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Temporal trends and future projections of hand osteoarthritis burden in China from 1990 to 2021
Yijia Gao1, Lei Chen2, Siwei Yang3
1Department of Physical Education, Changzhou Institute of Technology, Changzhou, China.
Background:
Hand osteoarthritis (HOA) is a prevalent degenerative joint disorder that causes pain, functional disability, and considerable socioeconomic burden. China's rapid population aging and widespread engagement in repetitive manual labor may have accelerated to the rise of HOA. However, long-term trends and future projections of its disease burden remain insufficiently characterized.
Objective:
To describe trends in HOA incidence, prevalence, and DALYs from 1990 to 2021, examine differences across age and sex, and project future disease burden.
Design:
A population-based descriptive study using GBD 2021 data to examine trends and project the burden of hand osteoarthritis in Chinese adults aged 30 years and older across national and subnational regions.
Methods:
Age-standardized incidence rate (ASIR), prevalence rate (ASPR), and disability-adjusted life year rate (ASDR) were analyzed by sex and age group. Temporal trends were quantified using Joinpoint regression to calculate annual and average annual percent changes (APC, AAPC), and future trends were projected to 2036 using an autoregressive integrated moving average (ARIMA) model.
Results:
Between 1990 and 2021, the burden of HOA increased substantially worldwide, with China showing a faster rise than the global average. In China, ASIR rose from 59.12 to 92.70 per 100,000, ASPR from 988.51 to 1603.85, and ASDR from 31.57 to 51.26, corresponding to AAPCs of 1.46%-1.58%. Females experienced consistently higher rates than males and faster growth. The disease burden rose sharply after age 50 and peaked between 65 and 79 years. Joinpoint analysis revealed multiple inflection points, with the steepest acceleration occurring from 2015 to 2019 (APC >5%). ARIMA projections indicate that male rates will plateau or slightly decline by 2035, whereas female rates will continue rising, potentially exceeding 150 per 100,000 for incidence and 3000 per 100,000 for prevalence.
Conclusion:
The burden of HOA in China is increasing rapidly and is likely associated with population aging, sex-specific biological vulnerability, and occupational exposure. Women and elderly adults are disproportionately affected, with widening sex and age disparities. Targeted interventions-including ergonomic protection, menopausal health management, and early rehabilitation-are essential to mitigate the projected rise in disease burden and to improve musculoskeletal health in an aging population.