Background/Objectives: Vertebral fractures (VFs) are a global health issue caused by traumatic or pathological factors that compromise spinal integrity. The burden of VFs is increasing, particularly in older adults. Methods: Data from the Global Burden of Disease 2021 were analyzed to estimate the prevalence, mortality, and years lived with disability due to VFs from 1990 to 2021. Estimates were stratified according to age, sex, and region. Bayesian meta-regression models were used to generate age-standardized rates, and projections for 2050 were calculated using demographic trends and the sociodemographic index. Das Gupta’s decomposition assessed the relative contributions of population growth, aging, and prevalence changes to future case numbers. Results: In 2021, approximately 5.37 million people (95% Uncertainty Interval [UI]: 4.70–6.20 million) experienced VFs globally, with an age-standardized prevalence of 65 per 100,000. Although the rates have declined slightly since 1990, the absolute burden has increased owing to population aging. VF prevalence was the highest in Eastern and Western Europe and in high-income regions. Males had higher VF rates until 70 years of age, after which females surpassed them, reflecting postmenopausal osteoporosis. Falls and road injuries were the leading causes of VF. By 2050, the number of VF cases is expected to increase to 8.01 million (95% UI: 6.57–8.64 million). Conclusions: While the age-standardized VF rates have decreased slightly, the global burden continues to increase. Targeted strategies for the early diagnosis, osteoporosis management, and fall prevention are necessary to reduce the impact of VFs.

Background/Objectives: Vertebral fractures (VFs) are a global health issue caused by traumatic or pathological factors that compromise spinal integrity. With an aging population, the burden of VFs is increasing, particularly in older adults. Methods: Data from the Global Burden of Disease 2021 were analyzed to estimate the prevalence, mortality, and years lived with disability due to traumatic vertebral fractures from 1990 to 2021. Estimates were stratified according to age, sex, and region. Bayesian meta-regression models were used to generate age-standardized rates, and projections to 2050 were calculated using demographic trends and the socio-demographic index. Das Gupta’s decomposition assessed the relative contributions of population growth, aging, and prevalence changes to future case numbers. Results: In 2021, approximately 5.37 million people (95% UI: 4.70–6.20 million) experienced VFs globally, with an age-standardized prevalence of 65 per 100,000. Although rates have declined slightly since 1990, the absolute burden has increased owing to population aging. VF prevalence was the highest in Eastern and Western Europe and high-income regions. Males had higher VF rates until 70 years, after which female rates surpassed them, reflecting postmenopausal osteoporosis. Falls and road injuries were the leading causes of VF. By 2050, VF cases are projected to rise to 8.01 million (95% UI: 6.57–8.64 million). Conclusions: Although age-standardized VF rates have decreased slightly, the global burden continues to increase. Targeted strategies for early diagnosis, management of osteoporosis, and fall prevention are required to reduce the impact of VFs.

Background: Stroke is the second leading cause of death and major cause of disability worldwide. Substantial regional variations exist in modifiable risk factor profiles, indicating the need for region-specific prevention strategies. Using the Global Burden of Disease (GBD) 2023 data, the burden, risk factor contributions, and future projections of stroke were compared across East Asia, Western Europe, and North America from 1990 to 2023, with forecasts to 2050. Methods: Deaths, disability-adjusted life years (DALYs), incidence, and prevalence of total stroke and the three subtypes were analyzed across 204 countries using GBD 2023 estimates. Temporal trends were assessed using estimated annual percentage changes. Changes in mortality were decomposed into population growth, population aging, and epidemiological components. Risk factor attribution was conducted within the GBD comparative risk assessment framework. The future burden through 2050 was projected using Bayesian age-period-cohort models with integrated nested Laplace approximation, incorporating intervention scenarios targeting systolic blood pressure (SBP), low-density lipoprotein (LDL) cholesterol, and ambient particulate matter (PM2.5). Results: From 1990 to 2023, the global age-standardized stroke mortality rate declined by 51.7%, whereas the absolute deaths increased from 4.58 million to 6.55 million. A seven-fold disparity was observed across the socio-demographic index strata. High SBP was the leading risk factor globally, while the second-ranking factor differed: ambient PM2.5 in East Asia and high LDL cholesterol in Western Europe and North America. Population aging accounted for a 113.1% increase in stroke deaths in East Asia, whereas adverse epidemiological trends have contributed to increased mortality in North America. A 50% reduction in high SBP prevalence is projected to avert substantial stroke deaths annually by 2050. Conclusions: Population aging is expected to continue to increase the absolute stroke burden despite declining age-standardized rates. Regional heterogeneity in the risk factor profiles supports differentiated prevention strategies that combine hypertension control with targeted environmental or metabolic interventions.

