Alzheimer’s Death Rate Climbs Tenfold : Health: Experts say the number of people who have the disease may be rising, but the statistical change more likely reflects physician awareness.
The reported death rate from Alzheimer’s disease jumped tenfold between 1979 and 1987, federal health officials said Thursday.
While the number of people contracting the disease may be rising, the statistical increase more likely reflects the fact that physicians are more aware of Alzheimer’s and are diagnosing it more frequently, according to the Centers for Disease Control, which released the findings.
Alzheimer’s disease is a progressive, irreversible neurological disorder of the elderly, marked by memory loss and severe disorientation. It currently afflicts an estimated 4 million Americans, according to the Alzheimer’s Assn.
From 1979 through 1987, Alzheimer’s was listed as the underlying cause of death for 46,202 Americans, the CDC reported. The death rate from the disease increased from 0.4 per 100,000 people in 1979 to 4.2 per 100,000 people in 1987, it said.
For men, the annual rate increased from 0.5 to 4.6 per 100,000 people, the CDC said. For women, the rate rose from 0.3 to 3.9.
In California, the number of reported deaths attributed to Alzheimer’s rose from 109 in 1979 to 1,052 in 1987. The state’s death rate increased from 0.5 per 100,000 people in 1979 to 3.9 in 1987.
“I think it’s true that the numbers of people may have increased over time, but it’s a little bit difficult to imagine that that would account for an almost tenfold increase,” said Dr. Richard Sun, a medical epidemiologist with the CDC. “If there had been a true increase in incidence, I think our nursing homes would be overrun. If anything, I think heightened awareness (on the part of physicians) is the stronger factor.”
Stephen McConnell, vice president for public policy of the Alzheimer’s Assn., a Washington-based organization, agreed.
“Alzheimer’s has been woefully under-reported in the past,” he said. “We know a lot more about diagnosing the disease now than we did 10 years ago. Until recently, when a person contracted Alzheimer’s and declined, the thing that finally brought it to an end was pneumonia or something else. That’s what would appear on the death certificate--and that’s what got reported. Now physicians are making sure that Alzheimer’s is on the death certificate.”
McConnell acknowledged, however, that the actual incidence of the disease could be rising as well. “People are living longer, and the elderly is the population with the highest incidence (of Alzheimer’s),” he said. “So there will be more people dying of it.”
He added: “Whatever the statistics, we still think it is under-reported.”
The CDC’s Sun said he believes “there are a lot of unknowns here,” and that “further investigation is needed to help clarify what is going on.”
He said the CDC plans to begin a study in collaboration with the Wesley Woods Geriatric Hospital in Atlanta “to resolve some of the issues.”
The study will look at patients who had been hospitalized and who died--either during or after hospitalization--to determine what percentage had Alzheimer’s and what percentage of those patients had Alzheimer’s listed as the official cause of death. Likewise, the study will attempt to determine what percentage of patients might have had Alzheimer’s incorrectly listed on their death certificates as the cause of death.
“Over time,” Sun said, “we’ll see if more people had it written on their death certificates in the true sense or mistakenly.”
The study could help reveal whether there is a heightened awareness among physicians, Sun said. “But it won’t answer the question of whether Alzheimer’s has actually increased in the population,” he added.
