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P3‐259: Geographic variation in mortality from dementia in the United States in 1999‐2006
Thomas Olabode Obisesan, Ralston Yorrick, Richard Frank Gillum. Alzheimer s & Dementia, 2011-07-01
Topic: Risk, prevention and care in population studies
Geographic variation in occurrence of dementia within the US has received little attention despite its importance for generation of new etiologic hypotheses and health services research. Wetest the hypotheses that the rate of death with underlying or contributing cause coded as dementia on the death certificate varies among states and within states in the US. Data were analyzed from the US multiple cause of death files for 2005-2006 and 1999-2000 for 555,904 US deaths with Alzheimer's Disease (International Classification of Disease 10 revision code G30) and other dementias (codes F01, F02, R54) coded as underlying or contributing cause of death based on the death certificate. Age-adjusted death rates were computed by state or county for persons aged 65years and over. In 2005-2006 combined, 555,904 total deaths occurred with any dementia type (212,386 Alzheimer's disease)coded as underlying or contributing cause. Among the states, age-adjusted rates per 100,000 per year varied by two fold ranging from 458 in New York to 921 in Oregon. High rates were seen in the Pacific Northwest, Northern New England, Southern Appalachia and the Dakotas. Low rates were seen in Southern New England and the Mid-Atlantic, Hawaii and Florida. Similar patterns were seen for Alzheimer's disease. Between 1999-2000 and 2005-2006 the US death rate for dementia increased from 559 to 695 (24%) while that for 3 Alzheimer's disease doubled from 135 to 266. Rates in Washington, Oregon and Vermont were high and New York, Hawaii and Florida low at both times. Use of specific versusnon-specific diagnoses varied among states and over time, explaining most of the temporal increase in rate of Alzheimer's disease. Marked geographic variation in rates of death with all dementias and Alzheimer's disease occurred among US states and overtime. Further research is needed to assess artifacts of diagnosis, certification or coding versus biological variation as possible causes of geographic variation to enhance utility of mortality data for disease monitoring and research.
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APA 7th
Obisesan, T. O., Yorrick, R., & Gillum, R. F. (2011). P3‐259: Geographic variation in mortality from dementia in the United States in 1999‐2006. Alzheimer s & Dementia. https://doi.org/10.1016/j.jalz.2011.05.1700
Vancouver
Obisesan TO, Yorrick R, Gillum RF. P3‐259: Geographic variation in mortality from dementia in the United States in 1999‐2006. Alzheimer s & Dementia. 2011. doi:10.1016/j.jalz.2011.05.1700.
BibTeX
@article{obisesan2011-55d3aea3,
author = {Obisesan, Thomas Olabode and Yorrick, Ralston and Gillum, Richard Frank},
title = {{P3‐259: Geographic variation in mortality from dementia in the United States in 1999‐2006}},
journal = {Alzheimer s \& Dementia},
year = {2011},
doi = {10.1016/j.jalz.2011.05.1700},
url = {https://doi.org/10.1016/j.jalz.2011.05.1700}
}
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Key findings
- Further research is needed to assess artifacts of diagnosis, certification or coding versus biological variation as possible causes of geographic variation to enhance utility of mortality data for disease monitoring and research.
Why it matters
This study found that death rates with dementia coded on the death certificate varied widely between US states and increased over the study period. It does not test any treatment, cure or prevention, and the authors say more research is needed to tell whether these patterns reflect real differences or differences in diagnosis and coding.
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Study details
- Evidence strengthLow
How this study scored 25/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2011 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 17 year(s) since 2011 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Richard Frank Gillum: h-index 62 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Howard University: institution h-index 335 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 25 / 100 | — |
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