#2-58E. Beyond Falls: The Hidden Global Burden of Low BMD in Road Injuries (Lancet Rheumatol, 2025)

When we discuss low bone mineral density (LBMD), we typically focus on fragility fractures in older women, but does this perspective capture the full scope of the global burden? This expansive analysis, leveraging Global Burden of Disease Study 2021 data, estimated the worldwide disability-adjusted life years (DALYs) and mortality attributed to LBMD-related fractures in individuals aged 40 and older between 1990 and 202012. The study confirmed a staggering increase in the absolute burden of LBMD over three decades, driven primarily by population aging and growth. Crucially, the analysis highlights that LBMD is a significant modifiable risk factor not only for falls-related fractures, which accounted for the majority of the burden, but also, for the first time, for fractures resulting from road injuries, particularly among middle-aged men (40-64 years) and women. This challenges the conventional perception of LBMD as solely an issue for the very old. However, it is essential to consider the limitation that the relative risks connecting LBMD and fracture were primarily derived from studies based in high-income countries, potentially limiting the generalizability of attribution across all global populations. For clinicians, these data underscore the need to expand LBMD screening and intervention strategies to younger patient groups and men, recognizing its systemic contribution to injury-related health loss beyond low-energy trauma.

Citation: Hsieh, E., Bryazka, D., Ong, K. L., et al. The global, regional, and national burden attributable to low bone mineral density, 1990–2020: an analysis of a modifiable risk factor from the Global Burden of Disease Study 2021. Lancet Rheumatol. 2025. DOI: 10.1016/ S2665-9913(25)00105-5

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