Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44

Abstract

We investigate trends in death rates from neurological diseases (ICD-10 codes G00-G98) for all age groups in the US using data from the CDC (Centers for Disease Control and Prevention). We also perform a detailed analysis for younger individuals aged 15 to 44. We investigate trends in neurological diseases where these appear on the death certificate under multiple causes (MC) of death, or as the underlying cause (UC), as well as the trends in the ratio of multiple cause to underlying cause death rates. For individuals aged 15 to 44 we show a rise in excess mortality from neurological diseases reported as the underlying cause of death, with a 4.

Full text

Trends in death rates from Neurological
diseases in the US for all ages and detailed
analysis for 15-44
C. Alegria 1,∗and Y. Nunes 1,2
1RiskMath Lda.*
, Portugal
2LibPhys†
, Department of Physics, FCT-NOVA, Portugal
Correspondence*:
Corresponding Author
calegria@phinancetech.com
ABSTRACT
We investigate trends in death rates from neurological diseases (ICD-10 codes G00-G98) for all
age groups in the US using data from the CDC (Centers for Disease Control and Prevention). We
also perform a detailed analysis for younger individuals aged 15 to 44. We investigate trends in
neurological diseases where these appear on the death certificate under multiple causes (MC)
of death, or as the underlying cause (UC), as well as the trends in the ratio of multiple cause to
underlying cause death rates.
For individuals aged 15 to 44 we show a rise in excess mortality from neurological diseases
reported as the underlying cause of death, with a 4.4% increase in 2020, 10.0% in 2021, 9.9% in
2022 and 8.1% in 2023, with
Z
-Scores of 4.9, 11.1, 11.0 and 9.0 in 2020, 2021, 2022 and 2023,
respectively, indicating highly statistically significant changes, particularly in 2021, 2022 and
2023. When looking at excess neurological disease deaths reported as multiple cause (MC) of
death, we observe that these track all-cause mortality rises, registering excess mortality of 11.2%
in 2020, 20.6% in 2021, 14.7% in 2022 and 7.1% in 2023, which were also highly statistically
significant. However, for excess neurological disease deaths reported as multiple cause of death,
once deaths where COVID-19 was also reported are removed, we observe that these follow a
very similar pattern of excess deaths to that observed for neurological deaths when reported as
underlying cause.
We also show that excess deaths from neurological diseases as underlying cause occurred
for most age groups, with the strongest effect in ages 15-44. For individuals 65 and older there
appears to be no statistically significant rise in excess mortality. The larger rise of excess death
rates from neurological diseases reported as one of multiple causes compared to the underlying
cause indicates that some deaths from these diseases are being brought forward by other causes,
such as COVID-19-related deaths. Consequently, the rise in neurological disease deaths as
underlying cause we report in the paper likely under-reports the described effect, particularly for
older individuals.
The results indicate that from 2020 a novel phenomenon leading to increased neurological
deaths appears to be present particularly in younger, working age individuals aged 15 to 44,
which requires further investigation.
*Phinance Technologies - Humanity Projects
†LibPhys
1

Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
Keywords: COVID-19 Over-reporting, Underlying cause of death, Comparative analysis
ResearchGate PrePrint 2

Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
1 INTRODUCTION
There are still a large number of unanswered que-
stions regarding the COVID-19 pandemic, ranging
from the effects of the SARS-CoV-2 virus itself
to the impacts of the lockdowns, social distancing,
COVID-19 treatment protocols, and the introdu-
ction of COVID-19 vaccines based upon novel
mRNA technology. One of the aspects that is still
not well recognized is the impact of the pande-
mic on neurological diseases and in particular the
increase in neurological disease-related death rates,
which we address in this paper.
A paper using data from the Global COVID
Vaccine Data Network (GVDN) examining over
99 million vaccine recipients showed an increase
in risk of neurological conditions such as Guillain-
Barr
´
e syndrome (GBS), Transverse myelitis (TM),
Bell’s palsy (BP), Acute disseminated encepha-
lomyelitis (ADEM), febrile seizures (FSZ) and
generalized seizures (GSZ), for a 42-day period
following vaccination (Faksova, et al., 2024)[
1
].
