This study aims to evaluate U.S. mortality trends in Alzheimer's, Parkinson’s, and basal ganglia degeneration from 1999 to 2020.

Neurodegenerative disorders, including Alzheimer's, Parkinson’s, and basal ganglia degeneration, are the major contributing factors for mortality and disability among older adults in the U.S. Assessing their long-term mortality rate is crucial to understand disease burden and to guide public health preventive measures.

Mortality data from the CDC WONDER database were analysed. Age-adjusted mortality rates (AAMRs) per 100,000 population were stratified by year, demographic, region, and urbanization. Annual percent change (APC) and average annual percent change (AAPC) were derived via JoinPoint regression, with p<0.05 considered significant.

From 1999 to 2020, a total of 30,315 deaths were reported among individuals aged ≥55 years, with a majority occurring in nursing homes 58.94%. The overall AAMR increased from 1999 to 2005 (APC: 5.38%, p < 0.05), followed by a significant decline until 2014 (APC: -3.45%, p < 0.05), and a slight increase thereafter. Males had a higher AAMR than females (2.45 vs. 1.62); male mortality rose significantly until 2005 (APC: 4.15%, p = 0.02) and then declined (APC: -2%, p = 0.02). By race, White individuals had the highest AAMR (2.06), and by ethnicity, Non-Hispanics had higher AAMR (1.95), with varying mortality rates from 1999 to 2020. Geographically, the West region had the highest AAMR (2.22), with a significant rise until 2006 (APC: 4.6%, p=0.01) followed by a decline through 2020 (APC: -2%, p<0.05). Rural areas showed higher mortality than urban areas (AAMR: 2.20 vs. 1.92). At state level, North Dakota had the highest AAMR (3.16).