To analyze the mortality rates due to dementia and heart failure (HF) in the US from 1999 to 2023. 

HF is a significant contributor to multiple chronic diseases and is closely linked to cognitive decline. Dementia is more frequently observed in individuals with HF than in the general population, highlighting a bidirectional relationship between the two diseases.

The descriptive study utilized the CDC WONDER database to analyze age-adjusted mortality rates (AAMRs) per 100,000 older adults (≥65) for HF and dementia from 1999 to 2023. Average annual percentage changes (AAPCs) were calculated using the Joinpoint Regression Program. 

From 1999 to 2023, dementia and HF caused a total of 785,002 deaths among older adults in the US. The AAMR for the entire cohort increased from 48.48 (95% CI: 48.09 – 49.58) in 1999 to 75.37 (74.62 – 76.13) in 2023, with a significant AAPC of 1.70% (0.43 – 3.00), indicating an increasing trend. Females showed consistently higher AAMRs than males. The AAMRs were also consistently higher in the non-Hispanic (NH) White individuals compared to other racial and ethnic groups. The NH Black individuals showed the highest increase in mortality as compared to other races (AAPC: 2.47%). When stratified by census regions, the Northeast had the highest AAMRs, while the Midwest had the lowest. The AAPC was the highest in the Northeast (1.88%), while the lowest was in the South (1.40%). The AAMRs were higher in the non-metropolitan areas than in the metropolitan areas.

The dementia and HF-related mortality exhibited an overall increasing trend. Variations in mortality rates had been noted when the cohort population was stratified by sex, race/ethnicity, census region, and urbanization. Targeted healthcare reforms are required to address these disparities.