Cause-Specific Mortality Among Adults Aged ≥65 Years in the United States, 1999 Through 2020

Abstract
Objective: Reports on recent mortality trends among adults aged >= 65 years are lacking. We examined trends in the leading causes of death from 1999 through 2020 among US adults aged >= 65 years. Methods: We used data from the National Vital Statistics System mortality files to identify the 10 leading causes of death among adults aged >= 65 years. We calculated overall and cause-specific age-adjusted death rates and then calculated the average annual percentage change (AAPC) in death rates from 1999 through 2020. Results: The overall age-adjusted death rate decreased on average by 0.5% (95% CI, -1.0% to -0.1%) per year from 1999 through 2020. Although rates for 7 of the top 10 causes of death decreased significantly, the rates of death from Alzheimer disease (AAPC = 3.0%; 95% CI, 1.5% to 4.5%) and from unintentional injuries (AAPC = 1.2%; 95% CI, 1.0% to 1.4%), notably falls (AAPC = 4.1%; 95% CI, 3.9% to 4.3%) and poisoning (AAPC = 6.6%; 95% CI, 6.0% to 7.2%), increased significantly. Conclusion: Public health prevention strategies and improved chronic disease management may have contributed to decreased rates in the leading causes of death. However, longer survival with comorbidities may have contributed to increased rates of death from Alzheimer disease and unintentional falls.