Trends, Disparities, and Forecasting of Transient Ischemic Attack-related Mortality Among the Elderly: A 21-Year Retrospective Analysis
Hanzala Farooqi1, Muzamil Akhtar2, Rayyan Nabi1, Fiza Wali1, sara zakris3
1Islamic International Medical College, 2Gujranwala Medical College, 3Tulane University School of Medicine
Objective:
To explore trends in TIA-Related Mortality Among the Elderly
Background:
Transient ischemic attacks (TIAs) are brief neurological dysfunctions caused by temporary cerebral hypoperfusion, with an estimated half a million cases occurring annually in the U.S. They precede strokes in up to 20% of patients. Understanding long-term and projected TIA-related mortality trends is vital for guiding preventive strategies and healthcare planning.
Design/Methods:
We conducted a population-based retrospective analysis of mortality data from the CDC WONDER database (1999–2020), focusing on individuals aged 65 years and older with deaths attributed to TIA and related syndromes. Age-adjusted mortality rates (AAMRs per 100,000 population) were calculated and analyzed using Joinpoint regression to determine annual percent changes (APC) and average annual percent changes (AAPC). Future mortality trends (2021–2050) were projected using autoregressive integrated moving average (ARIMA), exponential smoothing (ETS), and neural network autoregression (NNAR) models in R (version 4.4.0), each with 95% prediction intervals.
Results:
The majority of TIA-related deaths occurred in females and individuals residing in long-term care or nursing facilities. Between 1999 and 2020, AAMRs declined in the early 2000s but rose slightly after 2015, with the highest rates observed in Colorado, Mississippi, North Dakota, and Nebraska. Forecasting analysis showed that TIA-related mortality is expected to remain largely stable through 2050, with ARIMA predicting a consistent trend, ETS indicating a modest decline, and NNAR projecting a mild nonlinear rise within overlapping confidence intervals. The Midwest exhibited the highest historical AAMR, with a continuing upward tendency forecasted for western states.
Conclusions:
TIA-related mortality among elderly U.S. populations demonstrates regional and demographic disparities, with women and residents of care facilities disproportionately affected. Projections suggest mortality rates will likely stabilize over the coming decades, reflecting potential improvements in early detection and secondary prevention. Targeted interventions and equitable access to cerebrovascular care remain crucial to sustain and enhance these favorable trends.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.