A new analysis from the Global Burden of Disease Study 2021 reports a sharp rise in osteoarthritis cases among postmenopausal women worldwide from 1990 to 2021.
The study, published in BMJ Global Health, found that knee osteoarthritis (OA) accounts for the highest burden, with a significant increase in incidence, prevalence, and disability-adjusted life years (DALYs)—a measure that quantifies the gap between current health status and an ideal healthy life.
In 2021, researchers documented approximately 14,258,581 incident cases (95% UI: 12,226,984–16,599,583), 278,568,950 prevalent cases (95% UI: 246,376,337–309,958,505), and 9,944,716 DALYs (95% UI: 4,810,253–20,101,408) attributed to OA among postmenopausal women globally. These figures represent substantial increases of 133.1%, 139.8%, and 141.9% since 1990, respectively.
The global age-standardized rates (ASRs) were 1812.99 per 100,000 population for incidence, 35,420.24 per 100,000 for prevalence, and 1264.48 per 100,000 for DALYs.
The study highlights disparities in OA burden by region and socio-demographic index (SDI). High-income Asia Pacific and East Asia experienced the most substantial increases. East Asia had the highest estimated annual percentage change (EAPC) for prevalence (EAPC=0.505, 95%CI: 0.416 to 0.595) and DALYs (EAPC=0.494, 95%CI: 0.403 to 0.586). High-SDI countries reported the highest OA burden, with widening inequalities between high- and low-SDI nations.
In high-income North America, hip OA rates were the highest, with an ASR incidence of 146.48 per 100,000, prevalence of 4,497.12 per 100,000, and DALYs at 138.5 per 100,000. East Asia reported the lowest hip OA incidence at 41.82 per 100,000.
High body mass index (BMI) was identified as a major risk factor. "In high, high-middle, and middle SDI regions, over 20% of DALYs for OA among postmenopausal women are attributed to elevated BMI," the study noted. Between 1990 and 2021, the proportion of OA DALYs due to high BMI rose from 16.86% to 20.76%, with East Asia experiencing the most significant increase (from 14.04% to 22.87%).
OA burden increased with age, but knee OA DALYs peaked at 80–84 years before declining. Hand OA peaked earlier at age 55 before decreasing, suggesting a possible link to menopause. Women had significantly higher OA burden than men of the same age, particularly for knee and hand OA.
"The burden of OA among postmenopausal women continues to escalate, highlighting its significant impact on the global health of postmenopausal women," said Huadong Xu from the School of Public Health, Hangzhou Medical College, Hangzhou, People's Republic of China. "Necessarily, effective monitoring and management of risk factors, targeted lifestyle adjustments for BMI, and policy interventions accounting for demographic disparities are required to ease OA in postmenopausal women."
Researchers call for continued monitoring of risk factors and demographic disparities to track OA trends globally.
No conflicts of interest were disclosed.