Trends and Disparities in Atrial Fibrillation-Related Mortality Among Older Adults with Parkinson's Disease in the United States, 2000--2023

\articletype Original Articles Background: The coexistence of parkinson’s disease (PD) and atrial fibrillation (AF) is increasingly recognized, but the mortality burden and disparities among affected individuals remain poorly characterized. Objective: This study aimed to analyze 24-year trends, demographic patterns, and geographic disparities in AF-related mortality among US older adults with PD. Methods: We conducted a population-based analysis using CDC WONDER Multiple Cause of Death data from 2000 to 2023. Age-adjusted mortality rates (AAMRs) were calculated for adults aged ≥65 with both AF and PD listed as causes of death. Trends were analyzed using Joinpoint regression to compute annual percentage changes (APCs). Results: AAMRs increased from 3.1 to 8.2 per 100,000, with a significant acceleration from 2015–2021 (APC: +10.7%) before declining. Mortality was consistently higher in men than women. Non-Hispanic White adults had the highest overall AAMR (5.6), while Hispanic adults exhibited the steepest upward trend (APC: +6.8%). Pronounced geographic disparities existed, with the highest mortality in the Western US and nonmetropolitan areas. State-level AAMRs varied nearly fourfold. Conclusion: AF-related mortality among older adults with PD has risen substantially, marked by significant sex, racial, and geographic disparities. These findings underscore the urgent need for targeted interventions and integrated care models to mitigate risks in this vulnerable population.