Abstract TP111: Comparative Mortality Patterns of Stroke versus Alzheimer’s Disease: A 25-Year U.S. Analysis (1999–2023)

Background: Treatment and prevention of acute stroke during the past two decades probably rearranged mortality patterns, while Alzheimer's disease, with no disease-modifying therapy to characterize it, continues to accumulate increasingly onerous burdens for caregivers and health systems. Side-by-side comparison of long-term mortality patterns of these diseases can show emerging disparities and inform strategic resource allocation. Methods: We conducted a population-based, retrospective study of national death certificate data 1999–2023 utilizing the CDC WONDER Multiple Cause-of-Death database. Stroke and Alzheimer's disease were identified with accepted ICD-10 codes (I60–I69 for stroke; G30 for Alzheimer's disease). Age-adjusted mortality rates (AAMRs) were calculated per 100,000 population for comparison to the 2000 U.S. standard population. Temporal trends were analysed using Joinpoint Regression Software, Version 5.4.0 (April 2025) to compute APC and AAPC with 95% CIs. Differences were tested by sex, age groups, race/ethnicity, urbanization, U.S. census regions, and place of death. Results: Mortality from stroke declined significantly (average annual percent change AAPC –4.54%, 95% CI –5.52 to –3.55), with short-term bulges in 2018–2021. Mortality from Alzheimer's was stable overall (AAPC 0.56%, 95% CI –1.23 to 2.39) but increasing in women and the oldest-old. Blacks had the highest stroke and Alzheimer's mortality among non-Hispanic Whites. Non-metropolitan counties had higher mortality for both conditions across the board. Alzheimer's death (1,336 per 100,000) was higher than stroke (1,011 per 100,000) death among adults ≥85 years. Hospital death was more common among stroke; Alzheimer's death was more likely in nursing homes and at home. Conclusion: Over 25 years of decline, Mortality from stroke fell in populations due to increased prevention and acute care, while death from Alzheimer's continues uncontrolled in female, older, White, and rural populations. The divergent trends imply additional Alzheimer's disease interventions and cautious chronic care efforts.