Rising burden of fall-related vertebral fractures in Ecuador, 1990-2021: an analysis of the global burden of disease.

UNLABELLED: Fall-related vertebral fractures increased substantially in Ecuador from 1990-2021, with rising incidence and disability beyond population aging. Improved detection and secondary prevention are essential. BACKGROUND: Vertebral fractures are a major complication of bone fragility and a leading cause of chronic pain and disability in aging populations. Long-term national data are essential for guiding prevention efforts and healthcare system planning. OBJECTIVES: To describe trends in the incidence and prevalence of fall-related vertebral fractures, as well as years lived with disability (YLDs), of fall-related vertebral fractures among adults aged ≥ 50 years in Ecuador between 1990 and 2021 by using estimates from the Global Burden of Disease 2021 study. METHODS: An ecological time-series analysis was conducted using modeled epidemiological estimates from the Global Burden of Disease (GBD) 2021 study. The incidence, prevalence, and YLDs were evaluated as absolute numbers and age-standardized rates (ASRs) per 100,000 population, stratified by sex and age. Temporal trends were assessed using Joinpoint regression to estimate annual percentage change (APC) and average annual percentage change (AAPC). RESULTS: Between 1990 and 2021, the age-standardized incidence, prevalence, and YLD rates of fall-related vertebral fractures among adults aged ≥ 50 years increased from 65.8 to 97.4, 28.9 to 43.9, and 3.03 to 4.59 per 100,000, respectively. The absolute number of cases more than quadrupled. Men consistently showed higher ASRs, whereas women demonstrated sustained growth across all indicators. Disability was unevenly distributed among adults aged ≥ 70 years, especially those aged ≥ 80 years. Joinpoint analyses revealed early increases followed by stabilization in men and continuous upward trends in women. CONCLUSIONS: The incidence and disability rates of fall-related vertebral fractures in Ecuador have increased substantially over the past three decades, beyond demographic aging alone. Given the growing burden on older adults, fracture detection, secondary prevention, and integrated strategies for osteoporosis management need to be improved.