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. 2025 Aug;46(8):3619-3629.
doi: 10.1007/s10072-025-08152-4. Epub 2025 Apr 3.

Mortality patterns in patients with type 2 diabetes mellitus and late-onset Alzheimer's disease in the United States: a retrospective analysis from 1999 to 2020

Ahmed Raza  1 , Eeshal Fatima  2 , Abu Huraira Bin Gulzar  2 , Mirza Ammar Arshad  3 , Zain Ali Nadeem  4 , Rahman Tanveer  5 , Syed Hashim Ali Inam  6 , Paul Ferguson  7
Affiliations

Mortality patterns in patients with type 2 diabetes mellitus and late-onset Alzheimer's disease in the United States: a retrospective analysis from 1999 to 2020

Ahmed Raza et al. Neurol Sci. 2025 Aug.

Abstract

Background: Late-onset AD refers to the occurrence of AD after the age of 65. It is the primary cause of late-onset dementia. Studies indicate that persons diagnosed with diabetes are more susceptible to late-onset AD. Diabetes manifests as insulin resistance, which can have significant effects on cognitive function and contribute to the development of AD.

Methods: The CDC WONDER database was used to determine the crude death rates (CR) and age-adjusted mortality rates (AAMRs) per 100,000 individuals, 65 years and above. Joinpoint Regression Program was used to examine the changes in AAMR in the form of annual percent change (APC) and average annual percent change (AAPC).

Results: From 1999 to 2020, late-onset AD and diabetes were associated with 185,059 deaths in the older US population, demonstrating an increasing trend (AAPC = 2.87). Females (20.38) had higher AAMR than males (19.62). Non-Hispanic (NH) African Americans experienced the highest AAMR (28.01), while non-Hispanic Asians experienced the lowest (16.09). AAMRs varied by region (West: 23.53, Midwest: 21.51, South: 21.0, Northeast: 13.50). States with the highest AAMR percent change were Nebraska and Louisiana; those with the lowest were Montana and New Hampshire. Most deaths occurred at hospice/nursing facilities (57.96%). Non-metropolitan areas showed a higher mortality burden (25.05) than metropolitan areas (19.02).

Conclusions: There was an increasing mortality trend for late-onset AD among the population with diabetes in the US, with high mortality in females, NH African Americans, and the Western region.

Keywords: CDC WONDER; Diabetes mellitus; Late-onset Alzheimer’s disease; Mortality.

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Conflict of interest statement

Declarations. Consent and ethical approval: The research is based on de-identified data and is not applicable to the consent of the participants and ethical approval. Study participants: The research is based on de-identified human death certificate data from the CDC WONDER database. Competing interest: The authors have no relevant financial or non-financial interests to disclose.

References

    1. Ong KL, Stafford LK, McLaughlin SA, Boyko EJ, Vollset SE, Smith AE et al (2023) Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the global burden of disease study 2021. Lancet 402:203–234. https://doi.org/10.1016/S0140-6736(23)01301-6/ATTACHMENT/7EFD851A-C4E7-4... - DOI
    1. Raghavan S, Vassy JL, Ho YL, Song RJ, Gagnon DR, Cho K et al (2019) Diabetes mellitus–related all-cause and cardiovascular mortality in a national cohort of adults. J Am Heart Assoc 8. https://doi.org/10.1161/JAHA.118.011295/SUPPL_FILE/JAH33838-SUP-0001-FIG...
    1. Saeedi P, Salpea P, Karuranga S, Petersohn I, Malanda B, Gregg EW et al (2020) Mortality attributable to diabetes in 20–79 years old adults, 2019 estimates: results from the International diabetes federation diabetes atlas, 9th edition. Diabetes Res Clin Pract 162. https://doi.org/10.1016/j.diabres.2020.108086
    1. Rosenquist KJ, Fox CS (2018) Mortality trends in type 2 diabetes. In: Cowie CC et al (eds) Diabetes in America, 3rd edn. National Institute of Diabetes and Digestive and Kidney Diseases (US); NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK568010/
    1. Li X, Feng X, Sun X, Hou N, Han F, Liu Y (2022) Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2019. Front Aging Neurosci 14. https://doi.org/10.3389/FNAGI.2022.937486/PDF

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