The results show for example that the AstraZeneca
(ChAdOx1) vaccine was associated with a 2.49
increased risk of GBS, a 1.91 increased risk of TM,
and a 2.23 increased risk of ADEM, in the 42-day
period after the first dose. The Pfizer/BioNTech
(BNT162b2) had a safer profile for neurological
conditions, showing only a slightly concerning 1.05
increased risk of BP after the first dose.
A paper from Italy that reviews neurological
complication following COVID-19 vaccines in the
18 months following the start of the vaccinations
concludes that these complications are usually mild,
of short duration and self-limiting but also admit
that severe unexpected post-vaccination events
are rare but possible (Tondo, G. et al., 2022)[
2
].
A review of serious neurological adverse events
following vaccinations (Eslait-Olaciregui, et al.,
2023)[3] also finds that these tend to be rare.
A more recent Italian population-based study of
mild neurological complications following COVID-
19 vaccinations estimates that about a third of
the sampled individuals manifested neurological
symptoms following the vaccinations. For the Pfi-
zer/BioNTech (BNT162b2) vaccine the incidence
rate was 30.2%. The most common neurological
symptoms reported were headache (51.4%), sleepi-
ness (37.8%), vertigo (13.4%), paraesthesia (10.4%)
and cognitive fog (6.1%). The clinical onset of
the symptoms tended to occur within a week from
vaccination date and be short-lived.
Some observational data has implicated COVID-
19 itself in the development of neurological sym-
ptoms, such as the observations of a study on US
Veterans that spanned throughout 2021 (Xu, E. et
al., 2022)[
4
], which reported that the relative risk
of any neurological condition after COVID-19 was
1.42. The unfortunate need to rely on observational
data to investigate these effects means that doing
a risk/benefit analysis can produce wildly varying
results depending on the methodology. For exam-
ple, studies associating risk of a particular condition
after COVID-19 compared to after vaccination
rarely differentiate between long term conditions vs
acute effects that are self-resolving in a short period
of time (Patone, M. et al., 2021)[
5
]. In this case,
the researchers for the Veterans study began tra-
cking subjects before the rollout of the vaccine and
failed to adjust for exposure to the vaccine during
the follow-up period. As such, we cannot properly
determine whether these neurological associations
were affected by administering COVID-19 vaccina-
tion shortly after COVID infection, a practice which
has been shown to increase the risk of systemic side
effects (Menni, C. et al., 2021)[
6
], (Krammer, F. et
al., 2021)[
7
] but was nevertheless encouraged by
public health authorities. Furthermore, because the
study uses a population with a significant amount
of selection bias (United States Veterans), the exact
relative risk ratios cannot be easily compared with
other studies that calculated these same ratios after
exposure to the vaccine.
In this paper, we investigate trends in death rates
from neurological diseases (ICD-10 codes: G00 to
G98) in the US to investigate if the studies refere-
nced above, which focus on milder conditions and
of shorter duration, are reflected in increased death
rates from these conditions. We investigate trends in
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Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
neurological diseases where these appear on death
certificates as multiple causes (MC) of death, or as
the underlying cause (UC), as well as the trends
in the ratio of multiple cause to underlying cause
death rates. We first provide a detailed analysis of
the younger 15-44 age group as these individuals
were found to be the most affected by neurological
disease excess deaths, with statistically significant
excess deaths starting in 2020 and then increasing
substantially in 2021, 2022 and 2023. Later, we
analyze excess death trends for all ages, in ten-year
age groups, as provided by the CDC (US Centers
for Diseases Control and Prevention) WONDER
system.
2 DATA
2.1 Cause of Death Data
The data used in this analysis are the number of
deaths that occurred in the USA between 2000 and
2023, by underlying cause code (ICD-10), sex, and
10-year age groups, obtained using the CDC WON-
DER
1
system provided by the National Center for
Health Statistics of the Centers for Disease Con-
trol and Prevention (CDC). The mortality data is
final up to 2021 but provisional from 2022 onwards.
