{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:53:27Z","timestamp":1791276807583,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine temporal trends and demographic and geographic variation in population\u2010level rates of deaths with both Alzheimer's disease (AD) and cancer recorded on death certificates among U.S. adults aged \u2265\u200965\u2009years from 1999 to 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A population\u2010based descriptive time\u2010trend study using multiple\u2010cause\u2010of\u2010death data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>National mortality data from the CDC WONDER (1999\u20132023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Death certificates for U.S. residents aged \u2265\u200965\u2009years recording both AD (G30) and malignant neoplasms (C00\u2013C97) were included. Age\u2010adjusted mortality rates (AAMRs) were standardized to the 2000\u2009U.S. population; age\u2010group analyses used age\u2010specific crude mortality rates. Joinpoint regression estimated annual percent changes (APCs) and average annual percent changes (AAPCs), with analyses stratified by demographic and geographic characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Annual deaths increased from 4764 in 1999 to 6240 in 2023, while the overall AAMR declined from 13.96 to 12.05 per 100,000 (AAPC \u22120.73%, 95% CI \u22121.39 to \u22120.06). Significant declines occurred among males, adults aged 75\u2009\u201384\u2009years, non\u2010Hispanic Black populations, and residents of the Northeast and Midwest, whereas a significant increase occurred among Hispanic populations. Full\u2010period trends among females and non\u2010Hispanic Other populations were not statistically significant. Neither metropolitan nor nonmetropolitan areas showed a significant trend during 1999\u20132020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The overall age\u2010adjusted death\u2010certificate mortality rate declined modestly despite increasing annual death counts, with descriptive variation across demographic and geographic groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>The findings highlight the relevance of coordinated geriatric and oncology nursing assessment and care planning for older adults with complex health needs. Nurses may play an important role in identifying cognitive, functional, treatment\u2010related, and caregiver needs and facilitating multidisciplinary care. These descriptive findings identify areas for clinical attention but do not demonstrate the effectiveness of specific nursing interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What Problem Did the Study Address?<\/jats:title>\n                    <jats:p>Limited evidence exists on long\u2010term population\u2010level trends in deaths with both AD and cancer recorded on death certificates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What Were the Main Findings?<\/jats:title>\n                    <jats:p>The overall age\u2010adjusted mortality rate declined modestly while annual death counts increased. Subgroup\u2010specific trends varied, but no formal between\u2010group comparisons were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Where and on Whom Will the Research Have an Impact?<\/jats:title>\n                    <jats:p>The findings are relevant to clinicians, policymakers, and public health practitioners involved in the care of older adults with multimorbidity, particularly in underserved populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>This study adheres to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No Patient or Public Contribution. This study used publicly available, de\u2010identified mortality data and did not involve direct patient or public participation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nop2.70897","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:30:09Z","timestamp":1791275409000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends in Population\u2010Level Mortality Rates for Deaths With Both Alzheimer's Disease and Cancer Recorded on Death Certificates Among U.S. Adults Aged \u2265\u200965\u2009Years, 1999\u20132023"],"prefix":"10.1002","volume":"13","author":[{"given":"Xiangxiang","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Shaoxing Seventh People's Hospital  Shaoxing Zhejiang 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