Hypertension and Diabetes as Risk Factors for Alzheimer's Disease-related Mortality, a Retrospective Epidemiological Study
Mirza Ammar Arshad1, Aishwarya Koppanatham2, Komal Zulfiqar3, Abu Huraira Bin Gulzar4, Umair Ahmed3, Thomas Varkey5
1Rahbar Medical and Dental College, 2Andhra Medical College, 3Allama Iqbal Medical College, 4Services Institute of Medical Sciences, 5Banner University Medical Center
Objective:
This study aimed to assess mortality trends associated with hypertension and diabetes-associated Alzheimer's disease (AD) across various demographics in the United States.
Background:
Hypertension and diabetes have been linked to elevated Alzheimer's disease mortality in US adults aged 65+ over the last decade, necessitating additional research.
Design/Methods:
Death certificates from the CDC Wonder database (1999-2020) were analyzed for multiple causes of death, including Alzheimer's disease (MCD-ICD 10 Codes: G30.0, G30.1, G30.8, G30.9), hypertension (I10-I15), and diabetes mellitus (E10-E14). Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated and categorized by gender, race/ethnicity, census region, and urbanization.
Results:
Between 1999 and 2020, there were 518,697 deaths related to Hypertension and diabetes-linked Alzheimer's disease among individuals aged 65 and above. The age-adjusted mortality rate (AAMR) rose from 26.95 in 1999 to 56.77 in 2005 (APC: 10.41, 95% CI: 7.06 to 16.09), slightly increased to 57.01 in 2015 (APC: -0.80, 95% CI: -4.42 to 0.49), and then sharp increase to 82.25 in 2020 (APC: 7.01, 95% CI: 3.83 to 14.39). Females consistently had higher AAMRs than males, from 28.02 vs. 24.00 in 1999 to 90.48 vs. 68.67 in 2020. Non-Hispanic (NH) Black or African American individuals had the highest overall AAMR (94.82), followed by Hispanic or Latino (88.85), NH White (82.75), NH Asian or Pacific Islander (54.02), and NH American Indian or Alaska Native (51.47). Non-metropolitan areas had a higher AAMR (97.95) compared to metropolitan areas (79.06). Regionally, the Western U.S. had the highest AAMR (93.92), followed by the Midwest (90.06), South (88.13), and Northeast (48.6).
Conclusions:
Hypertension and diabetes-associated Alzheimer's disease mortality rates consistently rose from 1999-2005, fluctuated until 2015, and increased again from 2015 to 2020. Non-Hispanic Black or African American, female, non-metropolitan, and West region populations exhibited higher mortality rates. Targeted research and prevention strategies are necessary.
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