Amna Noor

Background: Alzheimer’s disease (AD) is the fifth leading cause of death for Americans older than 65. Though fluctuations have been noticed over the past two decades, the mortality of Alzheimer’s patients increased considerably during the COVID-19 pandemic. This study aims to explore the temporal trends in AD-associated mortality (ADAM) and disparities in these trends, and we aim to discern changes to these trends during the COVID-19 pandemic. Methods: The CDC WONDER Multiple Cause-of-Death Public Use Records from 1999 to 2022 were used to extract population data on deaths related to AD and stratify them based on age, biological sex, race, ethnicity, place of death, census region, and state. ICD-10 codes G30.0, G30.1, G30.8, and G30.9 were used to identify AD-related mortality. Statistical analysis was performed using the Joinpoint Regression Program version 5.0.2. Results: We confirmed an increase in mortality rate in all races, sexes, places of death, age groups above 65, and states/census regions. Interestingly, the age-adjusted mortality rate (AAMR) of AD was consistently higher in females compared to males. Non-Hispanic whites had the highest AD mortality by race and ethnicity. At the intersection of race and biological sex, White females had the highest AAMR with AD. Lastly, we noted an increase in AD mortality at hospice facilities as compared to other places of death. Conclusions: Our findings demonstrate that the number of deaths due to AD was exacerbated by the recent pandemic and that White females were disproportionately affected. The disparities relating to ADAM uncovered in this study may assist healthcare administrators and policymakers in their decisions. Additionally, the findings might help initiate larger studies focusing on these disparities to explore novel risk/prognostic factors for AD.

Background: Alzheimer’s disease (AD) is the fifth leading cause of death for Americans older than 65. Though fluctuations have been noticed over the past two decades, the mortality of Alzheimer’s patients increased considerably during the COVID-19 pandemic. This study aims to explore the temporal trends in AD-associated mortality (ADAM) and disparities in these trends, and we aim to discern changes to these trends during the COVID-19 pandemic. Methods: The CDC WONDER Multiple Cause-of-Death Public Use Records from 1999–2022 was used to extract population data on deaths related to AD and stratify them based on age, biological sex, race, ethnicity, place of death, census region, and state. ICD-10 codes G30.0, G30.1, G30.8, and G30.9 were used to identify AD-related mortality. Statistical analysis was performed using the Joinpoint Regression Program version 5.0.2. Results: We confirmed an increase in mortality rate in all races, sexes, places of death, age groups above 65, and states/census regions. Interestingly, the AAMR of AD was consistently higher in females compared to males. Non-Hispanic whites had the highest AD mortality by race and ethnicity. At the intersection of race and biological sex, white females had the highest AAMR with AD. Lastly, we noted an increase in AD mortality at hospice facilities as compared to other places of death. Our findings demonstrate not only that the number of deaths due to AD were exacerbated by the recent pandemic, but also that certain subgroups of AD patients were disproportionately affected. Conclusion: Our findings demonstrate that the number of deaths due to AD were exacerbated by the recent pandemic, and that white females were disproportionately affected. The disparities relating to ADAM uncovered in this study may assist healthcare administrators and policymakers in their decisions. Additionally, the findings might help initiate larger studies focusing on these disparities to explore novel risk/prognostic factors for AD.

Background: Parkinson’s disease (PD) is a progressive neurodegenerative condition characterized by the degradation of dopaminergic pathways in the brain. As the population in the United States continues to age, it is essential to understand the trends in mortality related to PD. This analysis of PD’s mortality characterizes temporal shifts, examines demographic and regional differences, and provides machine-learning predictions. Methods: PD-related deaths in the United States were gathered from CDC WONDER. Age-adjusted mortality rates (AAMR) were collected, and trends were analyzed based on gender, race, region, age, and place of death. Annual percent change and average annual percent change were calculated using Joinpoint Regression program. Forecasts were obtained using the optimal Autoregressive Integrated Moving Average (ARIMA) model. Results: Overall mortality rate due to Parkinson’s increased from 1999 to 2022. Male gender, White race, Southern region, and older ages were associated with higher mortality compared to other groups. Deaths at home decreased and hospice deaths increased during the study period. Conclusions: This study highlights the increasing rate of PD AAMR and how it may become even more prevalent with time, emphasizing the value of increasing knowledge surrounding the disease and its trends to better prepare health systems and individual families for the burden of PD.

A 60-year-old man with a history of diabetes mellitus and hypertension presented with diplopia and vertigo for two days. These symptoms had a gradual onset, were progressive, and were associated with a headache that had been present for 15 days. His blood sugar level was 376 mg/dl. His convergence and ability to adduct when looking laterally were affected bilaterally. Additionally, he presented with right exotropia on primary gaze and no ptosis. Brain imaging was normal. Following the rest of the work-up, diabetes mellitus was independently established as the cause of bilateral internuclear ophthalmoplegia in this patient. High blood sugar affects the brain at the molecular level by causing vascular damage, oxidative stress, and decreasing neuroplasticity.