Rising Hyperlipidemia and Dementia Related Mortality Among Older Adults: United States Epidemiological Trends (2000–2023)

Background Hyperlipidemia (HL) and dementia represent significant health burdens among older adults, with established pathophysiological links. This study examined mortality trends among older adults with both conditions in the United States from 2000 to 2023. Methods We analyzed CDC WONDER Multiple Cause of Death data for decedents aged ≥ 65 years with HL (E78.1-E78.5) and dementia (F01, F03, G30) listed as contributing or underlying causes. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated and stratified by sex, race/ethnicity, geographic region, and urbanization. Temporal trends were assessed using Joinpoint regression analysis. Results From 2000 to 2023, 216,705 HL and dementia-related deaths occurred among older adults. The AAMR increased over six-fold from 2.8 (95% CI: 2.6-3.0) in 2000 to 17.8 (95% CI: 17.7–17.9) in 2023 (AAPC: 11.8%; p < 0.001). Mortality accelerated sharply from 2018–2021 (APC: 16.3%), followed by a slight decline. Women consistently exhibited higher AAMRs than men. Non-Hispanic Black individuals experienced the highest burden and most rapid increase (AAMR: 2.0 to 40.4). Geographic disparities were pronounced, with Southern states and non-metropolitan areas demonstrating elevated mortality. Most deaths occurred in nursing homes (43.7%) or decedents' homes (27.3%). Conclusions HL and dementia-related mortality among older Americans has risen dramatically over two decades, with marked disparities by race, sex, and geography. These findings underscore an escalating public health crisis requiring targeted interventions for vulnerable populations.