To the Editor: In 2004, the National Center for Health Statistics (NCHS) ranked Alzheimer disease as the fifth leading cause of death among US residents older than 65 years, an increase from prior years.1 NCHS data are derived from death certificates. Retrospective studies of patients who died at various stages of dementia suggest this condition is underreported on death certificates.2,3 We prospectively observed a cohort of nursing home residents who had been diagnosed with end-stage dementia to describe which conditions were documented on their death certificates.
Reporting Dementia on the Death Certificates of Nursing Home Residents Dying With End-Stage Dementia. JAMA. 2008;300(22):2608-2610. doi:10.1001/jama.2008.768