To evaluate trends in Alzheimer's disease and related dementias (ADRD)-related fall mortality among older adults in the United States from 1999 to 2020.

ADRD is a major risk factor for debilitating falls in older adults. While the link between ADRD and falls is established, limited research addresses how demographic and geographic factors influence ADRD-related fall mortality.

Trends in ADRD-related fall mortality in adults aged ≥65 years were analyzed using the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. ADRD (ICD-10 codes: G30, F01, and F03) was recorded as a contributing cause, with falls (ICD-10 codes: W00-W19) as the underlying cause of death. Age-adjusted mortality rates (AAMRs) per 100,000 individuals and the annual percent change (APC) were computed, stratified by year, gender, age categories, race, and geographic region. A sensitivity analysis was conducted for older adults where falls (W00-W19) were listed as the underlying cause of death.

A total of 76,003 ADRD-related fall deaths were identified. The overall AAMR increased from 2.0 in 1999 to 13.9 in 2020, with an average annual percentage of 9.4 (95% CI: 8.9-10.14). Older males showed a higher AAMR (8.3) than older females (8.0). White populations consistently showed a higher AAMR (8.7) compared to Black populations (2.8). The Midwestern region recorded the highest AAMR (10.6) among all census regions. Urban areas exhibited greater overall AAMR (8.2) than rural areas (7.9). States with AAMRs in the top 90th percentile included Vermont, Minnesota, Wisconsin, Colorado, and Oregon.

The age-adjusted ADRD-related fall mortality rate increased at an alarming rate from 1999 to 2020, with the largest spike observed between 1999 and 2001. These findings highlight the need for targeted interventions to address these disparities.