Alzheimer’s Disease in New Mexico Michael Landen, MD, MPH State Epidemiologist New Mexico Department of Health

Objectives Present existing population based data for Alzheimer’s disease in New Mexico Discuss possible improvements to population based data for Alzheimer’s disease in New Mexico

New Mexico Health Regions Northeast Northwest Metro Southeast Southwest

NM Urban-Rural County Classification Metropolitan Counties Small Metro Counties Mixed Urban/Rural Counties Rural Counties

Top 8 Leading Causes of Death, New Mexico, 2017 and U.S., 2016 Source, New Mexico: Vital Records and Health Statistics United States: National Center for Health Statistics (NCHS)

Alzheimer’s Disease Death Rates New Mexico, 1999-2017 and U. S Rates have been age-adjusted to the standard U.S. 2000 population Source: NM Vital Records and Health Statistics; CDC WONDER

Alzheimer’s Disease Death Rates Ages 65+ New Mexico, 1999-2017 and U.S., 1999-2017 Source: NM Vital Records and Health Statistics; CDC WONDER

Alzheimer’s Disease Death Rates Ages 65+ by Sex New Mexico, 2015-2017 Source: NM Vital Records and Health Statistics

Alzheimer’s Disease Death Rates Ages 65+ by Race/Ethnicity New Mexico, 2015-2017 Source: NM Vital Records and Health Statistics

Alzheimer’s Disease Death Rates Ages 65+ by Health Region New Mexico, 2015-2017 Source: NM Vital Records and Health Statistics

Alzheimer’s Disease Death Rates Ages 65+ by Urban and Rural Counties New Mexico, 2015-2017 Source: NM Vital Records and Health Statistics

Alzheimer’s Disease Among New Mexico Adults Age 65+, 2015-2017 Education Level was associated with Tobacco Use. Reports of tobacco use declined with increased education. SOURCE: Hospital Inpatient and Discharge Data, ICD-9 331.0 (2015); ICD-10 G30 (2016 and 2017)

Alzheimer’s Disease Among New Mexico Adults Age 65+, 2015-2017 Education Level was associated with Tobacco Use. Reports of tobacco use declined with increased education. SOURCE: Hospital Inpatient and Discharge Data, ICD-9 331.0 (2015); ICD-10 G30 (2016 and 2017)

Alzheimer’s Disease Among New Mexico Adults Age 65+, by Race/Ethnicity, 2017 Education Level was associated with Tobacco Use. Reports of tobacco use declined with increased education. SOURCE: Hospital Inpatient and Discharge Data, ICD-9 331.0 (2015); ICD-10 G30 (2016 and 2017)

Alzheimer’s Disease Among New Mexico Adults Age 65+, by Health Region, 2017 Education Level was associated with Tobacco Use. Reports of tobacco use declined with increased education. SOURCE: Hospital Inpatient and Discharge Data, ICD-9 331.0 (2015); ICD-10 G30 (2016 and 2017)

Medical Conditions Related to Alzheimer’s Disease Among New Mexico Adults Age 65+, Hospitalization, 2017 TOP 8 Medical Conditions Count of Alzheimer’s disease Top 8 subcategories of MDC Infectious and Parasitic Diseases 228 Septicemia 215 Diseases of the Nervous System and Sense Organs 219 Fractures, All Sites 143 Diseases of the Circulatory System 203 Heart Disease 117 Injury and Poisoning 199 Psychoses 80 Diseases of the Respiratory System 167 Pneumonia 66 Diseases of the Genitourinary System 123 Cerebrovascular Disease 63 Mental Disorders 83 Urinary Tract Infection 58 Diseases of the Digestive System 77 Certain Complications of Surgical and Medical Care 24

Alzheimer’s Disease Among New Mexico Adults Age 65+, 2015-2017 Education Level was associated with Tobacco Use. Reports of tobacco use declined with increased education. SOURCE: Emergency Department Data, ICD-9 331.0 (2015); ICD-10 G30 (2016 and 2017)

SOURCE: Emergency Department Data, ICD-9 331 SOURCE: Emergency Department Data, ICD-9 331.0 (2015); ICD-10 G30 (2016 and 2017)

SOURCE: Emergency Department Data, ICD-9 331 SOURCE: Emergency Department Data, ICD-9 331.0 (2015); ICD-10 G30 (2016 and 2017)

SOURCE: Emergency Department Data, ICD-9 331 SOURCE: Emergency Department Data, ICD-9 331.0 (2015); ICD-10 G30 (2016 and 2017)

Alzheimer’s Disease and Related Dementias (ADRD) Early Onset (<65 Years), 2017 Vital Records* 20 individuals died from an underlying cause of ADRD who were younger than 65 years (1.4% of ADRD deaths). Mean Age: 57.3 years Range: 48-64 years (55% White and 35% Hispanic) ED Admissions ~ 837 ED admissions for ADRD in patients younger than 65 years (~8% of all ADRD ED admissions) Mean Age: ~ 54 years Range: 10 – 64 years (~43% White and ~43% Hispanic) Hospitalizations ~ 1017 Hospitalizations for ADRD patients younger than 65 years (10.7% of all ADRD Hospitalizations). Mean Age: 52.4 years Range: 0-64 years (~39% White, ~ 38% Hispanic and ~11% AIAN) *Source: NM Vital Records and Health Statistics, ICD-10 codes: G30, G31, F01, F03

Cognitive Decline in New Mexico, 2016 12.5% of adults over 45 years of age experienced confusion or memory loss that is happening more often or getting worse in the past twelve months Source: NM Behavioral Risk Factor Surveillance System

Subjective Cognitive Decline* by Health Region New Mexico, 2016 *NM Adults over 45 years of age who in the past 12 months experienced confusion or memory loss that is happening more often or is getting worse Source: NM Behavioral Risk Factor Surveillance System

Cognitive Decline* by Urban and Rural Counties New Mexico, 2016 *NM Adults over 45 years of age who in the past 12 months experienced confusion or memory loss that is happening more often or is getting worse Source: NM Behavioral Risk Factor Surveillance System

Cognitive Decline*, by Age Group New Mexico, 2016 *NM Adults over 45 years of age who in the past 12 months experienced confusion or memory loss that is happening more often or is getting worse Source: NM Behavioral Risk Factor Surveillance System

Cognitive Decline* by Household Income New Mexico, 2016 *NM Adults over 45 years of age who in the past 12 months experienced confusion or memory loss that is happening more often or is getting worse Source: NM Behavioral Risk Factor Surveillance System

Cognitive Decline* by Race/Ethnicity New Mexico, 2016 *NM Adults over 45 years of age who in the past 12 months experienced confusion or memory loss that is happening more often or is getting worse ** Suppressed due to a denominator <50 Source: NM Behavioral Risk Factor Surveillance System

Subjective Cognitive Decline Subjective Cognitive Decline* by Educational Attainment New Mexico, 2016 *NM Adults over 45 years of age who in the past 12 months experienced confusion or memory loss that is happening more often or is getting worse Source: NM Behavioral Risk Factor Surveillance System

Subjective Cognitive Decline* New Mexico vs. US, 2015-2016 *Adults over 45 years of age who in the past 12 months experienced confusion or memory loss that is happening more often or is getting worse Source: NM Behavioral Risk Factor Surveillance System

Caregiving in New Mexico and U.S. 2016-2017 *Adults who provide regular care or assistance to a Friend or Family member with a health problem or disability Source: NM Behavioral Risk Factor Surveillance System

Discussion What additional analyses of existing population based data are needed for NM? What additional population based data is needed on Alzheimer’s disease for NM?