Burden and temporal trends attributable to low bone mineral density in Mexico, 1990–2023: a global burden of disease analysis

Abstract

Summary

Low bone mineral density contributes to fractures and injury-related disability. Using Global Burden of Disease 2023 estimates for Mexico (1990–2023), we found rising total burden but declining age-standardised rates, with disability becoming increasingly important and a recent uptick in non-fatal outcomes. Strengthening fracture prevention is needed in ageing populations.

Background

Low bone mineral density (LBMD) is a modifiable risk factor for fractures and other injury-related outcomes; however, contemporary national estimates for Mexico remain limited, constraining policy planning and prevention priorities.

Methods

We conducted a secondary analysis of Mexico-specific Global Burden of Disease (GBD) 2023 estimates obtained from the IHME GBD Results Platform for adults aged ≥ 40 years from 1990 to 2023. We summarised all-age counts and age-standardised rates (ASRs) per 100,000 for deaths, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs). Population exposure to LBMD was assessed using the summary exposure value (SEV). Temporal trends were evaluated using joinpoint regression, reporting annual percentage change (APC) and average APC (AAPC) with 95% CIs.

Results

From 1990 to 2023, all-age deaths increased from 2,962.99 to 4,042.72 and DALYs from 183,439.82 to 344,078.31, driven mainly by rising YLDs (116,520.80 to 255,652.37). Despite rising counts, ASRs declined: the age-standardised death rate decreased from 7.41 to 3.06 per 100,000, and the age-standardised DALY rate decreased from 422.13 to 247.52. Overall, AAPCs indicated sustained declines for mortality (− 2.7%) and YLLs (− 2.5%), while DALYs decreased more modestly (AAPC − 1.6%), with a recent post-2020 increase in DALYs (APC 3.7%/year) and YLDs (APC 5.2%/year). SEV decreased modestly from 20.80 in 1990 to 18.78 in 2023 and remained consistently higher in females than males. In descriptive time-series analyses, the Sociodemographic Index showed inverse co-movement with LBMD-attributable ASRs (mortality rₛ =  − 0.998; DALYs rₛ =  − 0.994; YLLs rₛ =  − 0.999; YLDs rₛ =  − 0.950; all p < 0.001).

Conclusions

Mexico experienced rising absolute LBMD-attributable burden alongside declining age-standardised rates, with disability becoming increasingly prominent. These findings support strengthening fracture risk assessment, fall-prevention strategies, and post-fracture secondary prevention among Mexico’s ageing population.