Abstract DP103: Trends In Vascular Dementia Related Mortalities among older adults in the United States (1999-2023)

Abstract

Background: Cerebrovascular diseases (CVDs) are major contributors to vascular dementia, the second most prevalent type of dementia. Despite its strong link to modifiable CVD risk factors, vascular dementia remains under-recognized. Understanding mortality trends and disparities is vital to addressing their growing impact, particularly among adults aged 45 and older. Methods: We performed a retrospective analysis utilizing CDC Wonder death certificate data from 1999 to 2023 to examine mortality in U.S. adults aged ≥45 years with vascular dementia related to cerebrovascular diseases (CVDs). Death Identification was done using ICD-10 codes F01.0-F01.3, F01.8 and F01.9 and I60–I69. Data was stratified by year, sex, race/ethnicity, urbanization level, and region. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Temporal trends were assessed using Joinpoint regression to estimate annual and average annual percent changes (APCs and AAPCs) with 95% confidence intervals. Two-tailed t test was used to determine statistical significance. Results: From 1999 to 2023, 205,706 U.S. deaths were linked to vascular dementia and cerebrovascular disease. The age-adjusted mortality rate (AAMR) increased from 0.74 to 14.87 per 100,000. Joinpoint analysis identified four distinct trend phases, with a consistent rise from 2009 onward (APC: 9.34%). Females had higher mortality (62.5%) and a greater AAMR increase than males. Mortality rates were higher in metropolitan vs. non-metropolitan areas and varied significantly by age, with older adults showing earlier and steeper rises. Racial disparities were evident, with the highest APC among non-Hispanic Whites (93.55%), followed by Black or African Americans (40.33%). States like Alaska and Tennessee had the highest mortality rates, while Vermont and Utah had the lowest. All U.S. census regions showed rising trends, most notably in the South and West. Conclusion: Vascular dementia-related mortality has increased in the U.S., with clear disparities by sex, age, race, and geography. Addressing modifiable vascular risk factors and ensuring equitable access to prevention and care are essential to reverse these trends and reduce the national burden.