Significant Increase in Postmenopausal Osteoarthritis Cases Over Three Decades

A comprehensive global analysis has revealed a staggering increase of over 130% in the incidence of osteoarthritis among postmenopausal women from 1990 to 2021. This study, published in the journal BMJ Global Health, highlights the rising prevalence of this debilitating condition, which affects joint health and overall quality of life.

Osteoarthritis, primarily characterized by the degradation of joint cartilage, results in chronic pain and functional impairment. As of 2020, approximately 595 million individuals worldwide were afflicted by the condition, equating to nearly 8% of the global population, with postmenopausal women being particularly susceptible.

The research, which analyzed data from 204 countries and territories, focused on the rates of new and existing cases of knee, hip, hand, and other forms of osteoarthritis, as well as the years of healthy life lost (disability-adjusted life years or DALYs) among women aged 55 and older. The menopause transition, marked by a decline in estrogen, has been linked to changes in skeletal health and joint stability, contributing to the increased risk of osteoarthritis in this demographic.

According to the findings, the most rapid growth in osteoarthritis cases occurred in East Asia and high-income Asia-Pacific regions. Notably, excess body weight accounted for 20% of the total years lived with disability associated with osteoarthritis. The analysis indicated a steady rise in age-standardized rates of new and existing cases, as well as DALYs, for all osteoarthritis types among postmenopausal women across all age groups during the studied period.

In 2021, there were 14,258,581 new cases, 278,568,950 existing cases, and 99,447,16 DALYs attributed to osteoarthritis, representing increases of 133%, 140%, and 142% respectively since 1990. High Socio-Demographic Index (SDI) regions exhibited significantly greater rates of incidence and prevalence, particularly for knee osteoarthritis, which was found to be the most common type and associated with the highest loss of healthy years of life.

Regional variations were also observed, with high-income Asia-Pacific countries reporting the highest incidence and DALY rates for knee osteoarthritis per 100,000 people. Southeast Asia experienced the fastest rise in new cases of knee osteoarthritis, while East Asia saw the most rapid increase in prevalence and DALYs. In contrast, Central Asia reported the lowest rates of hand osteoarthritis.

The study revealed that women were significantly more affected by hand and knee osteoarthritis compared to their male counterparts of the same age, with disability-adjusted life years for hand osteoarthritis among women aged 55-59 being nearly double that of men. Furthermore, the fastest growth in hand and other osteoarthritis cases was observed among women aged 55-64 over the last decade.

Excess body weight, defined as a Body Mass Index (BMI) above 20 to 23 kg/m² for individuals aged 20 and older, emerged as a significant risk factor. The data indicated a marked increase in DALYs attributable to high BMI among postmenopausal women across all SDI categories, rising from approximately 17% in 1990 to around 21% in 2021, with East Asia witnessing the sharpest increase.

The researchers attributed these trends in East Asia to rapid population aging, increased workforce participation, and rising obesity rates linked to urbanization and lifestyle changes. In contrast, the burden of osteoarthritis in high-income Asia-Pacific regions may be due to advanced healthcare systems that facilitate better diagnosis and reporting of cases.

Despite the significant insights provided by this study, the researchers acknowledged limitations, including variations in data quality and the exclusion of some postmenopausal women who may have transitioned at younger ages. They emphasized the escalating burden of osteoarthritis among postmenopausal women and the urgent need for proactive measures to manage risk factors, particularly through lifestyle modifications aimed at controlling BMI. Additionally, they advocated for policies that account for socio-demographic disparities to alleviate the burden of osteoarthritis in this population.