To evaluate trends and disparities in stroke mortality among adults with mental disorders (MDs) in the United States (US) from 1999-2022.
Mental disorders (MDs) are associated with an elevated risk of stroke, with 1 in 6 strokes being linked to mental health. Yet their mortality trends and disparities among adults in the US remain underexplored.
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 25 years and older, with MDs (ICD-10 code: F01-F99) and stroke (ICD-10 code: I60-I69). Age-adjusted mortality rates (AAMR) per 100,000, annual percent change (APC), and average annual percent change (AAPC) with a 95% confidence interval (CI) were calculated through joint-point regression and trends were analyzed across gender, year, race, region, and state.
Between 1999 and 2022, a total of 1,114,024 stroke-related deaths were reported among adults with mental disorders. Overall, the AAMR increased from 13.5 in 1999 to 27.4 in 2022, a two-fold increase [AAPC: 2.34*%; 95% CI, 1.9 to 3.1]. AAMR rose substantially from 2016 to 2022 [APC: 5.45*; 95% CI, 3.6 to 11.3)]. Males had higher AAMR (22.6) than females (19.1). Non-Hispanic (NH) African Americans/Blacks had the highest AAMR (27.8), followed by NH American Indians (21.6), NH Whites (21), Hispanics (13.9), and NH Asians/Pacific Islanders (11.4). Regionally, the Midwest had the highest AAMR (23.1), followed by South (22.1), West (20.6), and Northeast (15.9). States above the 90th percentile for AAMR were Oregon, Vermont, Washington, North Dakota, and South Carolina.
Our study demonstrates a significant increase in stroke-related mortality among adults with mental disorders, particularly from 2016 to 2022, among men, NH African Americans, and residents of the Midwest region. A collaborative care approach, involving mental health professionals, primary care providers, and specialists is needed to lessen the mortality burden.