Abstract Wed164: Aging, Alzheimer's, and Stroke: A 25-Year Longitudinal Analysis of U.S. Mortality Trends

Introduction: Alzheimer’s Disease (AD) and stroke, both age-related conditions, share common risk factors including hypertension, smoking, diabetes, and the APOE E4 genotype, frequently coexisting in older adults. Research Question: How have stroke-related mortality patterns among AD patients changed in the U.S. from 1999 to 2023? Objectives: To examine disparities in stroke-related mortality among AD patients by sex, race/ethnicity, and geographic region. Methods: Age-adjusted mortality rates (AAMRs) per 100,000 in adults (65+) were obtained from CDC WONDER using ICD codes for AD (G30) and stroke (I60–I61, I63–I64, I69). Joinpoint regression estimated Annual Percent Change (APC) and Average APC (AAPC), with significance at p<0.01. Results: From 1999 to 2023, 154,323 stroke-related deaths occurred in AD patients, primarily in nursing homes (53.4%) and private residences (20%). The AAMR declined from 19.4 in 1999 to 10.5 in 2023 (AAPC: -2.6%, 95% CI: -3.0 to -2.3, p<0.000001). Women had higher AAMRs than men (15.9 vs. 12.6), though men saw a steeper decline (AAPC: -2.7%, 95% CI: -3.2 to -2.3, p<0.000001). Non-Hispanic (NH) Blacks had the highest AAMR (16.9), while NH Whites showed the greatest decline (AAPC: -2.7%, 95% CI: -3.2 to -2.3, p<0.000001). AAMRs ranged from 27 in Mississippi to 6 in New York, with the Northeast showing the largest decline (AAPC: -3.5%, 95% CI: -3.9 to -3.0, p<0.000001). Rural areas had higher AAMRs than urban (19.4 vs. 14.3), with both experiencing declining trends. Conclusion: Stroke-related mortality in AD patients has declined but remains unevenly distributed, with disparities among women, NH Blacks, rural communities and those from the West. Targeted interventions are needed.