To determine the mortality trends among patients with Parkinson disease-related dementia (PDD) in the United States from 1999 to 2020.

Parkinson Disease (PD) primarily affects 1% of adults aged ≥ 60, however, genetically predisposed individuals may develop PD earlier, exerting a significant burden on modern healthcare, with mortality rates rising in recent years. Moreover, dementia-a key feature of PD further elevates the risk of mortality in the US. Remarkably, the trends and burden of PDD mortality across demographic and regional subgroups in the US are not well studied.

We analyzed CDC Wonder data for individuals with PD and dementia (PDD) as multiple causes of death. Age-adjusted mortality rates (AAMR) per 100,000 were calculated and stratified by sex, race, and region. Joinpoint was used to analyze trends in AAMR and calculate annual percentage changes (APCs).

 A total of 127,200 PDD related deaths were reported. Overall, the AAMR increased from 1999 to 2001 (APC: 34.8%[18.4-49.2]). Following a steady increase from 2001 to 2011 (APC: 5.3% [2.6-6.7]), rates leveled off until 2018, with a significant increase from 2018 to 2020 (APC: 7.2% [0.3-11.8]) with an overall annual percentage decrease of 5.9% (5.06-6.86). Men had higher AAMR than women (2.55 vs 1.26). Non-Hispanic (NH) Whites showed the highest AAMR (1.91) followed by Hispanics (1.12), NH Blacks (0.98), and NH Asians (0.89). Regionally, the Midwest showed the highest AAMR (2.037) and West the lowest (1.6), with urban areas (1.76) surpassing rural areas (1.74). Minnesota showed the highest AAMR (2.8) and the District of Columbia the lowest (1.03).

Our findings underscore the burden of PDD on modern healthcare, highlighting the disparities across different subgroups, allowing targeted interventions critical to appropriate management, particularly in high-risk groups.