OBJECTIVES:

The growing prevalence of rheumatic and musculoskeletal diseases (RMDs) is a major public health problem associated with high morbidity and costs. This study aimed to project the national prevalence of RMDs in the adult Portuguese population through 2050, accounting for changing demography.

METHODS:

We used individual level data from the EpiReumaPt study (2011-2013) which was a national health survey where 10,661 adult Portuguese inhabitants were randomly selected to access the prevalence and characterize RMDs . The projected RMDs prevalence were obtained by age-group for the following main RMDs: low back pain (LBP), periarticular rheumatic disease (PD), osteoarthritis (OA; knee, hip and hand), osteoporosis (OP), fibromyalgia (FM), spondyloarthritis (SpA), rheumatoid arthritis (RA), gout (GO), and systemic lupus erythematosus (SLE). All projections were done based on the official demographic projections from the National Institute of Statistics (INE - Resident Population Projections, 2012-2060). Sensitivity analyses were performed by varying population projections.

RESULTS:

During this 37-year period (2013-2050) we estimated that the overall RMDs prevalence will increase by 10.1%. The projections for disease-specific prevalence of RMDs in the adult Portuguese population and due variation in 2020, 2030, 2040 and 2050 versus 2013 (EpiReumaPt study) are: LBP (2020:26.9%[∆1.8%]; 2030:27.6%[∆4.7%]; 2040: 28.3%[∆7.3%]; 2050:28.7%[∆8.6%]); PD (2020:16.2%[∆2.8%]; 2030:16.6%[∆5.1%]; 2040:16.5%[∆5.0%]; 2050:16.4%[∆4.2%]); Knee OA (2020:13.3%[∆7.5%]; 2030:14.7%[∆18.5%]; 2040:16.0%[∆29.0%]; 2050:17.0%[∆36.7%]); OP (2020:11.0%[∆8.4%]; 2030:12.3%[∆21.0%]; 2040:13.7%[∆34.6%]; 2050:14.7%[∆44.2%]); Hand OA (2020:9.5%[∆8.4%]; 2030:10.5%[∆20.7%]; 2040:11.6%[∆32.9%]; 2050:12.4%[∆42.3%]); Hip OA (2020:3.1%[∆6.6%]; 2030:3.4%[∆15.9%]; 2040:3.7%[∆24.5%]; 2050:3.9%[∆31.6%]); FM (2020:1.7%[∆2.2%]; 2030:1.7%[∆2.0%]; 2040:1.7%[∆-2.8%]; 2050:1.5%[∆-10.0%]); SpA (2020:1.6%[∆-1.7%]; 2030:1.5%[∆-4.7%]; 2040:1.5%[∆-10.0%]; 2050:1.4%[∆-13.0%]); GO (2020:1.4%[∆6.4%]; 2030:1.5%[∆14.0%]; 2040:1.5%[∆18.6%]; 2050:1.5%[∆18.1%]); RA (2020:0.8%[∆5.0%]; 2030:0.8%[∆12.0%]; 2040:0.9%[∆16.7%]; 2050:0.9%[∆18.0%]); SLE (2020:0.2%[∆1.3%]; 2030:0.1%[∆-0.8%]; 2040:0.2%[∆1.2%]; 2050:0.1%[∆-1.9%]). All performed sensitivity analysis provided similar results.

CONCLUSIONS:

Our findings suggest that, assuming no other changes, the overall prevalence of RMDs is likely to increase in the coming future, given the expected demographic trends. This should be taken in consideration by politics, health authorities and decision-makers when it comes to define and prioritize public health policies.