Diabetic Alzheimer's Mortality vs Hypertensive Alzheimer's Mortality: A CDC WONDER Analysis of Comorbid Alzheimer's Deaths (1999-2020)
Zuha Tariq1, Faraz Ahmad1, Rameez Qasim1, Zain Shahzad1, Fasih Khalil Ur Rehman1, Ahmed Faizan1, Sophia Ahmed1, Mubashir Raza2, Syeda Sana Samar3, Syed Ijlal Ahmed4
1Allama Iqbal Medical College, 2Baqai Medical University, 3University of Kentucky, 4SSM Health Saint Louis University SOM
Objective:
To compare disparities in mortality trends of Alzheimer’s disease patients with comorbid diabetes versus Alzheimer’s disease patients with hypertension in the U.S. between 1999 and 2020.
Background:
Alzheimer’s disease (AD) is a rising health issue in the United States, especially when found along with comorbid diseases such as diabetes mellitus (DM) and hypertension (HTN). Both conditions are being increasingly linked with a heightened risk and mortality in AD.
Design/Methods:
The CDC WONDER database was used to extract data for individuals aged 65+ years with AD (G30) and co-listed DM (E10–E14) or HTN (I10–I15). Annual percent changes (APCs) and average annual percent changes (AAPCs) were determined using joinpoint regression and then stratified into subgroups. The age-adjusted mortality rates (AAMRs) per 100,000 were computed based on the U.S. 2000 standard population.
Results:
From 1999–2020, 185,200 deaths were recorded for AD+DM (AAMR: 20.13; AAPC: 2.89%) and 409,112 for AD+HTN (AAMR: 43.96; AAPC: 5.42%). AD+HTN mortality was almost twice as high as AD+DM mortality across all demographic and geographic strata. For AD+DM, men (AAMR:19.62) and women (AAMR:20.8) exhibited comparable AAMRs, while for AD+HTN, AAMR was higher for women (AAMR:48.76) than men (AAMR:35.08). AD+HTN mortality was highest in NH Black individuals (AAMR: 56.59) and rural areas (AAMR:49.61), with Mississippi recording the highest state-level AAMR (94.96). AD+DM mortality was highest among NH Black individuals (AAMR:28.02) and rural areas (AAMR:25.10), in the state of North Dakota (AAMR:32.68). Temporal trends showed early rises, a mid-period plateau/decline, and a sharp increase after 2018 in both groups, especially among those aged 85+, Hispanics, and West residents.
Conclusions:
Mortality due to AD is higher with comorbid hypertension than with comorbid diabetes, with notable variations by race, geography, and sex. The rapid and consistent rise in AD+HTN mortality highlights the pressing need for interdisciplinary cardiovascular and neurodegenerative disease prevention strategies, especially in vulnerable populations.
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