Burden of fall-related fracture among postmenopausal women: findings from the global burden of disease study 2021

BACKGROUND: Falls are a significant public health concern, especially among postmenopausal women. This study aims to evaluate the global, regional, and national burden of fall-related fractures among postmenopausal women using data from the Global Burden of Disease (GBD) Study 2021. METHODS: This study assess the prevalence and incidence of fall-related fractures among women aged 55 and older from 1990 to 2021. The burden was evaluated by examining cases and rates of prevalence and incidence at the global level, stratified by age, region, nation, and socio-demographic index (SDI) levels. The estimated annual percentage change (EAPC) was utilized to assess temporal trends, while the Bayesian Age-Period-Cohort (BAPC) model was employed to forecast future trends. Additionally, the correlation between prevalence and incidence rates and SDI levels was analyzed across 21 GBD regions and 204 countries using locally estimated scatterplot smoothing (LOESS) regression. RESULTS: In 2021, fall-related fractures among postmenopausal women had 25.42 million incident cases and 96.05 million prevalent cases, up 156.58% and 132.62% since 1990. The incidence rate rose from 2752.20 to 3231.91 per 100,000 populations and the prevalence rate from 11,471.72 to 12,213.33 per 100,000 populations, with EAPCs of 0.52 and 0.13. The incidence and prevalence rates increase with age and are highest in the 95 + age group. Between 1990 and 2021, among regions, the incidence rate of fall-related fractures among postmenopausal women rose most in North Africa, the Middle East, and Australasia, but fell most in Central Europe and Central Latin America. Meanwhile, the prevalence rate increased most in the Caribbean and High-income North America, while decreasing most in Southern Sub-Saharan Africa and Central Latin America. At the national level, the incidence and prevalence rates saw the most significant increases in Turkey and Bhutan. In contrast, United Arab Emirates and Czechia exhibited the lowest incidence rate, while Czechia and Latvia had the lowest prevalence rate. The correlation analysis showed that incidence and prevalence rates increased with SDI levels, reached an initial peak at approximately 0.38, subsequently declined to a nadir at approximately 0.62, then rose to their highest levels. Predictions indicate a substantial increase in both incident and prevalent cases, along with a modest rise in incidence and prevalence rates. CONCLUSIONS: The burden of fall-related fractures among postmenopausal women is substantial and increasing globally. Public health policies and resource allocation need to address this critical issue to improve the well-being of postmenopausal women and reduce the economic burden on healthcare systems.