Alzheimer’s Disease a Much Larger Cause of Death Than Previously Recognized

A new study by researchers at Rush indicates that Alzheimer’s disease may be one of the leading causes of death in the United States

(CHICAGO) — A new study by researchers at Rush University Medical Center indicates that Alzheimer’s disease may be one of the leading causes of death in the United States. The study, published in the March 5 issue of Neurology, shows that the disease may be an underlying cause of five to six times as many deaths as currently reported.

“Alzheimer’s disease and other dementias are under-reported on death certificates and medical records,” said study author Bryan D. James, PhD, an epidemiologist with the Rush Alzheimer's Disease Center. “Death certificates often list the immediate cause of death, such as pneumonia, rather than listing dementia as an underlying cause.”

James added that attempting to identify a single cause of death does not always capture the reality of the process of dying for most elderly people, as multiple health issues often contribute.

According to the Centers for Disease Control and Prevention (CDC), Alzheimer’s disease is currently the sixth leading cause of death in the United States following cancer, the second leading cause of death; and heart disease, the number one cause of death among Americans. This data is reported on death certificates.

“The estimates generated by our analysis suggest that deaths from Alzheimer’s disease far exceed the numbers reported by the CDC and those listed on death certificates,” said James.

The death rate was more than four times higher after a diagnosis of Alzheimer’s in people age 75 to 84 and nearly three times higher in people age 85 and older. More than one-third of all deaths in those age groups were attributable to Alzheimer’s disease.

For the study, 2,566 people ages 65 and older received annual testing for dementia. The average age of the participants was 78. The research found that after an average of eight years, 1,090 participants died. A total of 559 participants without dementia at the start of the study developed Alzheimer’s disease. The average time from diagnosis to death was about four years. After death, Alzheimer’s disease was confirmed through autopsy for about 90 percent of those who were clinically diagnosed.

James said this translates into an estimated 503,400 deaths from Alzheimer’s in the U.S. population over age 75 in 2010, which is five to six times higher than the 83,494 number reported by the CDC based on death certificates.

“Determining the true effects of dementia in this country is important for raising public awareness and identifying research priorities regarding this epidemic,” said James. James is an epidemiologist with the Rush Alzheimer's Disease Center and an assistant professor in the Department of Internal Medicine, Section of Community Epidemiologic Research, Rush Medical College.

The study was supported by the National Institute on Aging and the Illinois Department of Public Health. The authors thank the participants in the Religious Orders Study and the Rush Memory and Aging Project.

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