2026 American Academy of Neurology Abstract Website

Ali Zubair¹, Aleena Sharif², Husnain Ahmad³, Minahil Zaheer⁴, Zohra Jabbar⁵, Affan Mudassar¹, Muhammad Haseeb Ahmad⁶, Dr wishad Waris¹, Sara Sharif¹, Syeda Malaika Mushtaq¹
¹Sheikh Zayed Medical College, Rahim Yar Khan, ²Sheikh Zayed Hospital, Lahore, ³Shalamar Medical and Dental College, Lahore, ⁴Hazrat Barisarkar Medical and Dental College, Islamabad, ⁵Shahida Islam Medical College, Lodhran, ⁶Sheikh Zayed Medical College, Rahim Yar Khan,Pakistan

Objective:

To examine disparities in Atrial Fibrillation related mortality among AD patients by sex, race/ethnicity, and geographic region, using national trends and future projections

Background:

Atrial Fibrillation has been linked to increased risk of dementia such as Alzheimer's Disease (AD) due to cerebral hypoperfusion, increased systemic inflammation and even impaired ability of brain to remove amyloid-beta plaques.

Design/Methods:

Age-adjusted mortality rates (AAMRs) per 100,000 in adults (65+) were obtained from CDC WONDER using ICD codes for AD (G30) and Atrial Fibrillation (I48). Joinpoint regression estimated Annual Percent Change (APC) and Average APC (AAPC), with significance set at p<0.05.Following the ADF/KPSS and Box-Ljung tests, ARIMA models with Box-Cox transformation were fitted for forecasting, and residual diagnostics were performed for model validation.

Results:

From 1999–2023, 139,580 Alzheimer’s disease–related deaths involved atrial fibrillation (mean AAMR: 12.37 per 100,000). Mortality rose sharply from 6.8 to 19.1, peaking in 2020 (APC: 6.69; 95% CI: 5.27–8.14). The ARIMA forecasting model predicted a rise in AAMR to 22.85 (95% CI: 17.01–28.68) by 2035 (ACDF p = 0.75; Box-Ljung test p = 0.90). Females accounted for 64.8% of deaths and had a higher AAMR compared with males (12.5 vs. 11.8). Non-Hispanic White individuals comprised 94% of deaths (AAMR: 12.96). The South showed the highest regional burden (AAMR: 11.78), while Oregon and Minnesota had the greatest state-level AAMRs (46.7 and 39.2, respectively). Urban–rural differences were modest, but higher rates were observed in non-metropolitan areas.

Conclusions:

Alzheimer’s disease related mortality involving atrial fibrillation has nearly tripled since 1999, with persistent disparities by sex, race, and geography. The South and non-metropolitan regions bear the highest burden, disproportionately affecting White individuals and women. These trends underscore the urgent need for integrated neurocardiac care, equitable resource allocation, and early rhythm control strategies in aging populations.