Background/Purpose: Osteoarthritis (OA) represents a growing public health concern, particularly among the aging population, contributing significantly to both mortality and Disability-Adjusted Life Years (DALYs). This study evaluates trends in OA-related DALY and mortality from 1990 to 2021, utilizing data from the Global Burden of Disease (GBD) database, with a comparative focus on the United States and global trends.

Methods: Data from the 2021 Global Burden of Disease (GBD) database were analyzed to evaluate osteoarthritis-related mortality and Disability-Adjusted Life Years (DALYs) among individuals aged 65 years and older in the United States and globally. DALY and mortality rates were reported per 100,000 population. Long-term trends from 1990 to 2021 were assessed using Annual Average Percentage Change (AAPC), with statistical significance determined by 95% confidence intervals (CIs) and p-values. Annual Percentage Change (APC) was also calculated for specific time intervals to identify periods of significant deviation from the overall trend.

Results: DALYs attributed to osteoarthritis showed a consistent upward trend globally, with a D-AAPC of 0.30% (95% CI: 0.28–0.31, p < 0.000001), observed similarly in both females (0.30%) and males (0.31%). Notably, a significant spike in DALY-APC (0.85%) was recorded between 2006 and 2009.In the United States, 44,590 OA-related deaths were reported between 1990 and 2021. The AAPC for mortality increased by 0.76% (95% CI: 0.11–0.41, p = 0.0215), aligning with the global trajectory. However, mortality trends showed fluctuations over time, with the lowest APC of -2.90% (95% CI: -3.93 to -1.18, p = 0.000035) between 2011 and 2018 and the highest APC of 13.03% (95% CI: 4.33–20.08, p = 0.0068).In the U.S., the D-AAPC over the last three decades increased by 1.68% (95% CI: 0.04–0.29, p = 0.0707), with a gender-specific increase of 0.12% for men and 0.24% for women. Several intervals showed declining mortality rates, notably between 1993–1996, 1996–1999, and 1999–2005 with D-APCs of -0.11%, -2.19%, and -1.08% respectively.

Conclusion: This study demonstrates a rising burden of osteoarthritis, reflected in both DALY and mortality trends, in the United States and globally over the past three decades. While some fluctuations exist, the overall trajectory suggests worsening impact, especially among older adults. These findings underscore the urgent need for targeted prevention strategies, improved access to musculoskeletal care, and investment in early intervention programs to reduce long-term disability and mortality. Further research is warranted to identify modifiable risk factors and health system inefficiencies contributing to these escalating trends.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/trends-in-mortality-and-disability-adjusted-life-years-dalys-from-osteoarthritis-in-the-united-states-compared-to-global-estimates-a-gbd-based-analysis-1990-2021/