Evolution of Glaucoma-Related Mortality among Older Adults in the United States: Insights from CDC WONDER (2000–2023)

Glaucoma is a common optic neuropathy in older U.S. adults, yet its national temporal mortality trends have not been elucidated. This study examines glaucoma-related trends and disparities in mortality among older adults, promoting awareness of ophthalmic health inequities. Death certificates from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database were analyzed among adults aged ≥ 65 years with glaucoma-related deaths from 2000 to 2023. Crude mortality rates (CMRs) and age-adjusted mortality rates (AAMRs) per 100,000 were calculated and stratified by demographics and geography. Trends in annual percent change (APC) and average APC were assessed using Jointpoint regression with 95% confidence intervals. A total of 21,805 glaucoma-related deaths occurred in older adults from 2000 to 2023. AAMRs declined initially from 2.98 in 2000 to 1.80 in 2009 (APC: -6.01; 95% CI: -10.46 to -4.53), followed by stable rates until 2023. Mortality rates were highest in adults aged ≥ 85 years, men, non-Hispanic (NH) Black/African Americans, residents of non-metropolitan areas, and Midwestern regions. Heart disease was the leading underlying cause of glaucoma-associated death, with COVID-19 playing a major role from 2000 to 2023. Glaucoma-related mortality in older adults rose with notable risks among adults aged ≥ 85 years, men, NH Black/African Americans, residents in non-metropolitan areas, and the Midwest. These findings call for targeted, informed public health interventions to ameliorate outcomes.