Age-adjusted mortality rates (AAMRs) per 100,000 in adults (65+) were obtained from CDC WONDER using ICD codes for AD (G30) and Atrial Fibrillation (I48). Joinpoint regression estimated Annual Percent Change (APC) and Average APC (AAPC), with significance set at p<0.05.Following the ADF/KPSS and Box-Ljung tests, ARIMA models with Box-Cox transformation were fitted for forecasting, and residual diagnostics were performed for model validation.

From 1999–2023, 139,580 Alzheimer’s disease–related deaths involved atrial fibrillation (mean AAMR: 12.37 per 100,000). Mortality rose sharply from 6.8 to 19.1, peaking in 2020 (APC: 6.69; 95% CI: 5.27–8.14). The ARIMA forecasting model predicted a rise in AAMR to 22.85 (95% CI: 17.01–28.68) by 2035 (ACDF p = 0.75; Box-Ljung test p = 0.90). Females accounted for 64.8% of deaths and had a higher AAMR compared with males (12.5 vs. 11.8). Non-Hispanic White individuals comprised 94% of deaths (AAMR: 12.96). The South showed the highest regional burden (AAMR: 11.78), while Oregon and Minnesota had the greatest state-level AAMRs (46.7 and 39.2, respectively). Urban–rural differences were modest, but higher rates were observed in non-metropolitan areas.

Alzheimer’s disease related mortality involving atrial fibrillation has nearly tripled since 1999, with persistent disparities by sex, race, and geography. The South and non-metropolitan regions bear the highest burden, disproportionately affecting White individuals and women. These trends underscore the urgent need for integrated neurocardiac care, equitable resource allocation, and early rhythm control strategies in aging populations.