Sohail Muhammad U, Batool Ruqiat M, Saad Muhammad, Waqas Saad A, Noushad Muhammed A, Sohail Muhammad O, Bates Matthew, Ahmed Raheel, Ripley David
Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
University Hospitals Plymouth NHS Trust, Plymouth, UK.
J Cardiovasc Electrophysiol. 2025 Jun;36(6):1234-1243. doi: 10.1111/jce.16644. Epub 2025 Mar 24.
Atrial fibrillation (AF) and dementia are increasingly prevalent in aging US populations. Their association raises public health concerns, emphasizing the need to understand mortality trends in older adults. This study examines AF and dementia-related mortality trends from 2000 to 2020.
Using the CDC WONDER Multiple Cause of Death database, we analyzed death certificates for individuals aged 65 and older, reporting age-adjusted mortality rates (AAMRs) per 100 000 persons. Trends were assessed through annual percent change (APC) analysis via Joinpoint regression, with stratifications by sex, race/ethnicity, urbanization, and Census regions.
A total of 400 103 AF and dementia-related deaths were recorded between 2000 and 2020. The AAMR increased markedly from 25.4 in 2000 to 70.4 in 2020. The overall AAMR showed a steady increase from 2000 to 2018 (APC: +4.2%; 95% CI: 2.5-5.5), with a sharper rise from 2018 to 2020 (APC: +9.5%; 95% CI: 4.5-12.2; p < 0.001). Mortality rates were comparable between men (AAMR: 44.4) and women (AAMR: 43.9). NH White individuals exhibited the highest AAMR (47.0), followed by NH Black (26.6), Hispanic (23.1), and NH Asian/Pacific Islander (18.0) populations. Nonmetropolitan areas had higher AAMRs (48.1) compared to metropolitan areas (43.5). Regionally, the Western US recorded the highest AAMR at 48.2, while state-level disparities showed a nearly threefold difference between the top 90th and bottom 10th percentiles.
Rising AF and dementia-related mortality rates among older adults highlight a need for targeted screening and intervention, particularly for high-risk demographics and underserved regions.
在美国老龄化人口中，心房颤动（AF）和痴呆症日益普遍。它们之间的关联引发了公众对健康的担忧，凸显了了解老年人死亡率趋势的必要性。本研究调查了2000年至2020年期间与AF和痴呆症相关的死亡率趋势。
使用美国疾病控制与预防中心（CDC）的死因多重编码数据库，我们分析了65岁及以上人群的死亡证明，报告了每10万人的年龄调整死亡率（AAMR）。通过Joinpoint回归分析年度百分比变化（APC）来评估趋势，并按性别、种族/族裔、城市化程度和人口普查区域进行分层。
2000年至2020年期间共记录了400103例与AF和痴呆症相关的死亡。AAMR从2000年的25.4显著增加到2020年的70.4。总体AAMR从2000年到2018年呈稳步上升趋势（APC：+4.2%；95%CI：2.5-5.5），从2018年到2020年上升更为明显（APC：+9.5%；95%CI：4.5-12.2；p<0.001）。男性（AAMR：44.4）和女性（AAMR：43.9）的死亡率相当。非西班牙裔白人个体的AAMR最高（47.0），其次是非西班牙裔黑人（26.6）、西班牙裔（23.1）和非西班牙裔亚裔/太平洋岛民（18.0）人群。与大都市地区（43.5）相比，非大都市地区的AAMR更高（48.1）。在区域方面，美国西部的AAMR最高，为48.2，而州级差异显示，第90百分位数和第10百分位数之间相差近三倍。
老年人中与AF和痴呆症相关的死亡率上升，凸显了进行针对性筛查和干预的必要性，特别是针对高危人群和服务不足的地区。
