Editorial: Addressing fracture risk in aging populations: integrated prevention tactics

Fragility fractures are increasingly prevalent in the aging population due to factors like osteoporosis and diminished bone strength, posing significant challenges to global health systems in terms of morbidity, mortality, and economic cost. (1)(2)(3) Addressing factors such as osteoporosis is crucial as the latter can also affect the surgical outcomes in various orthopaedic surgeries. (4)(5)(6)(7)(8)(9)(10)(11)(12) However, preventing these fractures remains the ideal approach. The aim of this Research Topic is to investigate and improve prevention strategies by employing a comprehensive, interdisciplinary approach that incorporates insights from epidemiology, gerontology, orthopedics, and health policy. This section highlights emerging evidence on the epidemiology and inequities of fragility fractures alongside advances in predictive analytics that collectively refine identification of high-risk older adults and inform targeted prevention strategies. At the population level, Gu et al. demonstrated substantial geotemporal disparities in hip fracture burden among adults aged ≥55 years across 204 countries, showing that global age-standardized incidence and prevalence increased between 1990 and 2021 and are projected to continue rising through 2050, largely driven by population aging and growth, with disproportionate burden in high-SDI regions and a more pronounced increase among males. (13) Similarly focusing on disparities, Lin et al. examined urban-rural differences in fall risk among older Chinese adults, reporting an overall fall incidence of 22.4%, higher in rural than urban populations, and showing that while common predictors included sex, age, prior falls, sleep duration, functional status, memory, and chair stand performance, the relative importance of these factors differed by setting.( 14 Collectively, the findings of this research topic carry significant public health implications. The consistent identification of modifiable risk factors supports the integration of musculoskeletal health screening into primary care and community-based aging programs. Advances in machinelearning and explainable AI models offer opportunities for scalable, cost-effective risk stratification tools that can be embedded within public health systems to proactively identify highrisk individuals. Moreover, the demonstrated disparities in fracture burden and post-fracture care access underscore the necessity of policy-level interventions aimed at improving insurance coverage, rural healthcare access, patient education, and continuity of care services. An integrated strategy that bridges epidemiologic surveillance, early risk prediction, equitable service delivery, and targeted preventive interventions will be essential to mitigating the projected rise in fragility fractures globally.