NCHS - U.S. National Center for Health Statistics

11/13/2024 | Press release | Distributed by Public on 11/12/2024 23:10

Dementia Mortality Among Adults Age 65 and Older: United States, 2018-2022

By Ellen A. Kramarow, Ph.D., and Betzaida Tejada-Vera, M.S.

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In 2022, 288,436 deaths among U.S. adults age 65 and older were attributed to dementia as the underlying cause of death. These deaths include vascular dementia, unspecified dementia, Alzheimer disease, and other degenerative diseases of nervous system (including Lewy body dementia) (1). Compared with earlier years, dementia mortality increased in 2020, the first year of the COVID-19 pandemic in the United States (2,3). This report updates a previous publication (4), presenting age-adjusted death rates by sex, race and Hispanic origin, and place of death for adults age 65 and older with dementia as the underlying cause of death during 2018-2022.

Between 2018 and 2019, age-adjusted death rates for dementia were stable. Between 2019 and 2020, the rate increased by 10.2%, from 520.1 deaths per 100,000 standard population to 572.9 (Figure 1, Table 1). Between 2019 and 2020, death rates increased for men by 7.1% (from 440.5 to 471.6) and for women by 11.8% (567.7 to 634.5). Between 2020 and 2022, dementia death rates overall declined to 548.9 but remained higher than the 2018 and 2019 rates. Dementia death rates for women declined each year from 2020 (634.5) to 2022 (599.6). For men, death rates declined from 2020 (471.6) to 2021 (465.3) but were stable from 2021 to 2022 (464.6). Dementia death rates were higher for women than men throughout the period.

During 2018-2022, dementia death rates were higher for White non-Hispanic (subsequently, White) adults age 65 and older compared with Black non-Hispanic (subsequently, Black) and Hispanic adults (Figure 2, Table 2). Death rates for all groups were stable between 2018 and 2019; from 2019 to 2020, death rates increased from 370.6 to 425.8 for Hispanic adults, from 502.9 to 582.7 for Black adults, and from 555.3 to 608.0 for White adults. Dementia death rates for Black and White adults declined from 2020 to 2022, while rates for Hispanic adults were stable between 2020 and 2022.

Between 2018 and 2022, changes occurred in the place where dementia deaths occur. The percentage of deaths occurring in nursing homes or long-term care facilities declined from 53.6% in 2018 to 44.6% in 2022 (Figure 3, Table 3). During this period, deaths occurring at home increased from 23.7% to 30.4% of all dementia deaths. The percentage of deaths in hospice facilities increased from 6.4% to 6.6%, and the percentage in hospitals declined from 8.2% to 7.6%.

Data source and methods

Estimates in this report are based on the National Vital Statistics System mortality files, accessed via CDC WONDER (1). Dementia deaths are identified using the International Classification of Diseases, 10th Revision underlying cause-of-death codes F01, vascular dementia; F03, unspecified dementia; G30, Alzheimer disease; and G31, other degenerative diseases of nervous system, not elsewhere classified (5). Age-adjusted death rates were calculated using the direct method and the 2000 U.S. standard population (6). Pairwise comparisons of rates were conducted using a z test with an alpha level of 0.05. Changes in the distribution of place of death were assessed using the Cochran-Armitage test for trends, a modified chi-squared test.

References

  1. Centers for Disease Control and Prevention. CDC WONDER. About underlying cause of death, 2018-2022, single race.
  2. Chen R, Charpignon ML, Raquib RV, Wang J, Meza E, Aschmann HE, et al. Excess mortality with Alzheimer disease and related dementias as an underlying or contributing cause during the COVID-19 pandemic in the US. JAMA Neurol 80(9):919-28. 2023. DOI: https://doi.org/10.1001/jamaneurol.2023.2226.
  3. Gilstrap L, Zhou W, Alsan M, Nanda A, Skinner JS. Trends in mortality rates among Medicare enrollees with Alzheimer disease and related dementias before and during the early phase of the COVID-19 pandemic. JAMA Neurol 79(4):342-8. 2022. DOI: https://doi.org/10.1001/jamaneurol.2022.0010.
  4. Kramarow EA, Tejada-Vera B. Dementia mortality in the United States, 2000-2017. National Vital Statistics Reports; vol 68 no 2. Hyattsville, MD: National Center for Health Statistics. 2019.
  5. World Health Organization. International statistical classification of diseases and related health problems, 10th revision (ICD-10). 5th ed. 2016.
  6. Anderson RN, Rosenberg HM. Age standardization of death rates: Implementation of the year 2000 standard. National Vital Statistics Reports; vol 47 no. 3. Hyattsville, MD: National Center for Health Statistics. 1998.

Suggested citation

Kramarow EA, Tejada-Vera B. Dementia mortality in adults age 65 and older: United States, 2018-2022. NCHS Health E-Stats. 2024. DOI: https://dx.doi.org/10.15620/cdc/165795.

Figures

Figure 1. Age-adjusted dementia death rate among adults age 65 and older, by sex: United States,
2018-2022

[Link]
1Significantly lower in 2018 and 2019 than in 2020, 2021, and 2022 (p < 0.05).
2Significantly higher in 2020 than in 2021 and 2022 (p < 0.05).
3Significantly higher in 2021 than in 2022 (p < 0.05).
NOTES: Dementia deaths are identified according to the International Classification of Diseases, 10th Revision underlying cause-of-death codes: F01 (vascular dementia), F03 (unspecified dementia), G30 (Alzheimer disease), and G31 (other degenerative diseases of nervous system). Age-adjusted death rates were calculated using the direct method and the 2000 U.S. standard population.
SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data file.

