Demographic and regional disparities in mortality among older adults with coexisting cerebrovascular disease and vascular dementia in the United States, 2005-2023: A CDC WONDER analysis

Background Age-related vascular injury accelerates cognitive decline and impairs memory consolidation, while progressive brain dysfunction further heightens the risk of cerebrovascular disease. The coexistence of cerebrovascular diseases (CeVD) and vascular dementia (VaD) represents a critical yet underexplored intersection contributing to morbidity and mortality in older adults. This study aimed to investigate national mortality trends associated with coexisting CeVD and VaD among U.S. adults aged ≥65 years from 2005 to 2023. Methods Mortality data were extracted from the CDC WONDER database (2005–2023) using ICD-10 codes F01 (VaD) and I60–I69 (CeVD). Age-adjusted and crude mortality rates (AAMRs and CMRs) were calculated, and Joinpoint regression analysis (v5.4.0) was applied to estimate annual percent change (APC) and average annual percent change (AAPC) across demographic and regional subgroups. Results Between 2005 and 2023, 200,450 deaths were attributed to coexisting CeVD and VaD among older adults. The overall AAMR increased markedly from 9.38 to 40.28 per 100,000 population (AAPC: 8.30; p < 0.05). Mortality was marginally higher in females than males (22.4 vs 21.1). Non-Hispanic (NH) Blacks exhibited the highest AAMR (28.5), followed by NH Whites (22.0), Hispanics (19.0), and NH Asians (15.9). The ≥85 age group showed the highest CMR (107.8). Regionally, the Western U.S. and metropolitan areas recorded the greatest mortality burdens. Conclusion Mortality linked to coexisting CeVD and VaD has risen sharply, disproportionately affecting geriatric females, NH Blacks, and urban populations. These findings underscore the urgent need for targeted neurovascular prevention and equitable geriatric health strategies.