Huntington’s Disease-Related Mortality Patterns: A Two-Decade Analysis of Mortality Trends in the United States, from 1999–2019

Author:

Bin Kashif Muhammad Arham1,Mahmood Samar1ORCID,Saqib Tahrim2,Waheed Syeda Tahira3,Kumar Piresh4,Javaid Aima5,Riaz Muhammad Asjad6,Fatima Urooj7,Nadeem Zain Ali6,Nasir Shahbaz Ali8,Hassan Afrah9

Affiliation:

1. Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan

2. Department of Internal Medicine, Foundation University Medical College, Islamabad, Pakistan

3. Department of Internal Medicine, Liaquat National Medical College and Hospital, Karachi, Pakistan

4. Department of Internal Medicine, Bahria University Health Sciences, Karachi, Pakistan

5. Department of Internal Medicine, Fatima Jinnah Medical University, Lahore, Pakistan

6. Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan

7. Department of Internal Medicine, Karachi Medical and Dental College, Karachi, Pakistan

8. Department of Internal Medicine, Indus Hospital Kahna Nau, Lahore, Pakistan

9. Department of Internal Medicine, Jinnah Sindh Medical University, Karachi, Pakistan

Abstract

Background: Huntington’s disease (HD) is an autosomal dominant, progressive neurodegenerative disorder debilitating mainly in adults. Objective: This study aimed to assess the trends in HD-related mortality regarding various demographic factors. Methods: Death certificates from the CDC WONDER were studied from 1999 to 2019, for HD-related mortality in adults aged 25 + years. Age-adjusted Mortality Rate (AAMR) per 100,000 persons and Annual Percentage Change (APC) were calculated and stratified by year, age groups, gender, race/ethnicity, state, census region, urbanization, and place of death. Results: Between 1999 to 2019, 22,595 deaths occurred in adults due to HD. The AAMR increased from 0.43 to 0.54 during this period (APC = 0.50; 95% CI: 0.18 to 0.84). Old adults (65–85 + years) had the highest overall AAMR, followed by middle-aged adults (45–64 years) and young adults (25–44 years) (AAMR old: 1.01 vs. AAMR middle-age: 0.68 vs. AAMR young: 0.16). Men had slightly greater overall AAMRs than women (AAMR men: 0.54 vs. AAMR women: 0.48). When stratified by race, non-Hispanic (NH) Whites had significantly higher mortality rates than NH African Americans (AAMR NH White: 0.61 vs. NH African American: 0.35), while the AAMR were lowest in Hispanic/Latino (0.28). The AAMRs also showed variation by region (overall AAMR: Midwest: 0.63, Northeast: 0.47, West: 0.48, South: 0.46), and non-metropolitan areas had higher HD-related AAMR (0.66) than metropolitan areas (0.47). Conclusions: HD-related mortality in US adults has increased since 1999. Reflecting on the variations in trends observed, new strategies are required to optimize the quality of care in long-term care facilities.

Publisher

IOS Press

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