The percentage of deaths attributable to dementia in the United States is underestimated when vital statistics are used, according to a study in JAMA Neurology.
In this prospective cohort study, data from 7342 adults aged 70 to 99 years from the Health and Retirement Study of noninstitutionalized individuals in the United States were analyzed.
At baseline, 64% were between ages 70 and 79 years, 31% were between 80 and 89 years, and 5% were between 90 and 99 years (percentages were weighted).
Between 2000 and 2009, 13.6% (95% CI, 12.2%-15.0%) deaths were attributed to dementia. The mortality burden was significantly higher among non-Hispanic Black participants and among adults with less than a high school education than non-Hispanic White participants and those with a college education, respectively.
The underlying cause of death recorded on death certificates underestimated the contribution of dementia to US mortality by a factor of 2.7, according to the study.
When deaths attributed to cognitive impairment without dementia (CIND) were incorporated, the underestimation was even higher.
The authors concluded that “dementia may represent a more important factor in US mortality than indicated by routine mortality statistics.”
Stokes AC, Weiss J, Lundberg DJ, et al. Estimates of the Association of Dementia With US Mortality Levels Using Linked Survey and Mortality Records. JAMA Neurol. Published online August 24, 2020. doi:10.1001/jamaneurol.2020.2831