Dementia May Cause 3 Times as Many US Deaths as Previously Believed


Although dementia-related deaths appear to be underreported overall, a study showed especially striking discrepancies for Black, male, and less educated older adults.

According to a new study published in JAMA Neurology, dementia may be an underlying cause of 13.6% of deaths, significantly more than was previously believed based off of death certificates indicating dementia as an underlying cause of death.

“These findings indicate that dementia represents a much more important factor in US mortality than previously indicated by routine death records,” said senior author Eileen Crimmins, PhD, in a press release.

Investigators at the Boston University School of Medicine used data from a nationally representative cohort of 7342 older adults in the Health and Retirement Study. For their purposes, the researchers used data from adults who entered the cohort in 2000 and followed them up to 2009, analyzing the association between dementia and death when adjusting for other variables.

“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 lead author Andrew Stokes, in a press release. “Our results indicate that the mortality burden of dementia may be greater than recognized, highlighting the importance of expanding dementia prevention and care.”

According to their findings, the 13.6% of deaths possibly attributable to dementia is 2.7 times more than the 5% of death certificates indicating dementia as a possible underlying cause. The amount of underestimation can vary greatly by race, however, with 7.1 times more Black older adults, 4.1 times more Hispanic older adults, and 2.3 times more white older adults dying from dementia than government records indicate, according to the study.

The authors also noted that dementia-related deaths were underreported more often for men than women, and more for individuals without a high school education. Earlier research has shown that dementia is disproportionately common among older adults who are Black, male, and have less education.

“In addition to underestimating dementia deaths, official tallies also appear to underestimate racial and ethnic disparities associated with dementia mortality,” Stokes said in the release. “Our estimates indicate an urgent need to realign resources to address the disproportionate burden of dementia in Black and Hispanic communities.”


Dementia kills nearly three times more people than previously thought: BU study [news release]. Boston University School of Medicine; August 24, 2020. Accessed August 25, 2020.

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