Dementia-Related Deaths in the U.S. May Be Higher Than Reported

A multi-institutional study in JAMA Neurology suggests that deaths attributed to dementia and other cognitive impairment may be vastly undercounted in the United States, reports the University of Southern California Leonard Davis School of Gerontology . Doctors and medical examiners noted dementia as a contributing factor on approximately 5 percent of death certificates posted from 2000 to 2009, but earlier comparisons of vital statistics to other sources indicated that dementia is significantly underreported as a cause of death. The researchers tracked more than 7,300 participants in the Health and Retirement Study of older adults between the ages of 70 and 99 during the study period. "In the case of dementia, there are numerous challenges to obtaining accurate death counts, including stigma and lack of routine testing for dementia in primary care," said Boston University School of Public Health Professor Andrew Stokes. "Our results indicate that the mortality burden of dementia may be greater than recognized, highlighting the importance of expanding dementia prevention and care." In analyzing health histories of study participants who died, 13.6 percent of deaths were attributable to dementia — more than 2.7 times the rate posted on death certificates from 2000 to 2009. Possible reasons for underreporting include individuals with Alzheimer's or another form of dementia often having multiple health conditions, and medical certifiers' unawareness of dementia diagnosis. Furthermore, cognitive impairment may impede the person's ability to report symptoms and receive a diagnosis to begin with.