Demographic trends of motor neurone disease-associated mortality from 1999-2020 in the United States.

Introduction: Motor Neurone Disease (MND) is a neurodegenerative condition affecting motor neurons in spinal cord and brainstem, leading to a reduced life expectancy. This study describes demographic trends in MND-associated mortality in the United States over a 20-year period. Methods: Data was extracted from the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research underlying cause of death database. All death certificates from 1999-2020 with MND (G12.2) recorded as the cause of mortality were extracted. Annual MND-associated crude mortality rates (CMR) and age-adjusted mortality rates (AAMR) per 100,000 persons with 95% confidence intervals (CI) were calculated. Joinpont regression was used to calculate the annual trends in MND-associated mortality by calculating the annual percentage change. Results: Between 1999 to 2020, there were a total 140,945 MND-associated deaths. Overall AAMR was 1.9 per 100,000 persons (95% CI 1.9-1.9). Male sex had a consistently higher AAMR (2.3 per 100,000 95% CI 2.3-2.3) than female sex (1.6 per 100,000 95% CI 1.5-1.6) across the study period. White patients had higher AAMR (2.1 per 100,000 95% CI 2.0-2.1) than Black/African Americans (1.1 per 100,000 95% CI 1.0-1.1), American Indians/Alaska Natives (0.8 per 100,000 95% CI 0.7-0.9), Asians/Pacific Islanders (0.8 per 100,000 95% CI 0.7-0.9). The 3 US States with the highest AAMR were Vermont, followed by Minnesota and Maine. Conclusions: There are a significant number of MND-associated deaths annually in the United States. The knowledge of these trends facilitates the design of appropriate services in areas of higher need, allowing for the introduction of pathways that support more suitable care and enhanced quality of life.