This study aims to investigate the mortality trends and disparities among patients with comorbid Alzheimer’s disease and cerebrovascular disease.

Alzheimer’s disease (AD) is associated with increased risk of cerebrovascular disease through shared vascular and neurodegenerative pathways. Given the limited existing data, this study aims to characterize contemporary trends in coexisting AD and cerebrovascular disease-related mortality among United States (US) adults (≥45 years old).

The Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database was used to acquire the mortality data. The age-adjusted mortality rates (AAMR) per 100,000 population were extracted. Cerebrovascular disease was identified using ICD-10 codes I60-I69. AD was identified using ICD-10 code G30. Those deaths were included in the analysis where both AD and cerebrovascular disease were either the underlying or contributing cause. Trends were analyzed by year, sex, and census region. Joinpoint regression was used to calculate the annual percent change (APC) in AAMR with 95% confidence intervals. Weighted average APCs were calculated and reported as AAPCs with 95% CIs to summarize mortality trends over the study period.

From 1999 to 2024, a total of 209,934 deaths were associated with coexisting AD and cerebrovascular disease, with an overall average AAMR of 6.84 per 100,000. The AAMR declined from 8.26 in 1999 to 6.14 in 2024 (AAPC: –1.27; p < 0.001). Women had a higher average AAMR than men (7.33 versus 5.93), though both showed significant declines (males: AAPC –1.36; p < 0.001; females: AAPC –1.08; p < 0.001). By region, the West had the highest average AAMR (8.02), followed by the South (7.41), the Midwest (7.12), and the Northeast (4.33).

Mortality from coexisting cerebrovascular disease and AD decreased nationwide, yet continues to show marked demographic and regional disparities, underscoring the need for targeted prevention and intervention strategies.