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Peer-reviewedCC BY 4.0Frontiers in Public Health

Trends and disparities in depression-related mortality among older adults in the United States, 1999–2020

  • Tong Feng1
  • Pengcheng Zheng2,3,4
  • Qingyuan Li2,3,4
  • Ding Han1
  • Ran Duan2,5
5 affiliations
  1. 1Department of Respiratory and Critical Care Medicine, Deyang People’s Hospital
  2. 2School of Clinical Medicine, Chengdu Medical College
  3. 3Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College
  4. 4Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institute
  5. 5Department of Oncology, The First Affiliated Hospital of Chengdu Medical College
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Abstract

Background: National trends in mortality with depression recorded as the underlying cause among older adults remain insufficiently characterized. We examined recorded mortality and demographic and geographic disparities among U.S. adults aged ≥65 years during 1999–2020.

Methods: CDC WONDER Underlying Cause of Death data were used to identify deaths with ICD-10 F32 or F33 as the underlying cause. Age-adjusted mortality rates (AAMRs) per 100,000 population and age-specific rates were calculated. Joinpoint regression assessed temporal trends, ARIMA generated exploratory projections through 2030, and Frontier analysis provided descriptive state-level benchmarking. Sensitivity analyses examined any mention of F32/F33 in multiple-cause-of-death records and trends after excluding 2020.

Results: The primary analysis identified 11,858 deaths, with an overall AAMR of 1.29 per 100,000. Higher recorded rates were observed among women, non-Hispanic and White older adults, nonmetropolitan residents, and residents of the Midwest. Overall AAMR declined (AAPC, −3.26%; p < 0.001), most sharply during 2003–2007; the 2018–2020 increase was not statistically significant. A long-term decline remained after excluding 2020. The broader multiple-cause definition identified 236,831 deaths, 19.97 times the primary count, and showed a different late-period pattern. ARIMA projected declining rates. Frontier analysis showed substantial state-level heterogeneity.

Conclusion: Mortality with depression recorded as the underlying cause declined, but the broader any-mention definition yielded different trends. Continued surveillance, equitable recognition and documentation, and culturally responsive geriatric mental health care remain important.

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Cite

BibTeXRIS
BibTeX
@article{feng2026trends,
  title = {{Trends and disparities in depression-related mortality among older adults in the United States, 1999–2020}},
  author = {Tong Feng and Pengcheng Zheng and Qingyuan Li and Ding Han and Ran Duan},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1908154},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1908154/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Trends and disparities in depression-related mortality among older adults in the United States, 1999–2020
AU  - Tong Feng
AU  - Pengcheng Zheng
AU  - Qingyuan Li
AU  - Ding Han
AU  - Ran Duan
PY  - 2026
DA  - 2026/10/28
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1908154
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1908154/full
AB  - Background: National trends in mortality with depression recorded as the underlying cause among older adults remain insufficiently characterized. We examined recorded mortality and demographic and geographic disparities among U.S. adults aged ≥65 years during 1999–2020.  Methods: CDC WONDER Underlying Cause of Death data were used to identify deaths with ICD-10 F32 or F33 as the underlying cause. Age-adjusted mortality rates (AAMRs) per 100,000 population and age-specific rates were calculated. Joinpoint regression assessed temporal trends, ARIMA generated exploratory projections through 2030, and Frontier analysis provided descriptive state-level benchmarking. Sensitivity analyses examined any mention of F32/F33 in multiple-cause-of-death records and trends after excluding 2020.  Results: The primary analysis identified 11,858 deaths, with an overall AAMR of 1.29 per 100,000. Higher recorded rates were observed among women, non-Hispanic and White older adults, nonmetropolitan residents, and residents of the Midwest. Overall AAMR declined (AAPC, −3.26%; p < 0.001), most sharply during 2003–2007; the 2018–2020 increase was not statistically significant. A long-term decline remained after excluding 2020. The broader multiple-cause definition identified 236,831 deaths, 19.97 times the primary count, and showed a different late-period pattern. ARIMA projected declining rates. Frontier analysis showed substantial state-level heterogeneity.  Conclusion: Mortality with depression recorded as the underlying cause declined, but the broader any-mention definition yielded different trends. Continued surveillance, equitable recognition and documentation, and culturally responsive geriatric mental health care remain important.
SN  - 2296-2565
ER  -