Demographic, gender and ethnic disparities in COPD associated mortality trends among older adults (>55 years) with Alzheimer's disease in the United States, 1999-2020: a 20 year retrospective analysis using CDC WONDER database.

BACKGROUND

Alzheimer's disease (AD) is the 3rd leading cause of global deaths. COPD and AD have a bi-directional positive relationship, increasing the interrelated mortality.

OBJECTIVES

To analyze the mortality trends associated with COPD in Alzheimer's disease among older adults (>55 years of age) in the United States, using CDC WONDER data from 1999 to 2020.

METHODS

A retrospective analysis using the CDC WONDER database was conducted to analyse the mortality trends due to COPD in Alzheimer's disease patients, stratified by sex, race/ethnicity, census region, states and urbanization status.

RESULTS

A total of 58,495 deaths due to COPD-associated Alzheimer's disease occurred among older adults (aged >55 years). Overall mortality increased from an AAMR of 2.04 per 100,000 in 1999 to 5.19 per 100,000 in 2020 (AAPC=4.31%, p < 0.05). Men exhibited higher mortality than women (AAMR 4.00 vs. 3.58 per 100,000). Non-Hispanic Whites had the highest mortality (AAMR 4.04), followed by Hispanics (AAMR; 2.58) and Non-Hispanic Blacks (AAMR; 2.39). The mortality was highest in the Western region (AAMR; 4.3), followed by Southern region (AAMR; 4.14), Midwestern region (AAMR; 3.94) and least in Northeastern region (AAMR; 2.26). Non-Metropolitan areas exhibit higher AAMR (4.62) than Metropolitan areas (AAMR; 3.52). Tennessee, Kentucky, and Washington were the top 3 states with the highest mortality. Significant increases in mortality were observed across most demographic groups (p < 0.05).

CONCLUSION

These findings highlight the increasing COPD-related mortality among Alzheimer's patients and reveal significant disparities by sex, race, and urbanization status. Systemic inflammation, oxidative stress, and COPD-induced hypoxia may contribute to cognitive impairment and dementia. These results underscore the urgent need for targeted healthcare strategies and further research to address these disparities.