Global burden and trends of musculoskeletal disorders in postmenopausal elderly women: a 1990–2021 analysis with projections to 2045

The global burden and trend of musculoskeletal disorders (MSDs) in postmenopausal women (PMW) remain unclear. Using the Global Burden of Disease (GBD) 2021 data, this study assessed the prevalence and disability-adjusted life years (DALYs) for rheumatoid arthritis (RA), osteoarthritis (OA), low back pain (LBP), neck pain (NP), gout, and other musculoskeletal conditions (OMSKDs) from 1990 to 2021. Bayesian Age-Period-Cohort (BAPC) models projected trends to 2045. Health inequalities were analyzed using the Slope Index of Inequality (SII) and the Concentration Index, with decomposition methods identifying the drivers of burden changes. From 1990 to 2021, the age-standardized prevalence and DALYs rates have significantly increased among PMW, with OA and LBP being the primary contributors to this burden. These increases were primarily driven by population growth. Specifically, RA, OA, and gout accounted for more than 50% of the total burden in women across all age groups, with RA burden being 1.2 times higher than that in premenopausal women, OA 3.1 times higher, and gout 2.9 times higher. Notably, in PMW, the burden of gout was 74%. The burden of gout is strongly correlated with the Socio-Demographic Index (SDI), particularly in high-income regions, such as North America, where the United States exhibits the highest DALYs rates. Furthermore, projections indicate that by 2045, the global burden of MSDs could double, with OA potentially affecting nearly 50% of the PMW. From 1990 to 2021, the global burden of MSDs among PMW has risen significantly, with notable regional disparities underscoring the critical need for tailored preventive strategies to alleviate the worldwide impact of these conditions.