Unmasking a Silent Surge: Mortality Trends due to Dementia in Hypertensive Older Adults: Insights from CDC-WONDER Database (1999-2023)
Maryam Saghir1, Nida Shoaib2, Eshal Saghir3, Hozefa mateen2, Muhammad Affan2, Hassan Khanzada4, Ryan Bean4, Shayan Marsia4
11.Jinnah Sindh Medical University, 2Jinnah Sindh Medical University, 3Dow University of Health Sciences, 4Corewell Health Hospitals
Objective:
To assess mortality trends for dementia in hypertensive older adults in the U.S. from 1999 to 2023, highlighting the disparities across demographics and regions.
Background:
Dementia is a leading neurological disorder characterized by progressive cognitive decline that represents a major public health burden globally. Hypertension, a common and modifiable risk factor, has been recognized as a key contributor to the development of cognitive impairment.
Design/Methods:
We analyzed mortality trends for dementia (ICD-10 code: G30, F01, F03) as an underlying cause of death in hypertensive (ICD-10 code: I10-I15) elderly, as the multiple cause of death, using the CDC-WONDER database from 1999 to 2023. Age adjusted mortality rates (AAMRs) per 100,000 were calculated and categorized by demographics and region. Joinpoint regression was used to estimate Annual Percent Change (APC) and Average Annual Percent Change (AAPC) with 95% confidence intervals.
Results:
From 1999 to 2023, dementia recorded 651,865 deaths among hypertensive elderly patients. The overall AAMR observed a significant incline from 10.5 to 84.4 (AAPC: 8.1; 95% CI: 7 to 9.2, p<0.01). Among the subgroups of dementia, Alzheimer’s disease reported the greatest mortality (48.3%). Women observed higher overall AAMR than men from (11.7 vs. 7.4) in 1999 to (95.4 vs. 66.8) in 2023. Racially, Non-Hispanic Black population had the highest overall AAMR (1999:11.8, 2023: 93.05, AAPC: 8.1, p< 0.01). Regionally, the highest overall AAMR was recorded by the Midwest (1999: 12.1, 2023: 88.9, AAPC: 7.9, p< 0.01). Non-metropolitan areas had higher AAMR than metropolitan areas (59.5 vs 54.8). State-level AAMRs ranged from 48.08 (Connecticut) to 188.2 (Oklahoma) in 2023.
Conclusions:
This nationwide analysis spanning from 1999 to 2023, demonstrated a marked rise in mortality rate due to dementia in hypertensive older adults. The escalating prevalence and mortality burden, underscore the urgent need for enhanced surveillance, preventive strategies, and targeted therapeutic interventions.
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