Abstract
BACKGROUND: Older adults in high-income countries face an increasing burden of musculoskeletal (MSK) disorders. Although the belief that meteorological variations influence musculoskeletal conditions is widespread, scientific evidence remains inconclusive. This study aimed to explore these meteorology-health relationships. METHODS: Using publicly available data from the Global Historical Climatology Network Daily, Behavioral Risk Factor Surveillance System and the Global Burden of Disease Study 2021, we investigated associations between inter-annual meteorological factors variability (temperature, humidity, wind speed, barometric pressure) and musculoskeletal burdens, measured by disability-adjusted life years, among adults aged ≥55 in the United States. Penalized Generalized Additive Models were employed to investigate the potential associations for rheumatoid arthritis, osteoarthritis, low back pain, neck pain, gout, and other musculoskeletal diseases. State-level Socio-demographic Index and behavioral indicators (obesity prevalence and smoking rate) were included as covariables, and population density and healthcare access indices were incorporated in sensitivity analyses. RESULTS: Musculoskeletal burdens among older U.S. adults substantially exceeded global averages (6,205.82 vs. 4,837.46 per 100,000), particularly for other musculoskeletal disorders in females and gout in males. Burdens generally increased from 2013 to 2021, except for rheumatoid arthritis and low back pain. Incorporating meteorological terms, jointly accounted for SDI, behavioral risk factors and residual temporal trends, improved model performance and revealed non-linear exposure-response patterns with potential thresholds. Inter-annual variations in temperature and humidity consistently exhibited significant associations with disease burden, while wind speed and barometric pressure also associated with burden. Sex-based heterogeneity emerged, most prominently for gout and rheumatoid arthritis. CONCLUSIONS: Our findings highlight consistent population-level associations between inter-annual meteorological variability and MSK burdens among older U.S. adults. These associations may reflect direct environmental influences as well as broader behavioral, infrastructural, and contextual contexts, underscoring the need for context-sensitive and sex-specific public-health strategies for aging populations.