Evidence map›Paper›PMID 42494202›Full record

ArticleBrain and behavior2026

Burden of Diabetes as a Contributing Cause in Dementia Mortality Among Older Adults in the United States, 1999-2020.

Aasim Ali, Ayisha Maqsood, Aswad Mustafa, Zeeshan Hussain, Areeba Ashraf, Sameen Sarfaraz, Ahmad Butt, Muhammad Shamoon, Labeeba Abdul Ghafoor, Hammad Azam and 5 more

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Article in Brain and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Aasim AliNeurology Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Ayisha MaqsoodInternal Medicine Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Aswad MustafaNeurology Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Zeeshan HussainWarwick Medical School, University of Warwick, Coventry, UK.
Areeba AshrafInternal Medicine Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Sameen SarfarazNeurology Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Ahmad ButtInternal Medicine Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Muhammad ShamoonNeurology Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Labeeba Abdul GhafoorNeurology Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Hammad AzamInternal Medicine Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Muhammad AbdullahInternal Medicine Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Aimen Anwaar PannunInternal Medicine Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Muhammad Asad ShabbirInternal Medicine Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Armaghana AbdullahInternal Medicine Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.
Mukesh Kumar SharmaNeurology Department, Dhankuta District Hospital, Dhankuta, Nepal.ORCID https://orcid.org/0009-0000-7424-6327

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiabetes is a well-established risk factor for cognitive decline and dementia; however, the extent to which diabetes is documented as a contributing cause on death certificates among decedents with dementia remains poorly characterized. This study aimed to evaluate temporal trends and demographic disparities in diabetes as a contributing condition among dementia-related deaths in older adults in the United States.

methodsWe analyzed multiple-cause-of-death data from the CDC WONDER database for adults aged ≥ 65 years with dementia listed as an underlying or contributing cause of death between 1999 and 2020. Diabetes was identified using ICD-10 codes E10-E14. We calculated age-adjusted mortality rates (AAMR), crude death rates (CDR), annual percentage changes (APC) using Joinpoint regression, and the proportion of dementia deaths with coexisting diabetes. Analyses were stratified by age, sex, race, and state.

resultsAmong 3,818,272 dementia-related deaths, 234,793 (6.2%) had diabetes documented as a contributing condition. The AAMR for dementia with diabetes increased from 8.7 per 100,000 in 1999 to 36.1 per 100,000 in 2020. Joinpoint regression identified a sharp increase from 1999 to 2009 (APC: +13.09%, 95% CI: 11.47-14.94, p < 0.001), followed by a stable trend from 2009 to 2020 (APC: +0.84%, 95% CI: -0.55-2.11, p = 0.187). Both dementia alone and dementia with diabetes demonstrated a sharp spike in 2020. The proportion of dementia deaths with coexisting diabetes was highest among decedents aged 65-74 years (8.5%) and decreased with age (85+ years: 5.3%). By race, American Indian/Alaska Native decedents had the highest proportion (10.4%), followed by Asian/Pacific Islander (9.2%), Black/African American (9.0%), and White (5.8%). Substantial state-level variation was observed across the United States.

conclusionsThe burden of diabetes, documented as a contributing condition among dementia-related deaths, increased substantially from 1999 to 2009 and remained relatively stable thereafter. Significant racial, age, and geographic disparities exist, with American Indian/Alaska Native decedents showing the highest proportion of coexisting diabetes. These findings highlight the burden of metabolic comorbidity among older adults with dementia and underscore the importance of continued surveillance and targeted public health strategies.

Indexed as

DementiaDiabetes MellitusAgedAged, 80 and overCause of DeathFemaleHumansMaleRisk FactorsUnited StatesAlzheimer's diseaseCDC WONDERdementiadiabetes mellitushealth disparitiesmortality

Identifiers

PMID42494202
PMCPMC13396878

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.