Objective:

We aimed to examine nationwide demographic trends of early-onset Alzheimer’s disease-related mortality (EOAD-RM) from 2003 to 2023. Additionally, we analyzed differences in EOAD-RM based on sex, race/ethnicity, and region.

Background:

The overall prevalence of early-onset Alzheimer’s disease (EOAD), defined as onset prior to 65 years, is estimated to be around 5-10%. While EOAD is rare, it is characterized by a more aggressive course than late-onset AD. Epidemiological data on EOAD and its related mortality remain limited.

Design/Methods:

This retrospective population-based study utilized data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiological Research (CDC WONDER) mortality records. We used International Classification of Diseases (ICD) code G30.0 to identify EOAD-RM. Data were stratified by sex, race/ethnicity, and region. Trends in age-adjusted mortality rates (AAMRs) were examined using joinpoint regression.

Results:

There were 5,167 EOAD-related deaths (62.4% female) in the United States over the study period. From 2003 to 2023, the AAMR increased approximately 25-fold, from 0.08 to 2.06 (95% CI 1.93-2.20) per one million population. The annualized percentage change (APC) was 19.9% (95% CI 17.98-21.82) between 2015 and 2023. This increase in mortality was seen irrespective of sex, race/ethnicity, or region. During the same period, females exhibited a faster rise in AAMR compared to males. Black or African American individuals showed the greatest relative increase (206%) between 2018 and 2023. Regionally, the West and Midwest experienced the largest rises, with AAMRs increasing 632% and 741%, respectively.

Conclusions:

The rapid increase in EOAD-RM in recent years underscores the growing burden of EOAD in the United States, the need to investigate underlying causes, and the need for effective treatments. These findings may shed light on EOAD prevalence, incidence, and contributing factors in order to improve clinical outcomes.