Typically, coroners list only the most immediate condition as a person’s cause of death on an official death certificate. But a new study suggests that this practice can lead to a drastic under-reporting of the number of people who die each year due to complications from Alzheimer’s disease.
Researchers estimate that Alzheimer’s, the most common form of dementia, is responsible for some 500,000 deaths a year in the USA (about 20% of all deaths), more than six times the official estimate of 83,000 deaths in 2010.
Applying the current death estimates from the U.S. Centers for Disease Control and Prevention (CDC) the report Alzheimer’s was responsible for 503,400 deaths 2010.
Deaths due to Alzheimer’s have been historically under-reported.
Swallowing disorders and malnutrition can lead to pneumonia, a common cause of death among Alzheimer’s patients. While pneumonia would be listed as the cause of death, it wouldn’t have happened if the person had not had Alzheimer’s.
Methods: Data came from 2,566 persons aged 65 years and older (mean 78.1 years) without dementia at baseline from 2 cohort studies of aging with identical annual diagnostic assessments of dementia. Because both studies require organ donation, ascertainment of mortality was complete and dates of death accurate. Mortality hazard ratios (HRs) after incident AD dementia were estimated per 10-year age strata from proportional hazards models. Population attributable risk percentage was derived to estimate excess mortality after a diagnosis of AD dementia. The number of excess deaths attributable to AD dementia in the United States was then estimated.
Results: Over an average of 8 years, 559 participants (21.8%) without dementia at baseline developed AD dementia and 1,090 (42.4%) died. Median time from AD dementia diagnosis to death was 3.8 years. The mortality HR for AD dementia was 4.30 (confidence interval = 3.33, 5.58) for ages 75–84 years and 2.77 (confidence interval = 2.37, 3.23) for ages 85 years and older (too few deaths after AD dementia in ages 65–74 were available to estimate HR). Population attributable risk percentage was 37.0% for ages 75–84 and 35.8% for ages 85 and older. An estimated 503,400 deaths in Americans aged 75 years and older were attributable to AD dementia in 2010.
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