Psychological Distress and Alzheimer's Disease Mortality in the United States: Results from the 1997-2014 National Health Interview Survey-National Death Index Record Linkage Study

Objective: This study examines the association between psychological distress and Alzheimer's disease mortality among US adults aged >= 45. Methods: We analyzed the Kessler 6-item psychological distress scale as a risk factor for Alzheimer's mortality using the pooled 1997-2014 National Health Interview Survey (NHIS)- National Death Index (NDI) database (N = 265,089). Cox regression was used to model mortality as a function of psychological distress and sociodemographic and behavioral covariates. Results: The Alzheimer's mortality risk was 97% higher (HR = 1.97; 95% confidence interval [CI] = 1.37, 2.84) in adults with serious psychological distress compared with those without psychological distress, controlling for sociodemographic covariates. The relative mortality risk remained statistically significant (HR = 1.49; 95% CI = 1.04, 2.13) after additional adjustment for smoking, alcohol consumption, health status, activity limitation, and body mass index. Discussion: US adults had significantly higher risks of Alzheimer's disease mortality at higher psychological distress levels. These findings underscore the significance of addressing psychological well-being as a strategy for reducing Alzheimer's disease mortality.