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Study: Alzheimer's and Other Types of Dementia May Be Underreported on Death Certificates

By Miranda Hitti
WebMD Health News

Reviewed By Louise Chang, MD

Dec. 9, 2008 -- Dementia, especially Alzheimer's disease, often doesn't get noted on death certificates, which may lead to an underestimate of how deadly those conditions are.

That's according to a letter published in the Dec. 10 edition of The Journal of the American Medical Association.

The letter comes from Melissa Wachterman, MD, MPH, of Brigham and Women's Hospital in Boston.

She writes that the National Center for Health Statistics ranked Alzheimer's disease as the No. 5 cause of death for U.S. residents older than age 65 in 2004, based on data from death certificates. But death certificate data may be flawed by underreporting of Alzheimer's and other types of dementia, Wachterman says.

Wachterman's team checked the death certificates of 165 elders in Boston who had been diagnosed with Alzheimer's disease or other forms of dementia before their deaths.

Dementia wasn't mentioned on 37% of the death certificates, even as a condition that wasn't the primary cause of death. And of the 114 people who had specifically been diagnosed with Alzheimer's disease before death, Alzheimer's was only mentioned on 27% of their death certificates.

It's not clear if such underreporting is common across the country, but if so, it raises questions about Alzheimer's death statistics based on death certificates, Wachterman notes.

Her point isn't just about statistical accuracy. "Underestimation of the burden of dementia as a major fatal illness may hamper planning of health services needed for persons dying with this condition," Wachterman writes.

SOURCES: Wachterman, M. The Journal of the American Medical Association, Dec. 10, 2008; vol 300: pp 2608-2610.

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