Global Burden, Demographic and Geographic Disparities of Osteoarthritis by Joint Site Among Adults Aged 55 Years and Older, 1990–2021
Abstract
Introduction To assess global osteoarthritis (OA) burden trends (1990–2021) in adults ≥55 years by joint type, sex, age, and SDI. Material and Methods Using Global Burden of Disease (GBD) 2021 data from 204 countries, we analyzed Estimated Annual Percentage Change (EAPC) in age-Standardized Incidence (ASIR) and DALY rates via Joinpoint regression, stratified for knee, hip, hand, and other OA. Results Global OA burden increased steadily. Overall EAPC was 0.21 (ASIR) and 0.33 (DALY). Knee OA had the highest burden (ASIR: 1045.52; DALY: 592.26/100,000), while hand OA grew fastest (ASIR EAPC: 0.43; DALY EAPC: 0.49). Women bore higher burden (ASIR: 1813.94 vs. men: 1354.57/100,000; DALY: 1262.98 vs. 891.58/100,000) with faster increases (EAPC 0.24 vs. 0.19). Incidence peaked at 55–59 years among participants aged ≥55 years included in this study (1800.1 per 100,000); DALY peaked at ≥90 years (1589.7/100,000). High-SDI regions had highest burden (ASIR: 1873.28; DALY: 1277.17/100,000), but middle-SDI regions showed fastest growth (ASIR EAPC: 0.40; DALY EAPC: 0.56), notably in Southeast Asia (ASIR EAPC: 0.46; DALY EAPC: 0.63), East Asia (0.43; 0.64), and South Asia (0.36; 0.57). Conclusion OA burden rises globally, with knee OA dominant but hand OA accelerating. Women and older adults face disproportionate impacts. Rapid growth in middle-SDI Asian regions underscores an urgent need for tailored interventions in modernizing aging populations. These findings highlight that joint-site, gender, age and socioeconomic stratifications should be fully integrated into global OA prevention frameworks. Developed regions should focus on long-term disability management for the oldest elderly, while emerging Asian economies require early screening and lifestyle modification strategies targeting middle-aged women and manual workers, which can effectively curb the future surge of OA-related disability.