Estimates of the Association of Dementia With US Mortality Levels Using Linked Survey and Mortality Records

Stokes, Andrew; Weiss, Jordan; Lundberg, Dielle J.; Xie, Wubin; Kim, Jung Ki; Preston, Samuel H.; Crimmins, Eileen M.

doi:10.1001/jamaneurol.2020.2831

Cited by 59 publications

(67 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4 However, death certification records are subject to error, with neurodegenerative disease diagnoses often underreported. 26 To address this, the present analysis included all available health records to identify incident neurodegenerative disease in both community and hospital settings, as well as deaths. Using this more complete ascertainment of neurodegenerative disease, we confirmed an approximately 3.5-fold higher risk of neurodegenerative disease among a cohort of Scottish male former professional soccer players, which corroborates our previous mortality analysis.…”

Section: Discussionmentioning

confidence: 99%

Association of Field Position and Career Length With Risk of Neurodegenerative Disease in Male Former Professional Soccer Players

et al. 2021

View full text Add to dashboard Cite

Key Points Question What is the association of field position, career length, and playing era with risk of neurodegenerative disease in male former professional soccer players? Findings In this cohort study of 7676 Scottish male former professional soccer players and 23 028 general population control individuals matched by sex, year of birth, and area socioeconomic status, risk of neurodegenerative disease among former soccer players varied by field position and career length but was similar across era of participation. Meaning In this study, risk of neurodegenerative disease was higher among former professional soccer players with longer careers and among those in nongoalkeeper positions, indicating that factors associated with nongoalkeeper positions should be scrutinized to mitigate risk; meanwhile, strategies to reduce head impact exposure may be advisable to reduce negative outcomes in this population.

show abstract

Section: Discussionmentioning

confidence: 99%

Association of Field Position and Career Length With Risk of Neurodegenerative Disease in Male Former Professional Soccer Players

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Further progress in the analyses of geographic disparities can be made through analysis of survey (such as Health and Retirement Study) and/or electronic health records for elderly populations (such as Medicare data) linked to MCD data to test whether the patterns observed in MCD data can be predicted by incidence‐based mortality for a specific disease and if other disease‐related factors such as competing risk from cardiovascular diseases or other conditions contribute to the final cause of mortality documented on the death certificates. Interconnections between these types of data for AD/ADRD outcomes have been recently studied 20,21 . Stokes et al, 21 for example, demonstrated that routine mortality statistics may underestimate the mortality burden associated with dementia.…”

Section: Discussionmentioning

confidence: 99%

Geographic disparities in mortality from Alzheimer's disease and related dementias

Akushevich

Yashkin

Yashin

et al. 2021

J American Geriatrics Society

View full text Add to dashboard Cite

Objectives The regions with highest and lowest Alzheimer's disease (AD) mortality across the United States at state/county levels were identified and their contribution to the differences in total mortality rates between these regions was evaluated. The disease, disease group, sex, race/ethnicity, and place‐of‐death‐related inter‐region differences that engender the disparity in mortality were quantitatively described. The hypothesis that inter‐regional differences in filling out death certificates are a major contributor to differences in AD mortality was tested. Design Retrospective evaluation of death certificate data. Setting The United States. Participants Deceased US residents, 1999–2018. Methods Region‐specific age‐adjusted mortality rates and group‐specific rate decomposition. Results The county clusters with the highest and lowest AD mortality rates were in Washington (WA) and New York (NY), respectively, with other notable high‐mortality clusters on the border of Tennessee, Georgia, and Alabama as well as in North Dakota and South Dakota. These patterns were stable over the 1999–2018 period. AD had the highest contribution to total mortality difference between WA and NY (156%, higher in WA), in contrast circulatory diseases had a contribution of comparable magnitude (154%) but were higher in NY. Differences in cause‐of‐death certificate coding, either through coding of non‐AD dementias, or other conditions accompanying a potential AD death could not account for differences in AD mortality between NY and WA. Conclusions Inter‐regional differences in filling out death certificates were not a major contributor to variation in AD mortality between the regions with the highest and lowest rates. The respective mitigation of the effects of neural and circulatory diseases and several other high‐impact conditions would not negate the disparity in mortality between NY and WA.

show abstract

“…A study using data from the Rush Memory and Aging Project and the Religious Orders Study estimated that 500,000 deaths among people age 75 and older in the United States in 2010 could be attributed to Alzheimer's dementia (estimates for people age 65 to 74 were not available), meaning that those deaths would not be expected to occur in that year if those individuals did not have Alzheimer's dementia 338 . A more recent study using data from the nationally representative Health and Retirement Study estimated that about 14% of deaths in Americans age 70 and older from 2000‐2009 were attributable to dementia, while only 5% of death certificates listed dementia as the underlying cause of death for this age group in that time period, indicating underreporting on death certificates 339 . According to 2014 Medicare claims data, about one‐third of all Medicare beneficiaries who die in a given year have been diagnosed with Alzheimer's or another dementia 340 .…”

Section: Mortality and Morbiditymentioning

confidence: 99%

2021 Alzheimer's disease facts and figures

2021

Alzheimer's & Dementia

1,800

849

View full text Add to dashboard Cite

This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on caregivers and society. The Special Report discusses the challenges of providing equitable health care for people with dementia in the United States. An estimated 6.2 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available, making Alzheimer's the sixth‐leading cause of death in the United States and the fifth‐leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated in 2020 by the COVID‐19 pandemic. More than 11 million family members and other unpaid caregivers provided an estimated 15.3 billion hours of care to people with Alzheimer's or other dementias in 2020. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $256.7 billion in 2020. Its costs, however, extend to family caregivers’ increased risk for emotional distress and negative mental and physical health outcomes — costs that have been aggravated by COVID‐19. Average per‐person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2021 for health care, long‐term care and hospice services for people age 65 and older with dementia are estimated to be $355 billion. Despite years of efforts to make health care more equitable in the United States, racial and ethnic disparities remain — both in terms of health disparities, which involve differences in the burden of illness, and health care disparities, which involve differences in the ability to use health care services. Blacks, Hispanics, Asian Americans and Native Americans continue to have a higher burden of illness and lower access to health care compared with Whites. Such disparities, which have become more apparent during COVID‐19, extend to dementia care. Surveys commissioned by the Alzheimer's Association recently shed new light on the role of discrimination in dementia care, the varying levels of trust between racial and ethnic groups in medical research, and the differences between groups in their levels of concern about and awareness of Alzheimer's disease. These findings emphasize the need to increase racial and ethnic diversity in both the dementia care workforce and in Alzheimer's clinical trials.

show abstract

Estimates of the Association of Dementia With US Mortality Levels Using Linked Survey and Mortality Records

Cited by 59 publications

References 40 publications

Association of Field Position and Career Length With Risk of Neurodegenerative Disease in Male Former Professional Soccer Players

Association of Field Position and Career Length With Risk of Neurodegenerative Disease in Male Former Professional Soccer Players

Geographic disparities in mortality from Alzheimer's disease and related dementias

2021 Alzheimer's disease facts and figures

Contact Info

Product

Resources

About