Objective:

Our objective is to identify the mortality patterns related to late-onset Alzheimer's Disease (AD) and diabetes mellitus in older adults in the United States (US), stratified by age, sex, race or ethnicity, region, state, and area; and to investigate any changes in the mortality trends.

Background:

Late-onset AD refers to the occurrence of AD after the age of 65. It is the primary cause of late-onset dementia. Studies indicate that persons diagnosed with diabetes are more susceptible to late-onset AD. Diabetes manifests as insulin resistance, which can have significant effects on cognitive function and contribute to the development of AD.

Design/Methods:

With the help of data retrieved from the CDC WONDER database, we were able to determine the crude death rates (CR) and age-adjusted mortality rates (AAMRs) per 100,000 individuals. We examined the changes in AAMR through annual percent change (APC) using Joinpoint regression.

Results:

From 1999 to 2020, late-onset AD and diabetes were associated with 185,059 deaths in the older US population, demonstrating an increasing trend (average APC = 2.87). Females (20.38) had higher AAMR than males (19.62). Non-Hispanic (NH) African Americans experienced the highest AAMR (28.01), while non-Hispanic Asians experienced the lowest (16.09). AAMRs varied by region (West: 23.53, Midwest: 21.51, South: 21.0, Northeast: 13.50). States with the highest AAMR percent change were Nebraska and Louisiana; those with the lowest were Montana and New Hampshire. Most deaths occurred at hospice/nursing facilities (57.96%). Non-metropolitan areas showed a higher mortality burden (25.05) than metropolitan areas (19.02).

Conclusions:

There was an increasing trend of late-onset AD and diabetes in the US, with high mortality rates in females, NH Black or African Americans, and in the West region. Future research should focus on targeted therapy for the vulnerable population, and the association between diabetes and AD should be studied to prevent its onset.