Mortality Due to Dementia and Heart Failure Among Older Adults in the United States from 1999 to 2023: A 24-Year Retrospective Analysis
Abdul Raheem Malik1, Syeda Takreem Fatima2, Taha Khalid3, Marium Meghani4, Ahmed Raza2, Ali Athar5, Jaweria Nawaz4, Syed Inam6
1Continental Medical College, Lahore, Pakistan, 2Services Institute of Medical Sciences, Lahore, Pakistan, 3St Mary’s Medical Center, West Virginia, USA, 4Dow University of Health Sciences, Karachi, Pakistan, 5Shalamar Medical and Dental College, Lahore, Pakistan, 6Louisiana State University School of Medicine, New Orleans, USA.
Objective:

 To analyze the mortality rates due to dementia and heart failure (HF) in the US from 1999 to 2023. 


Background:

HF is a significant contributor to multiple chronic diseases and is closely linked to cognitive decline. Dementia is more frequently observed in individuals with HF than in the general population, highlighting a bidirectional relationship between the two diseases.


Design/Methods:

The descriptive study utilized the CDC WONDER database to analyze age-adjusted mortality rates (AAMRs) per 100,000 older adults (≥65) for HF and dementia from 1999 to 2023. Average annual percentage changes (AAPCs) were calculated using the Joinpoint Regression Program. 


Results:

From 1999 to 2023, dementia and HF caused a total of 785,002 deaths among older adults in the US. The AAMR for the entire cohort increased from 48.48 (95% CI: 48.09 – 49.58) in 1999 to 75.37 (74.62 – 76.13) in 2023, with a significant AAPC of 1.70% (0.43 – 3.00), indicating an increasing trend. Females showed consistently higher AAMRs than males. The AAMRs were also consistently higher in the non-Hispanic (NH) White individuals compared to other racial and ethnic groups. The NH Black individuals showed the highest increase in mortality as compared to other races (AAPC: 2.47%). When stratified by census regions, the Northeast had the highest AAMRs, while the Midwest had the lowest. The AAPC was the highest in the Northeast (1.88%), while the lowest was in the South (1.40%). The AAMRs were higher in the non-metropolitan areas than in the metropolitan areas.


Conclusions:

The dementia and HF-related mortality exhibited an overall increasing trend. Variations in mortality rates had been noted when the cohort population was stratified by sex, race/ethnicity, census region, and urbanization. Targeted healthcare reforms are required to address these disparities. 


10.1212/WNL.0000000000215542
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