Background and aims: Pneumonia is a leading cause of death among Alzheimer’s disease (AD) patients, often due to complications like sepsis or respiratory failure. This study aims to analyze the joint mortality patterns of AD and pneumonia to provide an accurate update on the public health impact and help uncover modifiable factors that could mitigate the disease burden. Methods: In this retrospective observational study, deidentified CDC WONDER death certificate data (1999–2022) were analyzed for individuals aged 65+ with ICD-10 codes for AD (G30) and pneumonia (J09-J18). To identify cases of AD and pneumonia, death records from the Multiple Causes of Death Public Use registry were reviewed, with these conditions listed as either a contributing or underlying cause of death. Mortality rates were calculated, and trends were evaluated using the Joinpoint Regression Program (National Cancer Institute). Results: From 1999 to 2022, the overall mean age-adjusted mortality rate (AAMR) for AD- and pneumonia-related deaths was 21.33 (95% CI: 17.91–24.75). The AAMR declined significantly from 37 in 1999 to 11.32 in 2016 (APC: −7.20, 95% CI: −12.97 to −5.47; P = 0.03) and then remained stable until 2022 (APC: −0.79, P = 0.88). Males consistently had higher mortality (mean AAMR: 22.57) than females (20.39), with a notable decline in male AAMR from 42.36 in 1999 to 10.43 in 2022, and female AAMR from 33.81 to 8.58. Racial disparities were evident: NH Whites had the highest mean AAMR (22.21), followed by Hispanics (17.51), NH Blacks (14.81), and NH Asians (13.62). Regionally, the West had the highest AAMR (26.32), while the Northeast had the lowest (16.39). Metropolitan AAMR decreased significantly from 2004 to 2018 (APC: −8.41), while non-metropolitan areas showed a slower decline with a slight rise post-2018. Conclusion: Significant disparities in AD and pneumonia mortality highlight the need for targeted, community-focused interventions.
Faisal et al. (Tue,) studied this question.