Epidemiological Trends in Neurodegenerative Disease Mortality in the United States (1999–2023): Insights from CDC WONDER
Syeda Sana Samar1, Sophia Ahmed2, Saeed Aftab Khan2, Mahrukh Iqbal2, Muhammad Muaaz Sajid2, Muhammad Hamza Shoaib2, Oshaz Fatima3, Zainab Arshad2, Syed Ijlal Ahmed4
1University of Kentucky, 2Allama Iqbal Medical College, Lahore, Pakistan, 3Department of Medicine, King Edward Medical University, 4SSM Health Saint Louis University
Objective:
To assess national mortality trends, demographic disparities, and geographic variations associated with major neurodegenerative diseases in the United States from 1999 to 2023.
Background:

Neurodegenerative disorders including Alzheimer, Parkinson, Huntington, motor neuron disease, and other degenerative nervous system conditions are rising globally with aging populations. Despite their growing impact, population-level mortality patterns and disparities across demographic and regional strata remain understudied. Defining these trends can help target prevention, improve care delivery, and inform health policy.

Design/Methods:

We conducted a population-based analysis using the CDC WONDER Multiple Cause-of-Death (MCOD) database. Deaths were identified using ICD-10 codes G20, G10, G30, G31, and G12.2. Age-adjusted mortality rates (AAMRs) were standardized to the 2000 U.S. population and stratified by sex, race/ethnicity, region, urbanization, and place of death. Temporal trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC).

Results:

Between 1999 and 2023, 4,589,315 deaths were attributed to neurodegenerative disorders (AAMR: 53.0). Mortality increased steadily (AAPC: 1.75). Females had higher AAMRs than males (49.4 vs. 47.3). Non-Hispanic Whites had the highest AAMR (75.6), while Asian/Pacific Islanders had the lowest (40.3). The South showed the highest regional AAMR (77.2) and steepest growth (AAPC: 2.16). Rural mortality exceeded urban (74.0 vs. 70.8), with both increasing over time. Most deaths occurred in long-term care facilities (2.2 million), followed by home and hospice settings, which rose markedly in recent years.

Conclusions:

Neurodegenerative disease mortality has increased significantly over two decades, with marked demographic and geographic disparities. Higher mortality among females, non-Hispanic Whites, rural residents, and those in the South highlights the need for targeted interventions, equitable care access, and enhanced surveillance to address this growing public health burden.

10.1212/WNL.0000000000216841
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