Additionally, for comparing multiple cause (MC) of
death trends from neurological diseases with underl-
ying cause (UC) of death trends, we download data
from both the multiple cause of death databases and
underlying cause of death databases.
Query parameters:
For underlying cause of death data, select variable
grouped by: 1. Ten-year-age-groups, 2. Gender, 3.
Year, 4. UCD – ICD Chapter
(Link to the underlying cause of death databases)
.
For multiple cause of death data, select variable
grouped by: 1. Ten-year-age-groups, 2. Gender, 3.
Year, 4. MCD – ICD Chapter
(Link to the multiple cause of death databases)
1CDC Wonder
2.2 Definition of MC of death and UC of
death
The Centers for Disease Control and Prevention
(CDC) classifies deaths based on cause into two pri-
mary categories: ”Underlying Cause of Death” and
”Multiple Causes of Death”. These classifications
are useful for epidemiological studies, public health,
and understanding different mortality patterns. The
definitions are:
Underlying Cause (UC) of Death: The underl-
ying cause of death is defined as ”the disease or
injury which initiated the train of morbid events
leading directly to death, or the circumstances of
the accident or violence which produced the fatal
injury,” according to the World Health Organization
(WHO).
Multiple Causes (MC) of Death: Multiple causes
of death include all causes and conditions reported
on the death certificate that contributed to death,
not just the underlying cause. This includes the
underlying cause, immediate cause, and any other
significant conditions contributing to death. Each
death certificate contains a single underlying cause
of death, and up to twenty additional multiple
causes.
2.3 Data Use Restrictions
In this research paper we abide by the CDC’s
restrictions on data use which are:2:
“The Public Health Service Act (42 U.S.C. 242m(d))
provides that the data collected by the National Cen-
ter for Health Statistics (NCHS) may be used only
for the purpose for which they were obtained; any
effort to determine the identity of any reported cases,
or to use the information for any purpose other
than for health statistical reporting and analysis, is
against the law. Therefore, users will:
•
Use these data for health statistical reporting
and analysis only.
2CDC Wonder - Data Use Restrictions
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Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
•
Do not present or publish death counts of 9 or
fewer or death rates based on counts of nine or
fewer (in figures, graphs, maps, tables, etc.).
•
Make no attempt to learn the identity of any
person or establishment included in these data.
•
Make no disclosure or other use of the identity
of any person or establishment discovered ina-
dvertently and advise the NCHS Confidentiality
Officer of any such discovery.”
2.4 Population data
The source for the population data that are used
for computing death rates (deaths per 100,000) are
the data retrieved from the CDC queries. We chose
to use the CDC population data instead of data from
the US Census Bureau for consistency with other
researchers’ analyses.
2.5 All-cause deaths data
All cause deaths were retrieved from CDC WON-
DER, by using the following query parameters:
Ten-year-age-groups, 2. Gender, 3. Year
The ten-year-age-groups are: 1, 1-4, 5-14, 15-24,
25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85+
2.6 Data verification and limitations
The CDC WONDER system provides two sepa-
rate databases from which to query underlying
cause of death data and multiple cause of death data.
Additionally, each is separated into two datasets
comprising different time periods, so that in order
to obtain time series from 2000 to 2023, multiple
queries were performed.
Within the multiple cause of death databases, it is
also possible to obtain the underlying cause of death
data. We downloaded all the available yearly data
(for MC of death and UC of death) and compared
the different datasets for consistency, whenever the
time periods overlapped.
From 2010 to 2021 the MC and UC of death data
is final, while for 2022 and 2023 it is provisio-
nal. Details on provisional CDC deaths data can
be found here3.
3 METHODOLOGY
In this study, we analyze the trends in death rates
for neurological diseases. We investigate these
trends using yearly data and therefore a seasonal
adjustment to the data is unnecessary.
