Global trends in age at onset of gout, 1990-2023: a sex-stratified and forecast analysis of the Global Burden of Disease Study 2023.

BACKGROUND

Global gout burden is rising, yet temporal shifts in age at onset remain insufficiently characterized. Understanding secular changes in incident age distribution is essential for anticipating healthcare demands in aging populations.

METHODS

We conducted a secondary analysis of the Global Burden of Disease Study 2023 data to evaluate global incident gout trends from 1990 to 2023. Mean age at onset, proportion of young-onset cases (< 40 years), and sex-stratified patterns were analyzed using log-linear regression. Forecasting through 2040 was performed using time-series modeling.

RESULTS

Global incident gout cases increased by 158.2% between 1990 and 2023. Mean age at onset rose from 58.4 to 61.9 years, corresponding to an annual percent increase of approximately 0.18%. The proportion of young-onset cases declined from 15.8% to 9.8%. Males consistently exhibited earlier onset than females, with a stable ~ 4-year sex gap across the study period. Age-specific redistribution demonstrated progressive concentration of incident cases among individuals aged ≥ 60 years. Forecast modeling projects continued elevation in mean onset age to approximately 63.4 years by 2040.

CONCLUSIONS

The global expansion of gout burden is accompanied by aging of incident cohorts rather than earlier disease manifestation. These findings highlight the growing impact of demographic aging on gout epidemiology and underscore the need for age-adapted prevention and management strategies. Key Points • Global incident gout cases more than doubled between 1990 and 2023, demonstrating sustained expansion of disease burden worldwide. • Mean age at onset increased steadily over three decades, indicating progressive aging of incident gout cohorts. • The proportion of young-onset gout (40 years) declined substantially, reflecting redistribution of incidence toward older populations. • Forecast modeling projects continued elevation in age at onset through 2040, highlighting the growing influence of demographic aging on gout epidemiology.