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

Publication ,  Journal Article
Akushevich, I; Yashkin, AP; Yashin, AI; Kravchenko, J
Published in: J Am Geriatr Soc
August 2021

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.

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Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

August 2021

Volume

69

Issue

8

Start / End Page

2306 / 2315

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Male
  • Humans
  • Geriatrics
  • Female
  • Databases, Factual
  • Comorbidity
  • Cause of Death
  • Alzheimer Disease
 

Citation

APA
Chicago
ICMJE
MLA
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Akushevich, I., Yashkin, A. P., Yashin, A. I., & Kravchenko, J. (2021). Geographic disparities in mortality from Alzheimer's disease and related dementias. J Am Geriatr Soc, 69(8), 2306–2315. https://doi.org/10.1111/jgs.17215
Akushevich, Igor, Arseniy P. Yashkin, Anatoliy I. Yashin, and Julia Kravchenko. “Geographic disparities in mortality from Alzheimer's disease and related dementias.J Am Geriatr Soc 69, no. 8 (August 2021): 2306–15. https://doi.org/10.1111/jgs.17215.
Akushevich I, Yashkin AP, Yashin AI, Kravchenko J. Geographic disparities in mortality from Alzheimer's disease and related dementias. J Am Geriatr Soc. 2021 Aug;69(8):2306–15.
Akushevich, Igor, et al. “Geographic disparities in mortality from Alzheimer's disease and related dementias.J Am Geriatr Soc, vol. 69, no. 8, Aug. 2021, pp. 2306–15. Pubmed, doi:10.1111/jgs.17215.
Akushevich I, Yashkin AP, Yashin AI, Kravchenko J. Geographic disparities in mortality from Alzheimer's disease and related dementias. J Am Geriatr Soc. 2021 Aug;69(8):2306–2315.
Journal cover image

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

August 2021

Volume

69

Issue

8

Start / End Page

2306 / 2315

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Male
  • Humans
  • Geriatrics
  • Female
  • Databases, Factual
  • Comorbidity
  • Cause of Death
  • Alzheimer Disease