Mortality trends and disparities among older adults with coexisting diabetes and anemia from 1999 to 2023: a CDC WONDER database analysis

As the global population ages, diabetes and anemia increasingly coexist among older adults. This study examined mortality patterns involving both diabetes and anemia and associated demographic disparities among older adults in the United States from 1999 to 2023. This study utilized national mortality data from 1999 to 2023 obtained from the Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) database, focusing on deaths involving both diabetes and anemia among adults aged ≥ 65 years. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMR) per 100,000 population and annual percent change (APC) were calculated by year, sex, race/ethnicity, and urban-rural status. A total of 181,430 deaths involving both diabetes and anemia among the elderly were recorded during the study period. Trend analysis revealed a significant increase from 1999 to 2006 (APC = 3.52%), followed by a significant decline from 2006 to 2018 (APC = -1.25%). Subsequently, a sharp surge occurred from 2018 to 2021 (APC = 14.17%), after which a decrease was observed from 2021 to 2023 (APC = -4.13%). Marked disparities were observed: males consistently exhibited higher AAMRs than females; the non-Hispanic (NH) Black population had the highest AAMR among all the racial/ethnic groups; and AAMRs were higher in rural areas compared to urban areas. This study describes long-term mortality patterns involving both diabetes and anemia among older adults in the United States and highlights persistent demographic disparities. Further studies are warranted to clarify the mechanisms underlying these observed patterns.