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29/100

✓ Peer-reviewed alzhub usefulness score 29 out of 100. Disparities

Topic: Risk, prevention and care in population studies

Plain-language summary

Dementia, including Alzheimer’s disease and related dementias (ADRD), is a major cause of death among older adults in the United States. However, limited data exist on how dementia-related mortality patterns vary across urban and rural settings. This study aimed to examine national trends in dementia-related mortality from 1999 to 2020, with a focus on geographic disparities and differences in place of death. We analyzed mortality data from the CDC WONDER Multiple Cause of Death database for U.S. adults aged ≥65 years. Dementia-related deaths were identified using ICD-10 codes F01, F03, and G30. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Trends were assessed using joinpoint regression to estimate annual percent change (APC). Urbanization was classified using the 2013 NCHS Urban–Rural scheme. The place of death was examined by urban and rural residence. From 1999 to 2020, 6516,402 dementia-related deaths were recorded. The AAMR nearly doubled, increasing from 434.9 to 855.1 per 100,000. Females had higher AAMRs (from 444.5 to 905.9) than males (from 405.7 to 767.4). The steepest rise occurred in noncore rural counties (APC: 2.02 %; p < 0.001), while large central metropolitan areas showed slower growth (APC: 0.57 %). In rural areas, 61.8 % of dementia deaths occurred in nursing homes compared to 53.9 % in urban areas. Hospice facility deaths were less common in rural regions (2.1 % vs. 4.6 %), and home deaths were slightly lower (15.0 % vs. 18.6 %). Disparities persisted across age and racial/ethnic groups, with the oldest-old (≥85) and rural Black and White adults bearing the greatest burden. Dementia-related mortality has increased significantly over two decades, with disproportionately higher rates and institutional deaths in rural communities. These findings call for targeted interventions to reduce geographic disparities in dementia care and end-of-life services.

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APA 7th

Shah, S., Syed, R., Khan, A., Ali, M., & Syed, F. (2025). Urban–rural disparities in dementia-related mortality among older adults in the U.S. from 1999 to 2020. Archives of Gerontology and Geriatrics Plus. https://doi.org/10.1016/j.aggp.2025.100214

Vancouver

Shah S, Syed R, Khan A, Ali M, Syed F. Urban–rural disparities in dementia-related mortality among older adults in the U.S. from 1999 to 2020. Archives of Gerontology and Geriatrics Plus. 2025. doi:10.1016/j.aggp.2025.100214.

BibTeX

@article{shah2025-238a4bfe,
  author  = {Shah, Suleman and Syed, Rahman and Khan, Anfal and Ali, Mohsin and Syed, Fazal},
  title   = {{Urban–rural disparities in dementia-related mortality among older adults in the U.S. from 1999 to 2020}},
  journal = {Archives of Gerontology and Geriatrics Plus},
  year    = {2025},
  doi     = {10.1016/j.aggp.2025.100214},
  url     = {https://doi.org/10.1016/j.aggp.2025.100214}
}

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How to read this study

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What the evidence grade means here

This page is graded low. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. Low means the abstract matched neither pattern. It is the default label, and it does not mean the work is poor; many sound lab and imaging papers land here. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

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Key findings

In rural areas, 61.8 % of dementia deaths occurred in nursing homes compared to 53.9 % in urban areas.
Dementia-related mortality has increased significantly over two decades, with disproportionately higher rates and institutional deaths in rural communities.
These findings call for targeted interventions to reduce geographic disparities in dementia care and end-of-life services.

Why it matters

Dementia-related deaths in U.S. older adults nearly doubled from 1999 to 2020, with the steepest rise in noncore rural counties and more nursing home deaths in rural areas. The paper calls for targeted interventions to reduce geographic disparities but does not test any treatment, cure, or prevention.

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Study details

Evidence strengthLow

How this study scored 29/100

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. We have no data on senior author's track record, so that was left out: it earned 28 of the 96 points we could judge it on, which is 29 out of 100.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Archives of Gerontology and Geriatrics Plus)
Journal's citation record	0 / 4	Archives of Gerontology and Geriatrics Plus: journal h-index 12 (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	4 / 5	2025 — within 3 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	1 / 7	Cited 1 times (OpenAlex, 2026-10-10)
Citations per year	0 / 5	0.3 citations a year over 3 year(s) since 2025
Impact for its field and year	1 / 6	Cited 0.6× 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 1 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	— / 4	OpenAlex's profile for last-listed author Fazal Syed holds only 4 work(s), too few to judge a track record — left out of this score
Institution's track record	0 / 3	Saidu Medical College: institution h-index 20 (OpenAlex)
Multicenter collaboration	1 / 3	OpenAlex lists 2 institution(s) in 1 country
Indexed in PubMed	1 / 2	Not in PubMed, but has a DOI
Free to read	2 / 2	Free to read
Points	28 / 96	Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 28 of the 96 points we could judge it on is 29 out of 100.
Total	29 / 100	—

What each of these 20 components measures, and what this score is not →

Read the original

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