Geotemporal disparities in hip fractures burden among individuals aged ≥55 years (1990-2021) with projections to 2050

Hip fractures (HFs) are common among older adults and represent a major cause of long-term functional impairment. The lack of up-to-date epidemiological data hinders the development of effective public health policies. This study investigates trends in HFs among individuals aged ≥55 years (HFs (≥55 years)), providing essential evidence to inform future prevention strategies.

Using Global Burden of Disease Study 2021 data, we analyzed the age-standardized incidence rate (ASIR), prevalence rate (ASPR), and years lived with disability (YLDs) rate (ASYR), along with their trends, driving factors, age-sex-time patterns, health outcomes efficiency, and projections up to 2050.

In 2021, the global ASIR, ASPR, and ASYR of HFs (≥55 years) were 1,027.46 (95% UI: 719.73-1416.07), 2,037.39 (95% UI: 1,670.75-2475.71) per 100,000, and 185.49 (95% UI: 125.69-259.43) per 100,000 person-years, respectively. From 1990 to 2021, global ASIR and ASPR showed an overall upward trend, whereas ASYR declined (ASIR: AAPC = 0.20, 95% CI: 0.12-0.28; ASPR: AAPC = 0.31, 95% CI: 0.27-0.36; ASYR: AAPC = -0.43, 95% CI: -0.50 - -0.36). These trends are expected to persist by 2050, with ASIR reaching 1,102.66 (95% CI: 101.40-2,142.83), ASPR 2,052.14 (95% CI: 141.30-4,112.55) per 100,000, and ASYR declining to 174.43 (95% CI: 0-365.91) per 100,000 person-years. Significant disparities existed across 204 countries and territories. High SDI region bore a greater burden, though their growth rate had slowed, whereas Low SDI region showed a gradual increase from a lower baseline. Health inequalities were more pronounced in High SDI region, which also had the greatest potential for burden reduction. Population growth and aging were the primary drivers of these trends, with falls remaining the predominant cause. Notably, the burden increased more markedly among males.

The global burden of HFs (≥55 years) is rising, underscoring the need to account for the complex distribution across populations and regions. Effective, targeted prevention and treatment strategies are essential to mitigating the disease burden and improving patient outcomes.