Abstract HUP15: Epidemiologic Trends and Disparities in Parkinson’s Disease and Cerebrovascular Disease-Related Mortality in the United States From 1999 to 2019 – A Nationwide Analysis

Introduction: Parkinson’s disease (PD) and cerebrovascular disease (CeVD) often occur together due to shared risk factors. Despite the established association, the mortality trends by year, sex, race, and geographical area remain unexplored. This study determines the mortality trends adjusted for age in patients with comorbid PD and CeVD over the past two decades. Methods: The mortality data was accessed using the Centers for Disease Control and Prevention database, CDC WONDER. Age-adjusted mortality rates (AAMR) per 100,000 population were extracted from 1999 to 2019 for individuals aged >25 years. PD was identified using the ICD-10 code G20, and CeVD was identified using the ICD-10 codes I60-I69. Cases where PD and CeVD were either the underlying or contributing cause of death were included. Trends were analyzed by year, sex, race/ethnicity, census region, and metropolitan status. We used the Joinpoint regression to calculate the annual percent change (APC) in AAMR with 95% confidence intervals. Results: From 1999 to 2019, a total of 70,747 deaths occurred among patients with comorbid PD and CeVD, with an overall AAMR of 1.61 per 100,000 population. The AAMR declined from 2.36 in 1999 to 1.36 in 2019, with a significant decreasing trend from 1999 to 2004 (APC: -2.29, p = 0.007), 2004 to 2008 (APC: -8.50, p < 0.001), and 2008 to 2014 (APC: -2.86, p = 0.009), followed by a significant increase from 2014 to 2019 (APC: 2.47, p < 0.001). Men had a higher AAMR (2.31) than women (1.15). White individuals had the highest AAMR (1.70), followed by American Indian or Alaska Native (1.26). Asian or Pacific Islander and Hispanic or Latino populations had comparable AAMRs (1.18), while the Black or African American population had the lowest AAMR (1.16). Significant geographical variations were observed with the Midwest region (1.79) and the state of Nebraska (2.48) having the highest AAMR. AAMR in nonmetropolitan areas (1.82) was higher compared to that in metropolitan (1.55) areas. Conclusion: In conclusion, although the mortality related to coexisting PD and CeVD declined overall throughout the study period, it shows a recent increasing trend. Interestingly, this closely follows mortality trends for PD. The study also highlights several sociodemographic disparities, reflecting under-recognition of PD and CeVD in certain groups, underscoring the need for targeted interventions and research to reduce mortality.