Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 29:52:281-290.
doi: 10.1016/j.jot.2025.04.001. eCollection 2025 May.

Epidemiology and disease burden of fractures in Asia, 1990-2021: An analysis for the Global Burden of Disease Study 2021

Yechao Shen  1   2   3   4   5 , Boren Tan  1   2   3   4   5 , Jiahao Zhang  1   2   3   4   5 , Ning Zhang  1   2   3   4   5 , Zhan Wang  1   2   3   4   5
Affiliations

Epidemiology and disease burden of fractures in Asia, 1990-2021: An analysis for the Global Burden of Disease Study 2021

Yechao Shen et al. J Orthop Translat. .

Abstract

Background: Fractures are a significant global public health concern, imposing a substantial economic burden, particularly among the elderly. However, research on the fracture burden in Asia remains limited, highlighting the need for comprehensive and up-to-date studies to support the effective planning and allocation of healthcare resources across the region.

Methods: Using the Global Burden of Disease (GBD) 2021 database, we analyzed the age-standardized rates (ASRs) of incidence (ASIR), prevalence (ASPR), and years lived with disability (YLDs) (ASYR) associated with fracture burden across Asia. Our study explored trends over time, variations by age, sex, and country, and examined the correlation between fracture burden and the sociodemographic index (SDI).

Results: In 2021, fractures in Asia caused 91.3 million (95 % uncertainty interval, 83.65-99.47) incident cases, 232.71 million (95 % UI, (215.57-250.39) prevalent cases, and 12.97 million (95 % UI, 8.89-17.82) YLDs, with age-standardized rates of 1968.49 (95 % UI, 1799.15-2147.14) for incidence (ASIR), 4683.96 (95 % UI, 4347.58-5036.61) for prevalence (ASPR), and 261.72 (95 % UI, 179.43-358.94) for YLDs (ASYR) per 100,000 population. Despite a higher absolute burden, Asian age-standardized rates of fracture were slightly lower than the global average. For ASYR, the most burdensome fractures were those of the patella, tibia/fibula/ankle, hip, and pelvis. Between 1990 and 2021, fracture incident cases, prevalent cases, and YLDs in Asia increased markedly. Age and sex differences were observed, with the elderly experiencing the highest fracture burden, particularly for hip fractures in women. While men had a higher overall fracture burden, women faced a greater fracture disease burden in the elderly population. Geographically, High-income Asia Pacific and Central Asia exhibited the highest age-standardized YLD rates, while South and East Asia had the largest number of fractures and YLDs.

Conclusions: Our study provides an in-depth analysis of the fracture burden in Asia. From 1990 to 2021, the overall age-standardized fracture burden in Asia showed a gradual decline, yet the burden of hip fractures continued to increase. Asia holds the highest absolute number of fracture burden globally, with East Asia and South Asia being the primary regions contributing to this burden. The fracture burden increases with age in Asia, and women experience a higher fracture burden than men in older age groups. Strengthening surveillance and targeted prevention is essential to reduce the future fracture burden.

The translational potential of this article: Fracture is a kind of health problem with high incidence and serious disease burden in Asia. Although overall burden of disease for fractures in Asia from 1990 to 2021 was decreasing, the burden of hip fracture disease in Asia has continued to rise from 1990 to 2021 in terms of incidence and prevalence. Males had a higher fracture burden than females in Asia, yet females had a higher fracture disease burden in the elderly population in 2021.

Keywords: Asia; Fracture; Global burden of disease; Incidence; Prevalence; Years lived with disability.

PubMed Disclaimer

Conflict of interest statement

Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Disease burden for different anatomical sites of fractures in Asia, 1990–2021. (A) ASIR, ASPR and ASYR from 1990 to 2021 across four major regions worldwide. (B–C) Age-specific incidence and YLDs rate of fractures for each anatomical site, by age group and sex, 2021. (D) ASIR, ASPR and ASYR of fractures by anatomical site in Asia, 1990–2021. YLDs, years lived with disability; ASIR, Age-standardized incidence rates; ASPR, Age-standardized prevalence rates; ASYR, Age-standardized YLDs rates.
Fig. 2
Fig. 2
Sex- and age-structured analysis of Asian fracture burden in 2021. (A) Incident number and rates of fracture in Asia, by age group and sex, 2021. (B) YLDs number and rates of fracture in Asia, by age group and sex, 2021. (C) Asian age-specific rate of incidence, prevalence and YLDs in 1990 and 2021. YLDs, years lived with disability.
Fig. 3
Fig. 3
Asian distribution of fracture burden, 1990–2021. (A) ASIR, ASPR and ASYR from 1990 to 2021 across 5 major regions in Asia. (B) Ranking of ASIR for all fracture by Asian countries, 2021. (C) Ranking of ASYR for all fracture by Asian countries, 2021.
See this image and copyright information in PMC

References

    1. Polinder S., Haagsma J., Panneman M., Scholten A., Brugmans M., Van Beeck E. The economic burden of injury: health care and productivity costs of injuries in The Netherlands. Accid Anal Prev. 2016;93:92–100. - PubMed
    1. Court-Brown C.M., Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37(8):691–697. - PubMed
    1. Global, regional, and National burden of bone fractures in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Healthy Longev. 2021;2(9):e580–e592. - PMC - PubMed
    1. Borgström F., Karlsson L., Ortsäter G., Norton N., Halbout P., Cooper C., et al. Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporosis. 2020;15(1):59. - PMC - PubMed
    1. Pike C., Birnbaum H.G., Schiller M., Sharma H., Burge R., Edgell E.T. Direct and indirect costs of non-vertebral fracture patients with osteoporosis in the US. Pharmacoeconomics. 2010;28(5):395–409. - PubMed

LinkOut - more resources