In general terms, to estimate trends in these vari-
ables we use a methodology of computing excess
death rates, which is the difference between the
actual observed rates and a given baseline (expected
rates). Because we want to describe the impact of
the COVID-19 pandemic and post-pandemic peri-
ods relative to the prior state of the world, our
baselines are based upon the estimation of the trend
for a period prior to the pandemic.
In this study we will use method 2C, as descri-
bed in our report on methodologies for measuring
excess deaths in the population (Alegria, C. et al.,
2024)[
8
]. Method 2C is based on computing the
trends in death rates (deaths adjusted by the popula-
tion) instead of deaths, as the baseline for estimating
excess mortality. This method significantly reduces
the noise of the estimation as it adjusts for popu-
lation growth or decline, and by also providing
different rates for each age category, we adjust for
changes in population age distribution. The method
also considers the prior trend in death rates, which
tend to decline over time as the population grows
healthier and risk factors are better managed.
3.1 Method 2C for Estimating Excess
Death Rates
Excess
DeathsAG
ti
=DeathsAG
ti
−BaselineAG
ti(1)
3
https://wonder.cdc.gov/wonder/help/mcd-provisional.html#Technical-
Notes-for-Provisional-Mortality
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Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
Equation 1 is a general expression for estimating
the excess absence rates relative to a given base-
line. We use the superscript
AG
to indicate a given
population age range, as this is the primary focus
of the current analysis. Other cohorts which this
equation could apply to include a specific region,
sex, or underlying cause of death. The subscript
ti
refers to time, that is, the corresponding year for
which the excess deaths are computed.
For estimating the baseline for “normal or expe-
cted” death rates we use a simple linear fit:
Baseline(ti) = ˆ
b+ ˆa(ti−t0)(2)
Where
ˆa
and
ˆ
b
are the estimated coefficients of
the death rate trendline from 2010 to 2019. We also
compute a
Z
-Score that estimates the normalized
deviation from trend:
Z=hDeathsiAG
ti
−hBaselineiAG
ti
σ2010−2019
(3)
Where
σ
is the standard deviation of the excess
deaths during the pre-pandemic period 2010-2019.
3.2 ICD-10 Code List of Selected Causes
of Death for: Neurological Diseases
For this analysis we selected all the ICD-10 codes
from the CDC aggregated chapter lists (Letters G00
to G98), which refer to deaths attributed to Diseases
of the nervous system (Neurological Diseases).
4 YEARLY ANALYSIS OF EXCESS
DEATH RATES FOR AGES 15-44
In this section we perform an analysis of the trend
in yearly death rates for individuals aged 15 to 44
in the US, using the data from CDC WONDER. In
this analysis we use the 2010-2019 trend in deaths
per 100,000 (death rates) as the baseline estimate
for excess death rates. Excess death rates for the
2010-2019 period are in-sample while the rates
for 2020, 2021, 2022 and 2023 are out of sample
computations.
In our study we investigate trends in MC (multiple-
cause) and UC (underlying cause) deaths rates from
neurological diseases, and also, trends in MC*
death rates (MC deaths where COVID-19-related
death are removed).
To contextualize trends in death rates from neu-
rological diseases, we first analyze the trends in
all-cause death rates.
4.1 Deaths from All Causes
The analysis of the deaths from all causes allows
us to have a context by which we can then compare
the death rates from neurological diseases. Figure 1
(top) shows the death rate per 100,000 individuals
for all deaths in the US from 2010 to 2023, for the
15 to 44 age group. Figure 1 (bottom) shows the
actual number of deaths during the period.
The all-cause death rate for individuals aged 15 to
44 was 112.8 per 100,000 in 2010, increasing slowly
to 131.9 per 100,000 in 2019, corresponding to a
16.9% rise over the period. The death rate increased
in 2020 to 163.5 per 100,000 and then again in 2021
to 186.0 per 100,000. In 2022 the death rate dropped
slightly to 165.6 per 100,000 and in 2023 the death
rate “normalized” to 139.1 (below the 2010-2019
extrapolated trend). Even though the changes in
death rates are not age adjusted and could be due
to ageing populations within the 15-44 age group,
when looking at individuals 10-year age groups 15-
24, 25-34 and 35-44, we observe a similar pattern
of rising death rates.
