Global, regional, and national burden of hip fractures attributable to falls in older adults: changes from 1990–2021 and 2036 projections

Background Hip fractures attributable to falls (HFAF) represent one of the life-threatening conditions in older adults. This study aims to analyze trends and geographical distribution characteristics of HFAF in older adults from 1990 to 2021. Methods Key indicators including incidence, prevalence, and years lived with disability (YLDs) were extracted from the Global Burden of Disease (GBD) 2021 database. Spatiotemporal trends in disease burden were systematically described using methods including Joinpoint regression analysis, age-period-cohort analysis, inequality analysis, and frontier analysis. Decomposition analysis was used to explore key factors underlying fluctuations in HFAF burden in older adults. Finally, the ARIMA model was employed to project disease burden over the next 15 years. Result Globally, from 1990 to 2021, age-standardized prevalence (ASPR) and incidence (ASIR) of HFAF in older adults increased, whereas age-standardized YLDs (ASYR) decreased. Disease burden was greater in regions with higher socioeconomic status. Gender-based analysis showed that disease burden was greater among older women than among older men. Over time, cross-country inequalities widened. Frontier analysis identified that countries such as Belgium and Switzerland have substantial potential to improve disease control. Decomposition analysis identified population growth as the primary driver of the rising global burden. Projections indicated that case numbers will continue to rise by 2036, but age-standardized rates will decline. Conclusion This study indicates that the global disease burden of HFAF in older adults increased from 1990 to 2021 and is projected to continue rising through 2036. Reductions in ASYR suggest that current treatment measures are effective.