Global burden of osteoarthritis in middle-aged adults (40-59 years): estimates from the global burden of disease 2021 study

Osteoarthritis (OA) is a leading cause of chronic pain and disability worldwide, traditionally viewed as a disease of aging. However, emerging evidence highlights its increasing prevalence among middle-aged adults (40-59 years), a population critical to socioeconomic stability. This study is designed to assess the burden of OA among middle-aged adults. Data were sourced from the GBD Study 2021. Incidence, prevalence and YLDs of OA were calculated in middle-aged adults from 1990 to 2021. Variability in OA burden was examined by SDI and geographical region. Incidence was forecast to 2050 using the GBD Foresight Visualization tool. Incident cases of OA among middle-aged adults increased by 123.7%, from 11.8 million in 1990-26.4 million in 2021. ∼56.5% of incident cases and 37.9% of prevalent cases occur within middle-aged group, underscoring its critical burden. Middle-aged population experienced 70% and 331% higher incident cases compared with elderly population (>60 years) and younger population (30-39 years), respectively. The highest incidence YLDs were observed in the high-income region. A significant positive association was found between OA burden and SDI. By 2050, the age-standardized incident rate of OA in middle-aged population is projected to increase by 10.2%, with hand OA showing the largest rise. This study underscores the growing burden of OA among middle-aged adults, a population that has been historically underrepresented in OA research. The findings highlight the urgent need to prioritize prevention strategies. Early intervention could significantly delay disease progression and alleviate the future burden.