Trends in cerebrovascular diseases, pelvic and hip fractures-related mortality among older adults in the United States from 1999–2020

Background

We aim to evaluate trends in Cerebrovascular Diseases (CVD) and pelvic and hip fractures (PHF)-related deaths among adults (≥ 65 years) in the US from 1999 to 2020, highlighting the differences based on demographics.

Methods

We analyzed death certificates from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database spanning 1999 to 2020, related to CVD and PHF in people aged ≥65 years. Age-Adjusted Mortality Rates (AAMRs) per 100,000 persons and annual percent change (APC) were computed using Joinpoint software. The analysis was organized by year, sex, race/ethnicity, and geographic distribution (states, census regions, metropolitan/non-metropolitan areas).

Results

The AAMR for CVD and PHF decreased from 4.5 in 1999 to 2.2 in 2020. Similar pattern was observed for AAMR in females and males. Highest overall AAMR was noted in Non-Hispanic (NH) White adults (3.2) and lowest in African Americans (1.2). States of Wyoming, Alaska, North Dakota, Oregon, and Minnesota were in the top 90th percentile of AAMR while Florida, District of Columbia, Nevada, Arizona, and New York were in lower 10th percentile. Highest AAMRs were observed in Midwestern census region, followed by Western, Southern and Northeastern regions (3.8,2.8,2.7, and 1.9 respectively). Nonmetropolitan areas had a higher AAMR (4.4 vs 2.5) than metropolitan areas.

Conclusion

The CVDs and PHF related mortality rate increased steadily after 2014. NH white females were found to be at increased risk. A research-based management plan needs to be devised for post stroke pelvic and hip fractures in elderly.