Abstract Body (Do not enter title and authors here): Background: The coexistence of coronary artery disease (CAD) and Chronic Obstructive Pulmonary Disease (COPD) represents a major health challenge for older adults in the United States. This study designed to examine the variations in mortality rates associated with CAD and COPD among individuals aged 65 and above from 1999 to 2020.
Methods: Using the CDC WONDER database, a retrospective analysis was conducted on death certificate data from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and trends were evaluated using Average Annual Percentage Change (AAPC) and Annual Percentage Change (APC). The data were stratified by year, sex, race/ethnicity, and geographical region.
Results: Between 1999 and 2020, coronary artery disease (CAD) and Chronic Obstructive Pulmonary Disease (COPD) were responsible for 881,875 deaths among adults aged 65 and older in the United States. The majority of these deaths occurred in medical facilities (40.3%) and in the decedents' homes (28.3%). The overall Age-Adjusted Mortality Rate (AAMR) decreased from 119.4 in 1999 to 86.9 in 2020, with an Annual Percent Change (APC) of -1.65 (p < 0.000001). Notably, AAMRs moderately decreased from 1999 to 2018 (APC: -2.13, p = 0.025195), followed by a significant increase from 2018 to 2020 (APC: 2.95, p = 0.296341). Men had notably higher AAMRs than women (men: 139.8; women: 67.4), with both sexes experiencing almost equal declines over the study period. In terms of race, Whites had the highest AAMRs (106.5), followed by Native Americans (87.3), Blacks (60.7), Hispanics (51.0), and Asians (30.4). While all racial groups experienced decrease in AAMR , the decline was more signficance in Asians [AAPC: -3.26, (CI: -4.30 to -2.27) (p-value < 0.000001)]. Geographically, AAMRs varied widely among states, with the highest mortality rates observed in the Midwestern region. Nonmetropolitan areas generally had higher AAMRs than metropolitan areas, and both showed decreases from 1999 to 2020, with greater declines in metropolitan areas. Figure 1
Conclusion: This research emphasizes the temporal trends and demographic discrepancies in mortality rates linked to CAD and COPD among older adults aged 65 and above in the United States. Despite an overall decrease in mortality rates, the recent rise necessitates additional investigation and focused interventions to address inequalities and improve outcomes in affected demographic groups.