Abstract

Objective: This study aimed to assess the burden of osteoporosis and related fractures in the United States from 1990 to 2023 using a retrospective cohort framework and provides forecasts through the year 2050.
Methods: A retrospective population-based analysis was conducted using data from the Global Burden of Disease framework. Low bone mineral density-related falls were used as the principal proxy for osteoporo tic fracture burden. Outcomes included deaths, disability-adjusted life years (DALYs), and years lived with disability (YLDs). Temporal trends were assessed using estimated annual percentage change from log-link ear regression models. Forecasts to 2050 were generated with autoregressive integrated moving average models.
Results: Mortality attributable to low bone mineral density-related falls increased markedly over the study period, with the steepest rise in the oldest age groups. Among adults aged 90-94 years, deaths rose from 1,042 in 1990 to 5,759 in 2023, and the death rate increased from 143.96 to 334.59 per 100,000. The rate of DALY and YLD reduced for younger people, but it rose steadily from later adulthood. The greatest burden occurred for people aged 75 years and older by 2023. Females had a higher absolute burden for deaths and DALYs, while males had higher age-standardized death rates. Both death and DALY rates are expected to rise until the year 2050, with the older age groups being the main contributors.
Conclusion: The burden attributable to low bone mineral density-related falls in the United States has grown and is expected to increase further, particularly among the oldest adults.

Key words: Osteoporosis, low bone mineral density, falls, DALYs, YLD, osteoporotic fractures, United States