Recent Trends in Alzheimer Disease Mortality in the United States, 1999 to 2004

We have analyzed US Alzheimer disease (AD) mortality rates from 1999 to 2004, after 10th International Classification of Disease (ICD) revision coding made AD death certificate reporting more accurate. Age-standardized rates were calculated by year, age, sex, race, ethnicity, education, marital status, and geography. AD mortality increased 31% from 1999 to 2004. AD rates were higher in the northwest and the southeast. Stroke mortality shows a similar pattern; the correlation in state rates between stroke and AD is 0.79. Female AD mortality was 28% higher than male mortality. Whites had 56% higher rates than non-whites, and non-Hispanics had a 72% higher rate than Hispanics. Both less education and single marital status were associated with higher rates. The correlation between state rates for stroke and AD mortality could be due to artifacts of coding, or a true relationship, given that stroke is a risk factor for subsequent AD. Although AD mortality in the United States has been increasing over time it is not known whether incidence is increasing, due to lack of recent incidence data. AD reporting on death certificates is known to be poor. This is the first analysis of recent trends in AD mortality since the advent of ICD-10.