Objective:

This observational study aimed to assess demographic and regional disparities in mortality due to dementia and comorbid sepsis in older adults (≥65 years) in the United States from 1999 to 2020.

Background:

Dementia and sepsis are major contributors to morbidity and mortality among older adults. While mortality trends for these conditions have been studied separately, the combined impact of dementia with comorbid sepsis remains underexplored.

Design/Methods:

We analyzed death certificate data from the CDC WONDER Multiple Cause of Death database (1999–2020) for adults aged ≥65. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated, standardized to the 2000 U.S. population. Trends were assessed using Joinpoint regression to estimate annual percentage change (APC) with 95% confidence intervals (CIs). Mortality trends were stratified by age, sex, race/ethnicity, geographic region, and urban–rural classification.

Results:

From 1999 to 2020, dementia and sepsis accounted for 284,645 deaths, with an overall AAMR of 30.8 (95% CI: 30.7-30.9). Mortality remained stable over time [average annual percent change (AAPC): 0.20%; 95% CI: –0.19 to 0.60]. Males had higher mortality than females (31.8 vs. 30.0 per 100,000). Non-Hispanic (NH) Black individuals had the highest burden (AAMR: 51.8), whereas Hispanic and NH Asian/Pacific Islander individuals showed the steepest increases. Crude mortality rose with age, highest among those  ≥85 years (136.1 per 100,000), but the largest relative increase was seen in ages 75-84. Regionally, the South had the greatest mortality burden (AAMR: 35.8). Rural areas had consistently higher mortality (AAMR: 31.7).

Conclusions:

Mortality from dementia with comorbid sepsis has remained stable overall but reveals significant disparities by sex, race/ethnicity, geography, and urban–rural status. These findings highlight the need for targeted strategies to address high-risk populations and reduce the mortality burden associated with these conditions.