Data table for Figure 1. Age-adjusted dementia death rate among adults age 65 and older, by sex: United States, 2018-2022

Data table for Figure 1. Age-adjusted dementia death rate among adults age 65 and older, by sex: United States, 2018-2022

Table 1. Number of live births, maternal deaths, and maternal mortality rates, by race and Hispanic origin and age: United States, 2018-2020
Year Number of deaths Death rate
Total Women Men Total Women Men
2018 263,172 177,280 85,892 520.2 567.3 439.5
2019 267,914 179,406 88,508 520.1 567.7 440.5
2020 299,834 202,684 97,150 572.9 634.5 471.6
2021 275,538 185,229 90,309 565.3 627.5 465.3
2022 288,436 193,143 95,293 548.9 599.6 464.6

NOTES: Rates are per 100,000 standard population. Dementia deaths are identified according to the International Classification of Diseases, 10th Revision underlying cause-of-death codes: F01 (vascular dementia), F03 (unspecified dementia), G30 (Alzheimer disease), and G31 (other degenerative diseases of nervous system). Age-adjusted death rates were calculated using the direct method and the 2000 U.S. standard population.
SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data file.

Figure 2. Age-adjusted dementia death rate among adults age 65 and older, by race and Hispanic origin: United States, 2018-2022

[Link]
1Significantly lower in 2018 and 2019 than in 2020, 2021, and 2022 (p < 0.05).
2Significantly higher in 2020 than in 2021 and 2022 and significantly higher in 2021 than in 2022 (p < 0.05).
3Significantly higher than Black non-Hispanic adults for all years (p < 0.05).
4Significantly higher than Hispanic adults for all years (p < 0.05).
NOTES: Dementia deaths are identified according to the International Classification of Diseases, 10th Revision underlying cause-of-death codes: F01 (vascular dementia), F03 (unspecified dementia), G30 (Alzheimer disease), and G31 (other degenerative diseases of nervous system). Age-adjusted death rates were calculated using the direct method and the 2000 U.S. standard population. Race groups are single race. People of Hispanic origin may be of any race.
SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data file.

Data table for Figure 2. Age-adjusted dementia death rate among adults age 65 and older, by race and Hispanic origin: United States, 2018-2022
Table 1. Number of live births, maternal deaths, and maternal mortality rates, by race and Hispanic origin and age: United States, 2018-2020
Year Number of deaths Death rate
Hispanic Black, non-Hispanic White, non-Hispanic Hispanic Black, non-Hispanic White, non-Hispanic
2018 14,609 20,566 220,612 370.2 505.9 553.7
2019 15,127 21,120 223,916 370.6 502.9 555.3
2020 18,222 25,235 247,155 425.8 582.7 608.0
2021 17,523 23,144 226,060 421.2 560.0 604.2
2022 18,802 22,973 236,850 424.2 527.2 586.7

NOTES: Rates are per 100,000 standard population. Dementia deaths are identified according to the International Classification of Diseases, 10th Revision underlying cause-of-death codes: F01 (vascular dementia), F03 (unspecified dementia), G30 (Alzheimer disease), and G31 (other degenerative diseases of nervous system). Age-adjusted death rates were calculated using the direct method and the 2000 U.S. standard population. Race groups are single race. People of Hispanic origin may be of any race.
SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data file.

Figure 3. Percent distribution of dementia deaths in adults age 65 and older, by place of death: United States, 2018-2022

[Link]
1Significant increasing trend by year (p < 0.05).
2Significant decreasing trend by year (p < 0.05).
NOTES: Dementia deaths are identified according to the International Classification of Diseases, 10th Revision (ICD-10) underlying cause-of-death codes: F01 (vascular dementia), F03 (unspecified dementia), G30 (Alzheimer disease), and G31 (other degenerative diseases of nervous system). Percentages may not add to 100 because of rounding.
SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data file.

Data table for Figure 3. Percent distribution of dementia deaths in adults age 65 and older, by place of death: United States, 2018-2022
Table 1. Number of live births, maternal deaths, and maternal mortality rates, by race and Hispanic origin and age: United States, 2018-2020
Year Total Home Hospice facility Hospital or medical facility Nursing home or long-term care facility Other or unknown
Number of deaths Percent Number of deaths Percent Number of deaths Percent Number of deaths Percent Number of deaths Percent Number of deaths Percent
2018 263,172 100.1 62,327 23.7 16,716 6.4 21,587 8.2 140,995 53.6 21,547 8.2
2019 267,914 100.0 64,780 24.2 17,574 6.6 21,509 8.0 141,221 52.7 22,830 8.5
2020 299,834 100.1 84,268 28.1 17,272 5.8 21,047 7.0 150,071 50.1 27,176 9.1
2021 275,538 100.0 88,157 32.0 17,867 6.5 20,553 7.5 122,991 44.6 25,970 9.4
2022 288,436 100.0 87,755 30.4 19,144 6.6 22,026 7.6 128,502 44.6 31,009 10.8

NOTES: Rates are per 100,000 standard population. Dementia deaths are identified according to the International Classification of Diseases, 10th Revision underlying cause-of-death codes: F01 (vascular dementia), F03 (unspecified dementia), G30 (Alzheimer disease), and G31 (other degenerative diseases of nervous system). Percentages may not add to 100 because of rounding.
SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data file.