New research shows that, in around one-third of countries and territories worldwide, population ageing was the single most significant contributor to the rising burden of musculoskeletal disorders between 1990 and 2021. Published in Annals of the Rheumatic Diseases by Elsevier, the study offers substantial evidence to support more targeted public health planning and healthcare resource allocation, with the potential to reduce both the health and economic consequences of these widespread conditions.
Musculoskeletal disorders, such as arthritis, osteoporosis, and chronic back pain, are among the leading causes of disability globally. As populations age at an accelerating pace, the number of people affected by pain, reduced mobility, and long-term disability continues to increase. Although this trend has raised growing concern, it remains unclear how much of the expanding burden is explicitly driven by population ageing rather than by overall population growth or changes in disease rates within age groups.
To clarify this issue, the researchers quantified the independent effect of population ageing on the global burden and healthcare costs of musculoskeletal disorders. Using data from the Global Burden of Disease 2021 study, they separated the impact of ageing from that of population growth and age-specific epidemiological changes. Their analyses accounted for geographic variation, sociodemographic factors, sex differences, and major categories of musculoskeletal disease, while also estimating healthcare expenditure attributable to ageing populations.
The results show that, in approximately one-third of countries and territories, population ageing was the dominant driver of increasing musculoskeletal disease burden. Middle-income countries experienced the most significant proportional increases linked to ageing, despite generally having younger populations than high-income countries. This reflects the speed of demographic change in these regions, combined with healthcare systems that are often less prepared to meet the needs of older adults. Globally, men were more affected by ageing-related increases in musculoskeletal burden in higher-income settings, while women experienced greater impact in low- and middle-income countries. Osteoarthritis emerged as the most affected condition worldwide, followed by gout and rheumatoid arthritis.
The study also highlights the substantial economic implications of population ageing. In 2021, healthcare costs associated with ageing-related musculoskeletal disorders were estimated at US$96 billion, equivalent to around 0.10 per cent of global gross domestic product. This figure exceeds the expenses attributed to several common modifiable risk factors, underscoring the scale of the financial challenge posed by these conditions.
Overall, the findings underline that population ageing is an unavoidable global trend, but its impact on musculoskeletal health is unevenly distributed. The authors stress that their results can help policymakers prioritise interventions suited to local demographic and socioeconomic contexts, address sex-specific differences, and focus on the most affected conditions. Strengthening prevention, improving long-term management, and ensuring sustainable healthcare financing will be essential to reducing disability, improving the quality of life for older adults, and enhancing the resilience of healthcare systems worldwide.
More information: Shi-Yang Guan et al, The impact of population ageing on musculoskeletal disorders in 204 countries and territories, 1990-2021: global burden and healthcare costs, Annals of the Rheumatic Diseases. DOI: 10.1016/j.ard.2025.08.002
Journal information: Annals of the Rheumatic Diseases Provided by Elsevier
