Motor Neuron Disease Mortality in the USA, 2010-2023: A Demographic, Geographic, and Temporal Analysis

Our objective was to calculate age-adjusted motor neuron disease (MND) mortality rates in the USA, 2010-2023, by year, age, sex, race, origin, period, and state. Amyotrophic lateral sclerosis makes up almost 80% of all MNDs.

Multiple-cause mortality data were obtained from the National Center for Health Statistics (NCHS) for years 2010-2023. Cases were included if code G12.2, the code for MND listed in the International Classification of Diseases, 10th Revision (ICD-10), was listed as a cause of death. Using the direct method, cases were age-adjusted to the 2000 US standard population and mortality rates were calculated.

The overall national MND-associated mortality rate was 2.07 per 100,000 population (95% CI 2.06, 2.09). Rates were highest in those aged 80+ years (13.69; 95% CI: 13.49, 13.89) at death, non-Hispanic (2.17; 95% CI: 2.15, 2.18), and male (2.50; 95% CI: 2.48, 2.52). Northern states had higher rates (2.26; 95% CI: 2.23, 2.29) with a rate ratio of 1.05 (95% CI: 1.04, 1.07) when compared to the middle state tier (2.14; 95% CI: 2.12, 2.17; p < 0.01). State rates ranged from 3.07 (95% CI: 2.75, 3.42) in Vermont to 1.41 (95% CI: 1.27, 1.57) in Hawaii. The average annual percentage change was -1.62, corresponding to a statistically significant negative trend.

MND-associated mortality rates were higher among northern states and among decedents who were male, White, or non-Hispanic, which is consistent with previous studies of US MND mortality. Decreasing mortality rates may indicate longer patient life spans due to increased treatment options and care access, but further research is needed.