S2678 Trends and Disparities in Liver Disease and Metabolic Disorders-Related Mortality in Adults ≥65 Years From 1999 to 2023 in the United States

Introduction: The relationship between liver disease (LD) and metabolic disorders (MD) is complex and bidirectional. Given the liver’s central role in metabolism, metabolic disorders, such as Wilson disease, hemochromatosis, alpha-1 antitrypsin deficiency, hypertriglyceridemia, hypercholesterolemia, and amyloidosis, can impair hepatic function and increase mortality. Conversely, these conditions contribute to liver injury through toxic metabolite accumulation, inflammation, and oxidative stress, further elevating mortality risk. Trend analysis stratified by demographic and geographic categorization concerning LD and MD-related mortality within the United States has not been done before. This study analyses national LD and MD-related mortality trends among adults ≥65 years from 1999 to 2023. Methods: The CDC WONDER Multiple-Cause-of-Death dataset (1999–2023) was used to assess mortality trends in adults ≥65 years using International Classification of Diseases, Tenth Revision (ICD-10) codes for LD (K70-K76) and MD (E70-E89). Data were stratified by year, along with demographic and geographic classifications. Age-adjusted mortality rates (AAMR) were quantified per 100,000 persons with 95% confidence intervals (95% CI). Average annual percent change (AAPC) was calculated via the Joinpoint regression model, with statistical significance defined as P < 0.05. Results: A total of 62,110 LD and MD-related deaths occurred from 1999 to 2023. Overall AAMR rose from 3.7 in 1999 to 12.0 in 2023 (AAPC: 5.1; 95% CI: 4.9 to 5.4). Men had higher average AAMR compared to women, though both sexes had similar rates of increase (AAPC men: 5.2; 95% CI: 5.0 to 5.5, AAPC women: 5.2; 95% CI: 4.9 to 5.6). Racially, Hispanic/Latinos had the highest average AAMR, while non-Hispanic Whites had the highest rate of increase (AAPC: 5.4; 95% CI: 5.1 to 5.7). Regionally, the West had the highest average AAMR and the highest rate of increase (AAPC: 5.8; 95% CI: 5.3 to 6.4). From 1999 to 2020, rural areas, in comparison to urban areas, had higher average AAMR along with higher rates of increase (AAPC: 4.9; 95% CI: 4.4 to 5.3). Conclusion: LD and MD-related mortality rates among adults ≥65 years increased significantly from 1999 to 2023, with crucial disparities across demographic and geographical classifications. These disparities illustrate the urgency for targeted interventions and public health policy changes in high-risk populations so that mortality rates can decrease in the future.