Objective:

To evaluate the temporal trends and overlap between dementia and chronic kidney disease (CKD) related co-mortality from 1999 to 2023 in the United States.

Background:

Dementia and CKD are highly prevalent in the United States (US) population, and often cooccur. Mortality trends related to dementia and CKD in the US population are unknown. 

Design/Methods:

We analyzed the age-adjusted mortality rates (AAMR) in individuals with dementia and CKD captured within the Centre for Disease Control and Prevention WONDER database—a publicly-available population-based database that provides nationwide death certificate information and underlying causes of death. We used the “Multiple Cause of-Death” ICD-10 codes. Temporal trends were plotted, and annual percentage change (APC) calculated using the joinpoint regression models. We further assessed the association between mortality trends and sex, race, and age.

Results:

21,8981 deaths were reported in individuals with dementia and CKD from 1999-2023; 98.6% of individuals were ≥65-years-old at death. The AAMR increased from 1999-2012 (APC: +12.6%; 95% CI: 2.6–22.9), decreased from 2012-2015 (APC: -13%; 95% CI: -20.9–-22.9); and increased again from 2015-2023 (APC: +6.2%; 95% CI: 0.9–18.9). AAMR were higher in males (AAMR 2.87; p < 0.001) than females (AAMR: 2.24; p <0.001), and in Black (AAMR: 4.12; p < 0.001) versus White (AAMR: 2.3; p < 0.001) and Asian/Pacific Islander Americans (AAMR: 2.6; p < 0.001). The highest burden of co-mortality was observed in people living in the Midwest (AAMR: 2.71; p < 0.001), followed by South (AAMR: 2.58; p < 0.001) and West (AAMR: 2.57; p < 0.001) regions of the United States. 

Conclusions:

Mortality rates attributed to dementia and CKD are increasing among older Americans, with disproportionate effects experienced by males and Black Americans.