4.1.1 Excess All-Cause Death Rates
Figure 2 shows the excess death rate for registered
deaths (all-cause) in the US from 2010 to 2023
for the 15-44 age group. The columns in Figure
2 refer to relative deviations from the 2010-2019
trend while the dashed line refers to the respective
Z-Scores.
Figure 2 shows that excess deaths in 2020 were
around 19.9%, with a
Z
-Score of 6.5. These values
indicate a very high level of statistical significance,
being considered an extreme occurrence. In 2021
excess deaths further increased to around 33.8%
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Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
Figure 1. Yearly all-cause deaths for the US for
individuals aged 15 to 44. The red dashed line
shows the trend from 2010 to 2019. The dotted
line shows the extrapolation of the trend from 2020
until 2023. Top: Death rate (per 100,000). Bottom:
Deaths (Number).
with a
Z
-Score above 11.0. Excess deaths in 2022
were 16.8% with a
Z
-Score of 5.5, again indica-
ting very high statistical significance. Excess death
levels peaked in 2021, and in 2022 dropped to simi-
lar excess deaths to those calculated in 2020. In
2023 excess deaths were negative (-3.7%), pointing
to a normalization of excess all-cause mortality in
the 15-44 age group following the pandemic.
4.2 Trends in UC Death Rates for ICD-10
Codes G00 to G98 (Neurological
Diseases)
In this section we investigate the trends in death
rates from 2010 to 2023 where neurological dise-
ases (ICD-10 codes G00 to G98) were classified
as the underlying cause of death, for the 15-44 age
group of both sexes.
Figure 2. Excess all-cause death rates for both
sexes aged 15 to 44 in the US. Top: Relative devi-
ation from trend, percent. Bottom: Deviation from
trend Z-Score.
4.2.1 UC Death Rates
Figure 3 (top) shows the death rate per 100,000
individuals for deaths from neurological diseases
in the US from 2010 to 2023. We can observe that
deaths per year from neurological diseases in the
15-44 age group have been trending higher from
2010 to 2019. In 2010 the death rate was 2.94 per
100,000 and in 2019 it was 3.31 per 100,000, a
12.6% rise.
The death rate rose in 2020 to 3.52 per 100,000,
and then rose again to 3.76 per 100,000 in 2021. In
2022 the death rate rose further to 3.81 per 100,000
and in 2023 it was 3.80 per 100,000.
When presenting these numbers as the absolute
number of deaths for diseases from neurological dis-
eases, shown in Figure 3 (bottom), we can observe
that in 2020 there were 4602 deaths, while in 2021
there were 4963 deaths, 5085 in 2022, and 5070 in
2023.
4.2.2 Excess UC Death Rates
Figure 4 shows the excess death rate from neurolo-
gical diseases in the US, for the 15 to 44 age group
from 2010 to 2023. The plots also show the excess
all-cause deaths for comparison. The figure on the
top refers to relative deviations from the 2010-2019
trend, while Figure 4 (bottom) shows the
Z
-Score
(signal strength) for the deviations from trend.
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Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
Figure 3. Yearly deaths from neurological diseases
as underlying cause in the US for ages 15 to 44.
The red dashed line shows the trend from 2010 to
2019. The dotted line shows the extrapolation of
the trend from 2020 until 2023. Top: Deaths per
100,000. Bottom: Deaths (Number).
In Figure 4 (top) we can observe that the excess
death rates from neurological diseases as the underl-
ying cause (UC) were 4.4% in 2020, then rose to
10.0% in 2021, 9.9% in 2022 and 8.1% in 2023.
