Trends in mortality due to ischemic heart diseases among patients with Alzheimer's disease in the United States from 1999 to 2020

Background: Ischemic heart diseases (IHD) and Alzheimer's Disease (AD) significantly contribute to mortality in aging population. Understanding mortality trends where these conditions overlap is crucial for developing targeted interventions for vulnerable populations. Methods: We analyzed CDC WONDER mortality data from 1999 to 2020 for individuals aged >= 45 years. IHD and AD mortality were identified using ICD-10 codes I20-I25 and G30, respectively. Age-adjusted mortality rates (AAMR) per 100,000 were calculated, and trends were analyzed by gender, race, region, place of death and state. Joinpoint regression was used to calculate annual percentage changes (APC) with 95 % confidence intervals (CI). Results: A total of 171,080 deaths were attributed to IHD in individuals with AD from 1999 to 2020. The AAMR decreased from 10.6 in 1999 to 4.1 in 2020, with a significant decline between 2004 and 2014 (APC:-7.73; 95 % CI:-8.42 to-7.24). Females exhibited higher overall AAMR compared to males (Females: 6.8 vs. Males: 6.4). Individuals of Non-Hispanic (NH) White ancestry had the highest AAMR (6.8), followed by those of NH Black (6.5) and Hispanic ancestry (5.9). The West region reported the highest AAMR at 7.9, while the Midwest had the lowest at 6.3. Oklahoma recorded the highest state-level AAMR (10.9), while Utah had the lowest (3.2). Conclusions: IHD mortality in individuals with AD declined significantly, with disparities by gender, race, and geography. These findings underscore the need for tailored public health approaches to address the evolving burden of IHD in AD patients.