2025 American Academy of Neurology Abstract Website

Wajeeh Hassan¹, Javeria Javeid¹, Areej Javeid¹, Nishitha Bujala², Muhammad Saim³, Mohammad Munim Zahoor⁴, Usama Ahmed⁵, Muhammad Shehryar Hussain¹, Sadia Akram⁶, Syed Inam⁷, Edwin Serrano⁸
¹Allama Iqbal Medical College, Jinnah Hospital, ²Kamineni Institute of Medical Sciences, ³Mass General Brigham, ⁴Geisinger Health, ⁵Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, ⁶Jinnah Sindh Medical University, ⁷Marshall Neurology, ⁸Medstar Georgetown University Hospital

Objective:

To examine trends of stroke and dementia-related mortality stratified by sex, race, and region among older adults in the United States (US) from 1999 to 2022 and the impact of COVID-19 on them.

Background:

Stroke and dementia, the two leading causes of neurological deaths globally, have an integrated relation with increased risk of stroke in patients with dementia and 1 in 3 patients with stroke developing dementia. Data for stroke and dementia-related mortality remain underexplored in the US.

Design/Methods:

We analyzed the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) for death certificates (1999-2022) of adults 65 years and older, with stroke (ICD-10 code: I60-I69) and dementia (ICD-10 codes: F01, F03, G30, and G31). Age-adjusted mortality rates (AAMR) per 100,000 and annual percent change (APC) were calculated through joint-point regression analysis.

Results:

Between 1999 and 2022, a total of 882,676 deaths attributed to stroke and dementia were reported. Overall, the AAMR increased from 70.1 in 1999 to 102 in 2022 [(APC 1999-2002 = 14.74*), (APC 2002-2006 = -10.9*); (APC 2006-2015 = -0.56); (APC 2015-2022 = 5.4*)]. Women had a higher AAMR (87.98) than men (80.89). The AAMR peaked during COVID-19 (2020-2021) [AAMR =103.4] showing a percentage change of 23% as compared to the pre-COVID period (1999-2019) [AAMR = 83.6]. AAMR varied by race [Non-Hispanic (NH) African Americans=112.4; NH Whites=85.8; NH American Indians=66.5; Hispanics=64.4; and NH Asians or Pacific Islanders=57.2] and by region [West=93.5; South=93.4; Midwest=88.9; and Northeast=61.9]. States above the 90^th percentile were Vermont, Oregon, Washington, South Carolina, and Alaska.

Conclusions:

Stroke and dementia-related mortality has spiked recently in the US from 2015 to 2022, among women and African Americans, especially during COVID-19. Insights gained from this study can help identify high-risk populations and inform healthcare service requirements for managing stroke and dementia in the US.