By comparison, the excess mortality for all-cause
deaths was 19.9% in 2020, 33.8% in 2021, 16.8%
in 2022, and -3.7% in 2023. Noteworthy is that
while excess mortality for all-cause deaths drop-
ped substantially from 2021 to 2022, excess deaths
from neurological diseases as the underlying cause
remained stable. This trend continued in 2023, with
excess neurological deaths remaining high while
all-cause excess deaths were negative.
In terms of the statistical significance of the excess
deaths, we observe from Figure 4 (bottom) that the
Z
-Scores for neurological disease death rate devi-
ations from trend were 4.9 in 2020, 11.1 in 2021,
Figure 4. Excess UC death rates from neurological
diseases from 2010 to 2023 for both sexes of ages
15 to 44 in the US. Top: Relative deviation from
trend, percent. Bottom: Deviation from trend
Z
-
Score. Excess deaths from all causes are shown for
comparison.
11.0 in 2022 and 9.0 in 2023. The strength of the
statistical significance of the excess deaths from
neurological diseases was very high, being conside-
red extreme events, indicating a clear change from
the prior 2010-2019 trend.
4.3 Trends in MC Death Rates for ICD-10
Codes G00 to G98 (Neurological
Diseases)
In this section we investigate the trends in death
rates from 2010 to 2023 where neurological dise-
ases (ICD-10 codes G00 to G98) were reported in
one of the multiple causes of death (either underl-
ying or secondary cause of death), for the 15-44 age
group of both sexes.
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Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
MC deaths rates need to be analyzed with a degree
of caution as they refer to death rates for a given
disease where it is either the underlying cause or
a contributing factor towards death. Neurological
diseases tend to be contributing causes of death
instead of underlying cause which means that MC
death rates from neurological diseases could amount
to several times the UC death rate. Nonetheless,
by analyzing both MC death rates and UC death
rates, we can have a better understanding of the
underlying phenomena that lead to neurological-
related deaths.
This analysis provides additional information in
understanding the phenomenon of increased deaths
from neurological diseases during the pandemic
years, for this age group.
4.3.1 Deaths MC (Multiple cause) from
ICD-10 Codes G00 to G98
(Neurological Diseases)
Figure 5 (top) shows the death rate per 100,000
individuals for deaths from neurological disease
in the US from 2010 to 2023, where neurological
diseases appear as one of multiple causes of death
(either underlying or contributing). The figure also
shows the MC* death rates from neurological disea-
ses, which is death rates with neurological diseases
as a multiple cause, except where COVID-19 is also
reported as the underlying or a contributing cause.
We can observe that MC deaths per year from
neurological diseases have been trending upwards
from 2010 to 2019. In 2010 the death rate was 6.85
per 100,000 and in 2019 it was 8.32 per 100,000, a
21.5% rise.
MC death rates from neurological diseases rose
substantially in 2020 to 9.54 per 100,000 and then
rose to 10.57 per 100,000 in 2021 and then dropped
slightly to 10.26 per 100,000 in 2022 and to 9.78 per
100,000 in 2023. When deaths where COVID-19
was also reported as a cause of death were removed,
we observe that the MC* death rates (per 100,000)
from neurological diseases were 9.07 in 2020, 9.53
in 2021 and 9.63 in 2022 and 9.61 in 2023. Even
after removing COVID-19 related deaths, we obse-
rve an increase in MC* neurological deaths in 2020,
2021 and 2022, and a stabilization in 2023 rather
than a reversion to trend.
Figure 5. Yearly deaths from neurological diseases
as one of multiple causes (underlying or contribu-
ting factor) in the US, for ages 15 to 44. The red
dashed line shows the trend from 2010 to 2019. The
dotted line shows the extrapolation of the trend from
2020 until 2023. Top: Deaths per 100,000. Bottom:
Deaths (Number).
4.3.2 Excess MC Deaths Rates
Figure 6 compares the excess MC death rates from
neurological diseases from 2010 to 2023, while
also showing, for comparison, the excess from MC
deaths from neurological diseases where COVID-
19-related deaths were not counted, for ages 15 to
44 in the US. The figure on the top refers to relative
deviations from the 2010-2019 trend, while Figure
6 (bottom) shows the
Z
-Score (signal strength) for
the deviations from trend.
