: 136,288 to 227,914) and 6,735,144 DALYs (95% UI: 5,253,930 to 8,436,635). Disease burden was higher in Asia, Europe and North America and relatively lower in Africa. Population growth was the most significant factor driving DALYs related to LBMD-fractures. Deaths and DALYs among post-menopausal women were projected to reach 397,537 and 14,350,582 by 2050, respectively, though no obvious changes in ASRs across 2022 to 2050.

CONCLUSIONS

The global burden of LBMD-fractures remains concerning, particularly among post-menopausal women. Efforts to reduce health inequalities associated with LBMD-fractures across countries and territories are necessitated.