Global Health Effects of Osteopenia and Osteoporosis, 1990-2021.

Background and Aims: Osteopenia and osteoporosis present a significant global public health challenge. This study analyses the global, regional, and national burden of disease attributable to low bone mineral density, including both osteopenia and osteoporosis, across 204 countries and territories from 1990 to 2021. Methods: Data were used to quantify deaths and disability-adjusted life years (DALYs) linked to osteopenia and osteoporosis. Results: In 2021, osteopenia and osteoporosis were responsible for 459,661 deaths and 17.3 million DALYs globally, with population attributable fractions of 0.7% and 0.6%, respectively. The global age-standardized death rate was 5.7 per 100,000, while the age-standardized DALY rate was 205 per 100,000, reflecting declines of 9.4% and 14.8%, respectively, from 1990 to 2021. The highest age-standardized DALY rates were seen in Saudi Arabia and India, while the lowest were in Azerbaijan and Jamaica. Significant increases in DALY rates were noted in Lesotho and the Netherlands, whereas the largest decreases occurred in Hungary and Taiwan. DALY rates for osteopenia and osteoporosis were highest in the 95+ age group for both sexes, with females generally experiencing higher rates, particularly in older age groups. The main contributing causes varied by age, with falls being the leading cause in the 80-84 age group, road injuries in the 40-44 age group, and exposure to mechanical forces in the 50-54 age group. A negative correlation was observed between regional socio-demographic index and age-standardized DALY rates from 1990 to 2021. Conclusion: Addressing the global burden of osteopenia and osteoporosis requires targeted interventions, further research, and efforts to reduce regional disparities and improve healthcare access.