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Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
It should be noted that the way excess death
rates (either MC death rates or UC cause death
rates) are computed, they adjust for prior trends in
deaths rates and are also scale-adjusted when rela-
tive deviation from trends are computed. We also
compute volatility-adjusted (dispersion around the
trend) excess death rates which allows us to have an
idea of the signal strengths, and which also allows
for a direct comparison of excess MC death rates
with excess UC death rates.
Figure 6. Excess MC death rates from neurolo-
gical diseases from 2010 to 2023 for both sexes
of ages 15 to 44 in the USA. Top: Relative devia-
tion from trend, percent. Bottom: Deviation from
trend
Z
-Score. Excess MC* death rates (where
COVID-19-related deaths are removed) are shown
for comparison.
In Figure 6 (top) we can observe that the excess
MC death rates from neurological diseases were
11.2% in 2020, then rose to 20.6% in 2021, before
declining to 14.7% in 2022, and 7.1% in 2023.
These numbers track the rises in all-cause mortality
which we mentioned in Figure 4, and are closely
associated with COVID-19-related deaths.
By comparison, the excess MC death rates from
neurological diseases where COVID-19-related dea-
ths were removed, were 5.8% in 2020, 8.8% in 2021,
7.7% in 2022 and 5.2% in 2023. Of note is that the
rise in excess mortality for MC deaths from neu-
rological diseases where COVID-19-related deaths
were removed, exhibited a similar pattern to UC
excess death rates from neurological diseases.
In terms of the statistical significance of the excess
deaths, when looking at excess MC deaths from
neurological diseases, the
Z
-Score in 2020 was 8.6,
15.8 in 2021, 11.3 in 2022 and 5.4 in 2023. These
are extreme events.
In terms of the statistical significance of the excess
deaths, when looking at excess MC* deaths from
neurological diseases (where COVID-19-related
deaths are not counted), the
Z
-Score in 2020 was
4.5, 6.7 in 2021, 5.9 in 2022 and 4.0 in 2023. These
values show high statistical significance.
4.4 Comparison of MC* and UC Death
Rates from Neurological Diseases
We now compare the trends in MC*
4
death rates
and UC death rates from neurological diseases
(ICD-10 codes G00 to G98), from 2010 to 2023
for the 15-44 age group of both sexes.
Figure 7 (top) shows the MC* deaths rates and UC
death rates from neurological diseases for ages 15
to 44 in the US, from 2010 to 2023. When compa-
ring UC and MC* death rates, we observe that both
have been trending higher from 2010 to 2019. We
also observe that MC* death rates are substantially
higher than UC death rates from neurological disea-
ses, as illustrated by the ratio of MC*/UC death
rates, Figure 7 (bottom)), which is close to 2.5
across the 2010-2023 period. The ratio did not vary
significantly during the pandemic years, 2020, 2021,
2022 and 2023, indicating that both MC* and UC
4
MC* death rates refer from MC death rates from neurological diseases
where COVID-19-related deaths were removed
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Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
death rates from neurological diseases had similar
trends during those years.
Figure 7. Yearly deaths from neurological diseases
as multiple cause (underlying or contributing factor)
in the US, for ages 15 to 44, with COVID-19-related
deaths removed. The red dashed line shows the
trend from 2010 to 2019. The dotted line shows
the extrapolation of the trend from 2020 until 2023.
Top: Deaths per 100,000. Bottom: Ratio MC*/UC.
This is confirmed in Figure 8 that illustrates the
excess MC* and UC deaths rates from neurologi-
cal diseases, which overall show similar pattern of
excess death rates in 2020, 2021, 2022 and 2023.
In 2020, the excess UC death rate from neurologi-
cal diseases was 4.4%, while 5.8% for MC* death
rate, both having high
Z
-Scores of 4.9 and 4.5,
respectively (as shown in Figure 8 bottom).
