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Research Article: Trends and inequities in fall- and musculoskeletal disorder–related mortality among U.S. adults aged 65 years and older, 1999–2023

Date Published: 2026-04-22

Abstract:
Musculoskeletal disorders (MSDs) and falls increasingly threaten U.S. older adults. Contemporary trend analyses are essential for targeted prevention. To assess national and subgroup trends in aggregate mortality attributable to MSDs or falls among U.S. adults aged ?65 years (1999–2023). Analyzing CDC WONDER data, deaths with an underlying cause of MSDs or falls were aggregated. We calculated age-adjusted mortality rates (AAMRs) per 100,000 and estimated average annual percent changes (AAPCs) using joinpoint regression, stratified by year, sex, age group, race/ethnicity, state, Census region, and urban–rural classification. From 1999 to 2023, the composite AAMR rose from 51.73 to 98.30 (AAPC = 2.87%). Disaggregated analysis revealed a historic divergence followed by a recent synergistic surge: post-2017, both MSD- and fall-specific mortalities accelerated concurrently (APCs 4.51% and 3.19%). In 2023, the AAMR and AAPC were 111.65 and 2.94% for men, and 88.13 and 2.56% for women, respectively. Non-Hispanic White adults recorded the highest AAMR (110.94). Geographically, the South (AAPC = 3.23%) and non-metropolitan counties (2020 AAMR: 92.17 vs. 85.82) faced the heaviest burdens. State-level AAPCs peaked in Oklahoma (5.70%) and Vermont (5.30%). The macroscopic mortality burden of musculoskeletal decline and falls is worsening. The recent concurrent acceleration in both domains indicates a systemic breakdown in geriatric mobility preservation, highlighting an urgent need for integrated public health interventions targeting high-risk demographics and regions.

Introduction:
Musculoskeletal disorders (MSDs) and falls increasingly threaten U.S. older adults. Contemporary trend analyses are essential for targeted prevention.

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