Abstract Body (Do not enter title and authors here): Background:
Cerebrovascular disease is a leading cause of morbidity and mortality in the US, mainly affecting older adults. Aging significantly influences its manifestations and pathophysiology, impacting late-life quality. However, mortality trends in cerebrovascular disease among older adults of different gender, race, and geographic areas have not been thoroughly examined. Understanding these correlations and current death patterns is crucial for improving medical treatment and strategies.

Research Aim:
To investigate the impact of gender, race, and geographic disparities on cerebrovascular disease-related mortality rates among older adults in the United States, utilizing CDC-WONDER data from 1999 to 2020.

Methodology:
Cerebrovascular disease-related data from the CDC-WONDER database (1999-2020) using ICD-10 codes I60-I69 were analyzed. Annual Percent Change (APC), and Age-adjusted mortality rates (AAMR) per 100,000 persons were calculated and stratified by gender, race, place of death, state, census regions, and urban/rural classification. Joinpoint regression was utilized to assess trend changes and APC.

Results:
Between 1999 and 2020, 3,813,729 elderly individuals died from cerebrovascular disease. Overall, AAMR decreased from 1264.3 to 812.5, yet a rise was noted from 2018 to 2020, particularly in males (APC 6.069* vs. 4.668* in females). Non-Hispanic (NH) Blacks showed the highest APC (8.026*) from 2018 to 2020, while NH American Indians or Alaska Natives declined from 2013 to 2020 (-0.926). Non-metropolitan areas consistently had higher AAMRs, sharply increasing since 2018 (APC 4.818* vs. 5.135*). The Midwest had the highest APC (7.253*) from 2018 to 2020, while the South had the lowest APC (4.598*). Tennessee had the highest overall AAMR (1076.3) from 1999 to 2020, and New York had the lowest AAMR (609.7). (Figure 1)


Conclusion
Despite declining overall mortality, persistent disparities exist in cerebrovascular disease-related mortality, with NH black males and rural residents facing the highest rates. Urgent public health action is needed, given the alarming rise in mortality from 2018 to 2020.