Trends in Dementia Associated Mortality among Patients with Underlying Stroke: A Nationwide Retrospective Analysis...

Dementia contributes significantly to morbidity and mortality associated with stroke, which has been a leading cause of death and disability in the U.S. We aim to determine the stroke mortality trends in the older population with dementia in the U.S from 1999 to 2023.

Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database was utilized to analyze the death records of older patients (aged ≥ 65 years) listing stroke as the underlying cause and dementia as the contributing cause of death. Age-adjusted mortality rates were computed per 100,000 population, and their variations over time were estimated as annual percent changes (APC).

A total of 259,607 deaths occurred from stroke in older patients with dementia, with a 59% decrease in AAMR from 1999 (28.09) to 2023 (16.51). A stark rise in rates occurred from 1999 to 2001 (APC: 21.25; P < 0.05), followed by continuous declines until 2023. AAMRs were higher in females (26.3) than in males (21.9) and peaked in NH African Americans (29.5) and older adults aged 85 + years (114.73). Further rates peaked among non-metropolitan residents, the west (26.9), and the south regions (26.8).

Despite the decline in the dementia related mortality among older people with underlying stroke, the burden is still considerable and disproportionately affects females, NH African Americans, and non-metropolitan areas, therefore necessitating stroke-informed dementia care, better risk stratification, and even distribution of resources.