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Estimates of the Association of Dementia With US Mortality Levels Using Linked Survey and Mortality Records
Stokes AC, Weiss J, Lundberg DJ, Xie W, Kim JK, Preston SH, Crimmins EM.. JAMA neurology, 2020-12-01
Topic: Risk, prevention and care in population studies
Results were compared with information on cause of death from death certificates. Results Of the 7342 total sample, 4348 participants (60.3%) were women. The mortality burden of dementia was significantly higher among non-Hispanic Black participants (24.7%; 95% CI, 17.3-31.4) than non-Hispanic White participants (12.2%; 95% CI, 10.7-13.6) and among adults with less than a high school education (16.2%; 95% CI, 13.2%-19.0%) compared with those with a college education (9.8%; 95% CI, 7.0%-12.5%). Incorporating deaths attributable to CIND revealed an even greater underestimation. Conclusions and relevance The findings of this study suggest that the mortality burden associated with dementia is underestimated using vital statistics, especially when considering CIND in addition to dementia.
Key findings
- Results were compared with information on cause of death from death certificates.
- Results Of the 7342 total sample, 4348 participants (60.3%) were women.
- The mortality burden of dementia was significantly higher among non-Hispanic Black participants (24.7%; 95% CI, 17.3-31.4) than non-Hispanic White participants (12.2%; 95% CI, 10.7-13.6) and among adults with less than a high school education (16.2%; 95% CI, 13.2%-19.0%) compared with those with a college education (9.8%; 95% CI, 7.0%-12.5%).
- Incorporating deaths attributable to CIND revealed an even greater underestimation.
- Conclusions and relevance The findings of this study suggest that the mortality burden associated with dementia is underestimated using vital statistics, especially when considering CIND in addition to dementia.
Why it matters
Death certificates and other vital statistics undercount how many US deaths are associated with dementia, this study of 7,342 survey participants linked to mortality records suggests. The estimated dementia mortality burden was 24.7% among non-Hispanic Black participants versus 12.2% among non-Hispanic White participants, and 16.2% among adults without a high-school diploma versus 9.8% among college graduates. It measures how deaths are counted; it does not test any treatment or explain why the groups differ.
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Study details
- Study designcohort study
- Participants7,342
- Effect size60.3%; 64.0%; 31.0%
- Evidence strengthModerate
How this study scored 67/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (JAMA neurology) |
| Journal's citation record | 2 / 4 | JAMA Neurology: journal h-index 235 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 3 / 4 | 7,342 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 93 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 11.6 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 3 / 6 | Cited 7.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 15 other studies in this library |
| Still being cited | 2 / 4 | Cited 47 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Eileen M. Crimmins: h-index 91 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, Berkeley: institution h-index 2,012 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 32852519) |
| Free to read | 2 / 2 | Free to read |
| Total | 67 / 100 | — |
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Read the original
- DOI: 10.1001/jamaneurol.2020.2831
- PubMed: 32852519
- Original source →
- Free full text: JAMA Neurology →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Stokes, A. C., Weiss, J., Lundberg, D. J., Xie, W., Kim, J. K., Preston, S. H., et al. (2020). Estimates of the Association of Dementia With US Mortality Levels Using Linked Survey and Mortality Records. JAMA neurology. https://doi.org/10.1001/jamaneurol.2020.2831
Vancouver
Stokes AC, Weiss J, Lundberg DJ, Xie W, Kim JK, Preston SH, et al. Estimates of the Association of Dementia With US Mortality Levels Using Linked Survey and Mortality Records. JAMA neurology. 2020. doi:10.1001/jamaneurol.2020.2831. PMID: 32852519.
BibTeX
@article{stokes2020-32852519,
author = {Stokes, A. C. and Weiss, J. and Lundberg, D. J. and Xie, W. and Kim, J. K. and Preston, S. H. and Crimmins, E. M.},
title = {{Estimates of the Association of Dementia With US Mortality Levels Using Linked Survey and Mortality Records}},
journal = {JAMA neurology},
year = {2020},
doi = {10.1001/jamaneurol.2020.2831},
pmid = {32852519},
url = {https://doi.org/10.1001/jamaneurol.2020.2831}
}
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