Mortality trends due to respiratory and Parkinson’s disease among patients in United States: a 22 year retrospective analysis

Respiratory diseases and Parkinson’s disease (PD) are leading causes of death in older adults, yet national trends examining their overlap remain understudied. We aim to analyze Respiratory Diseases and Parkinson’s Disease (PD)-related mortality among older adults (≥ 65) in the United States from 1999 to 2020. We conducted a retrospective analysis of national mortality data from 1999 to 2020 using the CDC WONDER Multiple Cause of Death database. Death certificates listing both Parkinson’s disease (ICD-10: G20) and respiratory system diseases (ICD-10: J00–J98) were included. AAMRs were calculated using the U.S. 2000 standard population. Joinpoint regression analysis was used to assess average annual percent changes (APCs) and identify statistically significant shifts in mortality trends across demographic, geographic, and racial subgroups. From 1999 to 2019, national AAMRs declined from 33.1 to 21.3 per 100,000, with a sharp increase to 28.6 in 2020. A reversal of previously declining trends was observed in nearly all subgroups beginning in 2018. Males consistently exhibited higher AAMRs than females, and White individuals had the highest rates among racial groups. Regionally, the Midwest and Northeast showed the highest mortality burdens in 2020, while states such as Nebraska and Vermont recorded the highest AAMRs. Significant heterogeneity in APCs was noted by sex, region, race, and urbanization, with a uniform increase from 2018 to 2020, most likely reflecting pandemic-related disruptions. Despite their clinical significance, respiratory and PD-related deaths remain underrepresented in population-level surveillance. This analysis highlights rising mortality trends and underscores the need for integrated public health strategies that address both respiratory and neurological health. Recognizing the overlap between these condition is essential for improving outcomes in this high-risk population.