Abstract WP062: Trends and Disparities in Respiratory Disease and Stroke associated mortality Among Older Adults in the United States: A CDC WONDER Analysis (1999-2023)

Background: Stroke is the second leading cause of death worldwide, with about 5.5 million annual fatalities, and is closely associated with COPD—a progressive respiratory disease often linked with cardiovascular comorbidities that increase stroke risk. This risk intensifies in advanced COPD, underscoring the need for integrated care. Our study examines mortality trends and disparities among U.S. older adults with coexisting stroke and respiratory diseases, which complicate clinical management. Methods: Using CDC WONDER's Multiple Cause-of-Death database, we analyzed deaths from 1999 to 2023 with ICD−10 codes for stroke (I60−I64) and respiratory diseases (J00−J98). We calculated age-adjusted mortality rates (AAMR) per 100,000, stratified by gender, race, U.S. region, and metropolitan status. Crude rates were also examined across ten-year age groups. Join-point regression determined annual percentage changes (APC) and average annual percentage change (AAPC) with 95% confidence intervals. Statistical significance was defined as p < 0.05. Results: Over 24 years, 941,675 deaths involved stroke and respiratory diseases. The AAMR declined from 148.16 in 1999 to 69.4 in 2023 (AAPC: -3.21%; 95% CI: -4.19 to -2.22). Men had higher rates than women (191.98 to 81.76 vs. 122.51 to 59.9). The highest AAMRs were among Non-Hispanic Blacks (185.69 to 102), followed by Asian/Pacific Islanders (149.71 to 54.15), Whites (145.25 to 67.6), Native Americans (143.93 to 58.1), and Hispanics (126.66 to 61.27). Regionally, the West had the highest rates (167.99 to 68.91), then South (156.31 to 76.72), Midwest (143.28 to 65.01), and Northeast (122.72 to 59.82). Urban areas showed higher AAMRs (86.03) than rural areas (104.62). The highest crude mortality rate was in those aged 85+ (487.55 to 193.85). Conclusion: Mortality from concurrent stroke and respiratory disease has decreased overall but remains highest among males, Black populations, and residents of urban and Western regions. These disparities highlight the urgent need for targeted, equitable public health interventions to reduce mortality in these vulnerable groups.