Global Burden of Musculoskeletal Disorders in Adults Aged 50 and Over, 1990–2021: Risk Factors and Sociodemographic Inequalities

IF 9.1 1区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Cachexia Sarcopenia and Muscle Pub Date : 2025-07-10 DOI:10.1002/jcsm.70008

Shi-Yang Guan, Jin-Xin Zheng, Shun-Xian Zhang, Shengqian Xu, Zongwen Shuai, Hong-Yan Cai, Faming Pan

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Abstract

Background

Adults aged 50 and over are particularly vulnerable to musculoskeletal (MSK) disorders, with their impact expected to intensify as the global population ages. This study aims to comprehensively assess the global burden of MSK disorders among adults aged 50 and over from 1990 to 2021, as well as temporal trends, risk factors and sociodemographic inequalities.

Methods

Data were sourced from the Global Burden of Disease 2021 study. Temporal trends in age-standardized rates were evaluated by calculating average annual percent changes (AAPC). Absolute and relative inequalities were assessed using the slope index of inequality and concentration index, respectively.

Results

From 1990 to 2021, MSK disorders remained the largest contributor to total years lived with disability (YLDs) among adults aged 50 and over globally. The global age-standardized incidence rate significantly decreased (AAPC = −0.181, 95% CI: −0.190 to −0.172), whereas the global prevalence and disability-adjusted life-year (DALY) rates significantly increased (AAPC = 0.126, 95% CI: 0.118–0.134, and AAPC = 0.057, 95% CI: 0.042–0.072, respectively). High sociodemographic index (SDI) countries exhibited the highest age-standardized incidence, prevalence and DALY rates (11 236.6, 56 308.1 and 5277.1 per 100 000 population, respectively), whereas low-middle SDI countries showed the most rapid increases in prevalence and DALY rates (AAPC = 0.229, 95% CI: 0.218–0.240, and AAPC = 0.230, 95% CI: 0.204–0.256, respectively). Significantly positive associations were identified between SDI and age-standardized incidence, prevalence and DALY rates (all p < 0.001). High body mass index (BMI) was the largest contributor to global DALYs of MSK disorders, accounting for 10.3% of the total in this population, whereas occupational ergonomic factors, smoking and kidney dysfunction contributed 7.3%, 6.0% and 0.2%, respectively. Although the proportions of DALYs due to occupational ergonomic factors and smoking declined globally (from 9.2% to 7.3% and from 8.9% to 6.0%, respectively), those due to high BMI and kidney dysfunction increased (from 7.7% to 10.3% and from 0.19% to 0.22%, respectively). Both absolute and relative SDI-related inequalities persisted across 204 countries and territories, with no significant changes observed.

Conclusions

MSK disorders have remained the largest contributor to disability among adults aged 50 and over. Despite significant progress in reducing the incidence rate, both the prevalence and DALY rates have significantly increased. With the expanding global ageing population, there is an urgent need for improved prevention strategies to mitigate the long-term impacts of MSK disorders in this vulnerable population.

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1990-2021年50岁及以上成年人肌肉骨骼疾病的全球负担：风险因素和社会人口不平等

50岁及以上的成年人特别容易受到肌肉骨骼（MSK）疾病的影响，随着全球人口老龄化，其影响预计会加剧。本研究旨在全面评估1990年至2021年50岁及以上成年人MSK疾病的全球负担，以及时间趋势、风险因素和社会人口不平等。数据来自2021年全球疾病负担研究。通过计算平均年百分比变化（AAPC）来评估年龄标准化率的时间趋势。绝对不平等和相对不平等分别采用不平等斜率指数和浓度指数进行评价。从1990年到2021年，MSK疾病仍然是全球50岁及以上成年人残疾总生活年（YLDs）的最大贡献者。全球年龄标准化发病率显著下降（AAPC = - 0.181, 95% CI: - 0.190至- 0.172），而全球患病率和残疾调整生命年（DALY）率显著增加（AAPC = 0.126, 95% CI: 0.118-0.134, AAPC = 0.057, 95% CI: 0.042-0.072）。高社会人口指数（SDI）国家的年龄标准化发病率、患病率和DALY率最高（分别为每10万人11 236.6、56 308.1和5277.1），而中低SDI国家的患病率和DALY率增长最快（AAPC = 0.229, 95% CI: 0.218-0.240, AAPC = 0.230, 95% CI: 0.204-0.256）。SDI与年龄标准化发病率、患病率和DALY率之间存在显著正相关（均p <； 0.001）。高身体质量指数（BMI）是全球MSK疾病DALYs的最大贡献者，占该人群总DALYs的10.3%，而职业人体工程学因素、吸烟和肾功能障碍分别占7.3%、6.0%和0.2%。尽管职业人体工程学因素和吸烟导致的伤残调整寿命比例在全球范围内下降（分别从9.2%降至7.3%和从8.9%降至6.0%），但高BMI和肾功能障碍导致的伤残调整寿命比例上升（分别从7.7%降至10.3%和从0.19%降至0.22%）。与sdi相关的绝对和相对不平等在204个国家和地区持续存在，没有观察到显著变化。结论：在50岁及以上的成年人中，MSK障碍仍然是导致残疾的最大因素。尽管在降低发病率方面取得了重大进展，但患病率和DALY率都显著增加。随着全球人口老龄化的扩大，迫切需要改进预防策略，以减轻MSK疾病对这一弱势群体的长期影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-

CiteScore

13.30

自引率

12.40%

发文量

234

审稿时长

16 weeks

期刊介绍： The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.