Trends in mortality due to acute myocardial infarction and pneumonia among older adults in the U.S.: a CDC wonder analysis (1999-2023)

Abstract

This study aims to assess the comprehensive national trends in deaths related to pneumonia and AMI in the US from 1999 to 2023. CDC wonder multiple cause of death database was used to extract data of elderly (≥65 years) with pneumonia and AMI as main or contributing cause of death. Age-Adjusted Mortality Rates (AAMRs) per 100,000 population were calculated. Trends were stratified by sex, race/ethnicity, state, urban-rural classification, census region, ten-year age group, and place of death. A total of 186,411 deaths associated with pneumonia and AMI during 1999-2023 were identified. The cumulative AAMR was 17.76 during 1999-2020, and 14.2 during 2021-2023. A significant decline in AAMR was found through the study period (AAPC:-4.26, 95% CI −6.71 to -1.74). The AAMR of men was higher than women, and the decrease of AAMR was steeper in women (AAPC:-4.38, 95% CI -6.78 to -1.92 among women vs. -4.07, 95% CI -5.68 to -2.43 among men). NH American Indian or Alaska Native has the highest AAMR, while NH Asian or Pacific Islander had the lowest AAPC (-5.03, 95% CI -7.95 to -2.02). Non-metropolitan had higher AAMR (22.93 vs. 16.59) and AAPC (-1.69 vs. -3.51) than metropolitan. South region showed the highest AAMR and AAPC compared to other census regions. The AAMR per 100,000 of pneumonia and AMI decreased among older adults in the US during 1999-2023, with higher mortality burden among men, NH American Indian or Alaska Native, rural area, and South region.