To identify and provide insights on demographic and urbanization trends and disparities in chronic renal failure mortality in Alzheimer’s patients in the US from 1999 to 2023. 

Chronic renal failure and Alzheimer’s disease are both common chronic conditions and major public health burdens in the aging U.S. population. Emerging evidence suggests a link between impaired kidney function and Alzheimer’s disease. This study aims to explore disparities in mortality in different population subgroups for optimizing healthcare access for these chronic conditions associated with aging.

CDC WONDER mortality database was used to evaluate chronic renal failure (N18.9) related mortality in  older adults (65+ years) with Alzheimer’s disease (G30.9) from 1999 to 2023. We calculated the age-adjusted mortality rate (AAMR) per 100,000 followed by an assessment of mortality trends via APC and AAPC using Joinpoint regression analysis and stratified by gender, race/ethnicity, regional, and urbanization classifications.

A total of 43,658 chronic renal failure-related deaths occurred in Alzheimer’s patients and most of these deaths occurred in Decedent’s home (14.24%) and 85+years age group (rate:21.94). Overall mortality increased from 1.5 in 1999 to 4.7 in 2023, with Annual Percentage Change (APC) of 2.76%. Females experienced higher mortality burden (AAMR:4.19) than males (AAMR:3.94). NH White had the highest AAMR (4.25), followed by African American populations (4.99) and Hispanics (3.31). Regionally, Midwestern had the highest mortality (7.3) and Northeast had the lowest (3.5).Rural areas surpassed urban areas (4.13 vs 3.4). North Dakota had the highest mortality burden (12.1) while New York exhibited the lowest (1.7).

These results show significant rise in chronic renal failure related mortality in Alzheimer’s patients from 1999 to 2023 with 85+age group, females, NH White, Midwestern regions and rural areas being the most affected.This highlights the need for targeted interventions to address these disparities.