Rising Comorbid Alzheimer's and Hypertension Mortality in Older Adults in the United States: Trends and Disparities From a 21‐Year CDC WONDER Analysis (1999–2019)

ABSTRACT

Hypertension, affecting nearly half of US adults, is a significant modifiable risk factor for Alzheimer's disease (AD), the fifth leading cause of death among Americans aged 65 and older. Hypertension contributes to AD through microvascular damage, reduced cerebral perfusion and neuroinflammation, leading to cognitive decline and dementia. This study examines US national trends and disparities in mortality due to comorbid AD and hypertension in older adults (≥65 years) using CDC WONDER data from 1999–2019. Age‐adjusted mortality rates (AAMRs) per 100 000 individuals and crude rates (CRs) were determined. Joinpoint regression was used to calculate Annual Percentage Changes (APCs) and Average Annual Percentage Changes (AAPCs). A total of 372 839 deaths occurred, increasing from 4948 to 27 257 annually (1999–2019). AAMRs rose from 14.51 to 53.13, with an AAPC of 6.16%. Females (47.09) had higher AAMRs than males (33.80). Non‐Hispanic Blacks experienced the highest mortality rates (54.82), while NH Asians had the lowest (28.14); Hispanics experienced the highest AAPC (6.81). The 85+ age group bore the greatest mortality burden (AAPC: 6.84%). Most deaths (60.05%) occurred in hospice/nursing facilities. Mortality was highest in the West (AAMR: 50.28) and lowest in the Northeast (27.00). Mississippi had the highest, Massachusetts the lowest state‐level mortality burden. Non‐metropolitan areas exceeded metropolitan AAMRs (47.89 vs. 41.28). Targeted interventions are needed to counter observed trends, addressing hypertension as a key manageable risk factor for AD prevention.