Global OA Burden Shows Dramatic Rise in Postmenopausal Women

TOPLINE:

The global burden of osteoarthritis (OA) among postmenopausal women increased substantially from 1990 to 2021, with over 14 million incident cases of OA and nearly 10 million disability-adjusted life years (DALYs) in 2021.

METHODOLOGY:

• Researchers used data from the Global Burden of Disease 2021 study to examine the burden of OA among postmenopausal women across 204 countries and territories from 1990 to 2021.
• They specifically examined the incidence and prevalence rates of knee, hip, hand, and other types of OA as well as the years of healthy life lost (measured in DALYs) among postmenopausal women aged 55 years or older.
• Age-standardized rates (ASRs) for incidence, prevalence, and DALYs of OA were calculated using the global population age standard, with temporal patterns analyzed using estimated annual percentage change assessments by considering age, body mass index (BMI), and the Sociodemographic Index (SDI).
• The definition for OA cases was based on symptomatic OA confirmed through the radiologic assessment of meeting the Kellgren-Lawrence grading criteria (grades 2-4); it was classified using the International Classification of Diseases 10 codes.

TAKEAWAY:

• In 2021, there were approximately 14.3 million incident cases of OA, 278.6 million prevalent cases of OA, and 9.9 million DALYs among postmenopausal women, representing estimated annual percentage changes of 0.211, 0.356, and 0.395, from 1990 to 2021, respectively.
• Knee OA represented the highest burden (ASRs for incidence, 1192.48 per 100,000 population), whereas hip OA represented the lowest burden (ASRs for incidence, 70.19 per 100,000 population).
• High BMI was identified as a significant risk factor for OA, particularly in regions with high, high-middle, and middle SDI quintiles, where DALYs attributed to high BMI exceeded 20%. A notable rise in BMI-attributable DALYs was noted in East Asia.
• SDI was positively associated with ASRs of hip, knee, hand, and other OA. High-income Asia Pacific regions had the most substantial increases in knee OA burden, while Central Asia had the lowest. East Asia showed a rapid increase in knee OA and hand OA burden.

IN PRACTICE:

“High SDI countries face a disproportionate OA burden, with widening SDI-related inequalities among nations over time. This underscores the urgent need for targeted interventions and rigorous health strategies to control and manage OA, focusing on modifiable risk factor reduction,” the authors wrote.

SOURCE:

The study was led by Huadong Xu, PhD, Hangzhou Medical College, Hangzhou, People’s Republic of China, and was published online on March 4, 2025, in BMJ Global Health.

LIMITATIONS:

Regional variations in data quality and scarcity of data from low-income countries may have affected the precision of global OA burden estimates. The diagnostic codes used primarily captured diagnosed, severe OA cases, potentially missing milder or undiagnosed cases. The use of a cutoff (55 years) to define menopause may have reduced sensitivity, particularly for women experiencing menopause at a younger age. This definition may have overlooked a significant number of postmenopausal women, including those aged 45-54 years.

DISCLOSURES:

This study was supported by the Key Discipline of Zhejiang Province in Public Health and Preventive Medicine, Hangzhou Medical College. The authors declared no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.