Nationwide trends and forecasts in Alzheimer's and cerebrovascular disease-related mortality in the United States, 1999-2023: A CDC WONDER analysis.

ObjectiveTo describe nationwide mortality patterns related to Alzheimer's disease and cerebrovascular disease in United States adults aged ≥65 years and explore future trend projections.MethodsIn this retrospective study, we utilized the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database (ICD-10 G30, I60-I69) to calculate crude and age-adjusted mortality rates per 100,000 population. Temporal trends were modeled using Joinpoint regression, and 10-year forecasts were obtained using autoregressive integrated moving average models. Subgroup analyses were performed by sex, race/ethnicity, census region, urbanization, and place of death.ResultsWe identified 199,606 Alzheimer's disease-cardiovascular disease-related deaths. Overall, age-adjusted mortality rates peaked at 24.8 in 2002, reduced to 14.2 in 2013, and then rose to 18.7 in 2020 before dropping to 16.6 in 2023. Women exhibited higher age-adjusted mortality rates than men (20.1 vs. 16.0). Individuals of White and Black ethnicity bore the greatest burden, and the South and West recorded the highest regional age-adjusted mortality rates. These rates were consistently higher in non-metropolitan areas than in metropolitan areas. Exploratory projections estimate an overall age-adjusted mortality rate of 16.6 by 2033, with persistently higher rates in women, non-Hispanic Black populations, and among those residing in the West and non-metropolitan areas.ConclusionsDespite substantial decline since the early 2000s, Alzheimer's disease-cardiovascular disease mortality remains high and unevenly distributed. Exploratory projections suggest that the burden will remain substantial, underscoring the need for targeted prevention, vascular risk reduction, and equity-focused dementia care.