2025 American Academy of Neurology Abstract Website

Objective:

We sought to elucidate temporal trends and disparities in aspiration pneumonia related mortality in patients with Alzheimer’s disease.

Background:

Aspiration pneumonia is a major cause of mortality in older adults with Alzheimer’s disease, however, data regarding mortality trends is scarce.

Design/Methods:

We conducted a retrospective analysis using the CDC WONDER dataset, extracting age-adjusted mortality rates (AAMR) per 100,000, calculating the annual percentage change (APC) and the average annual percentage change (AAPC), through Joinpoint regression.

Results:

A total of 115,284 deaths were attributed to aspiration pneumonia in older patients (>65 years old) with Alzheimer’s disease. During this period, the AAMR declined considerably from 15.49 to 8.62, reflecting an average annual percentage change (AAPC) of -2.94 (95% CI: -3.81 to -2.16). A higher AAMR was reported among the male (14.73, 95% CI: 14.60 to 14.86) cohort than the females (11.11, 95% CI: 11.03 to 11.20), with both cohorts experiencing a decline over the duration of the study. Profound racial/ethnic variations were observed, with NH White (13.0) cohort exhibiting the highest AAMR, followed by Hispanic or Latino (10.69), NH Black or African Americans (9.6) and NH American Indians/Alaska Natives (9.57), while NH Asian/Pacific Islanders (7.50) had the lowest AAMRs. Pronounced disparities were observed across the U.S states, with the highest AAMR reported in Rhode Island (32.93) nearly 8 times that of the lowest AAMR reported in New York (4.32). Regionally, the highest AAMR was recorded in the West (15.32), followed by the South (13.27) and Midwest (11.49), while the Northeastern (9.21) region reported the lowest. Marked variation were also noted across urban-rural classifications, large metropolitan (11.95) areas reported lower AAMRs than micropolitan (14.18) areas.

Conclusions:

Mortality from aspiration pneumonia declined over time but pronounced disparities across sex, race, and region endure. Targeted interventions are needed to address persistent disparities and improve outcomes for high-risk populations.