AUTHOR=Yuan Kong-Jun , Zhu Dan , Huang Zeng-Jin , Zhong Jia-Ming , Shi Si-Xiong , Lin Lin , Zhou Ji-Xiang , Jiao Gen-Long , Zheng Shuai 
  
TITLE=Population aging and divergent burden trajectories of fall-related spinal cord injury: a cross national analysis
  
JOURNAL=International Journal of Public Health
  
VOLUME=Volume 71 - 2026
  
YEAR=2026
  
URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2026.1609458
  
DOI=10.3389/ijph.2026.1609458
  
ISSN=1661-8564
  
ABSTRACT=ObjectivesTo examine how population aging influences the burden of fall-related spinal cord injury (SCI) across countries at different demographic stages.MethodsUsing GBD 2023 data, we analyzed age-standardized incidence, prevalence, and years lived with disability (YLD) rates of fall-related SCI in India, China, the United States, and Japan. Trends and drivers were assessed using EAPC, joinpoint regression, age-period-cohort models, and demographic decomposition.ResultsChina showed a significant increase in incidence (AAPC = 1.62%, 95% CI: 0.89–2.36) with a rise-peak-decline-rebound pattern. The United States maintained stable incidence but achieved a marked reduction in YLD burden (AAPC = −2.58%, 95% CI: −3.13 to −2.03). India and Japan exhibited lower burdens and sustained improvements; India’s YLD rate declined by 1.58% annually (95% CI: −1.93 to −1.22). APC analysis identified an age-progressive risk pattern in China but age-regressive patterns in the United States and India. Population aging was the main driver of increased prevalence in China (39.53%).ConclusionFall-related SCI burden varies across demographic stages. Population aging is a key determinant in aging societies, highlighting the need for stage-specific prevention and care strategies.