Purpose: Osteosarcopenia, characterized by the concurrent deterioration of bone and muscle, is increasingly recognized as a major geriatric syndrome. However, its causal role in degenerative spinal disorders remains unclear owing to confounding and reverse causation in observational studies.Methods: Two-sample Mendelian randomization (MR) was performed using appendicular lean mass (ALM), hand grip strength (HGS), walking pace (WP), and total bone mineral density (BMD) as variables. The outcomes included intervertebral disc disorder (IVDD), spinal stenosis, and spondylosis. Bidirectional MR analysis was also conducted. Genome-wide association study data were obtained from the UK Biobank, Million Veteran Program and Genetic Investigation of Anthropometric Traits (GIANT) consortium. Inverse-variance weighted was the main method for evaluating the causal relationship. Linkage disequilibrium score regression (LDSC) was used to assess genetic correlations. Multivariable MR incorporating body mass index was performed to identify the direct and indirect pathways.Results: LDSC revealed significant genetic correlations between ALM and total BMD and degenerative spinal disorders, and WP showed consistent negative genetic correlations across outcomes. In univariable MR, genetically predicted higher ALM was associated with increased risks of IVDD, spinal stenosis, and spondylosis, whereas faster WP and higher total BMD were protective. HGS showed no robust association in the primary MR analyses, although a modest protective signal for spondylosis appeared only after outlier correction. Reverse-direction MR provided limited evidence of causality.Conclusion: Osteosarcopenia-related traits exhibit heterogeneous causal relationships with degenerative spinal disorders. Muscle mass (ALM) was positively associated with the risk of spinal disorders, whereas mobility (WP) and bone density (BMD) were protective. Body size-related pathways likely contribute to these relationships, and method-dependent findings—particularly for HGS and reverse-direction analyses—should be interpreted cautiously.

Introduction: Sleep-related phenotypes, including insomnia symptoms, sleep apnea, and habitual sleep duration, are increasingly recognized as potentially modifiable factors associated with psychiatric disorders. However, their potential causal roles remain uncertain because observational studies are susceptible to confounding and reverse causation. Methods: Two-sample mendelian randomization (MR) was performed using self-reported insomnia symptoms, sleep apnea, and habitual sleep duration, as exposures against 10 psychiatric outcomes: ADHD, PTSD, MDD, PPD, BIP, ASD, OCS, SCZ, AN, and PD. GWAS summary statistics were obtained from the UK Biobank, Psychiatric Genomics Consortium, and affiliated consortia. Inverse-variance weighted (IVW) was the primary method, with MR-Egger, weighted median, and MR-PRESSO applied as sensitivity analyses. Multivariable MR (MVMR) was conducted to estimate independent associations of the sleep-related phenotypes modeled simultaneously. Results: Genetically predicted insomnia symptoms showed Bonferroni-significant associations with increased risk of ADHD (OR 2.50, 95% CI 1.65–3.78, p < 0.001) and PTSD (OR 1.32, 95% CI 1.12–1.56, p < 0.001). Nominal associations were observed for MDD (OR 1.57, 95% CI 1.16–2.12, p = 0.003), PPD (OR 2.35, 95% CI 1.07–5.13, p = 0.033), and BIP (OR 1.67, 95% CI 1.03–2.68, p = 0.036). Genetically predicted sleep apnea showed nominal associations with OCS (OR 1.20, 95% CI 1.07–1.35, p = 0.002) and AN (OR 1.57, 95% CI 1.17–2.11, p = 0.003). Genetically predicted longer sleep duration showed nominal associations with increased risk of BIP (OR 1.26) and SCZ (OR 1.67) but did not survive multiple-testing correction. MVMR analyses showed associations of longer sleep duration with ADHD (protective; OR 0.16, 95% CI 0.05–0.54, p = 0.004) and AN (OR 37.66, 95% CI 4.12–345.21, p = 0.001); however, these estimates were imprecise and potentially affected by conditional weak-instrument bias. Sensitivity analyses did not detect significant evidence of directional horizontal pleiotropy based on the MR-Egger intercept test in univariable analyses, although MVMR estimates remained imprecise. Conclusion: The sleep-related phenotypes showed heterogeneous patterns of association with psychiatric disorders. Genetically predicted insomnia symptoms were associated with the broadest range of psychiatric outcomes, whereas sleep apnea showed more outcome-specific associations. These findings highlight the importance of considering multiple dimensions of sleep when evaluating psychiatric disorders.