In 2021, the excess UC death rate was 10.0% with
a
Z
-Score of 11.1, while for MC*, the excess death
rate was 8.8% with a
Z
-Score of 6.7. In 2022, the
UC excess death rate was 9.9%, while 7.7% for
MC*, with respective
Z
-Scores of 11.0 and 5.9. In
2023, the UC excess death rate was 8.1%, while
5.2% for MC*, with respective
Z
-Scores of 9.0 and
4.0.
Figure 8. Excess MC* and UC deaths rates from
neurological diseases for ages 15 to 44, in the US.
Top: Relative deviation from trend, percent. Bottom:
Deviation from trend Z-Score.
Interestingly, for comparison, the excess UC death
rates from neoplasms for individuals aged 15 to
44 in the US were 1.7% in 2020, 5.6% in 2021,
and 7.9% in 2022, with
Z
-Scores of 3.5, 11.8 and
16.5, respectively, as reported in our previous paper
showing an equivalent analysis for neoplasm deaths
(Alegria, et al., 2024)[9].
We conclude that UC neurological disease deaths
show a similar pattern of excess death rates as pre-
viously reported for neoplasms, with the main dif-
ference being that neurological death rates showed
larger rises in 2020, a rise that already represented
a signal with high statistical significance.
ResearchGate PrePrint 11

Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
Possible explanations for the change from the
historical trend in neurological deaths in 2020,
include the collateral effects of the lockdowns on
the lifestyle habits of individuals aged 15 to 44, such
as alcohol consumption, fentanyl, or other drugs.
Other explanations could include COVID-19 side
effects that were not recognized or recorded on the
death certificates. From 2021 onwards, lockdowns
likely played a smaller role in the continued rising
excess death rates from neurological diseases, while
a new factor was introduced in the form of the novel
COVID-19 vaccinations which could have played a
significant role, together with enduring effects from
multiple SARS-CoV-2 exposures.
5 ANALYSIS OF EXCESS DEATH
TRENDS FROM NEUROLOGICAL
DISEASES FOR ALL AGES
In this chapter we generalize the previous analysis
for all age groups. We compute the excess deaths
(deviation from trend) from neurological diseases,
for the different age groups in the US.
5.1 Excess UC Deaths from Neurological
Diseases for Different Age Groups
Here we compute, for all age groups, the excess
UC death rates from neurological diseases in 2020,
2021, 2022 and 2023, shown in Figure 9. The
detailed results are also shown in the appendix.
In Figure 9 (top) we plot the excess UC death
rate (in percent) while Figure 9 (bottom) shows the
respective
Z
-Scores. Each data-point on the graphs
is obtained by performing the analysis described
in the methodology section where the extrapola-
ted 2010-2019 trendline in death rates is subtracted
from the death rates in 2020, 2021, 2022 and 2023,
for each of the age groups. The highlighted region
corresponds to the results for the detailed analysis
shown previously for the 15 to 44 age group.
Figure 9 shows that the excess UC death rates
from neurological diseases seem to have impacted
mostly younger individuals aged 15 to 44 and also
new-born below 1 year of age. For age groups 45-54
and older we do not notice outstanding excess death
rates, similarly for age groups 1-4 and 5-14. For a
more detailed analysis, the appendix tables shows
all the individual values that are plotted in Figure 9.
For age groups 15-24, 25-34 and 35-44 we
observe statistically significant excess death rates,
particularly in 2021, 2022 and 2023. The signal
strengths in 2020 were weak for 15-24 and 25-34
age groups, likely due to small sample sizes, while
for age group 35-44 there was already a statistically
significant increase in death rates starting in 2020.
The largest percentage of excess deaths were
observed in the younger 15-24 age group, where
excess death rates were 6.8% (
Z
-Score: 2.3) in
2020, 14.5% (
Z
-Score: 4.9) in 2021, 16.5% (
Z
-
Score: 5.6) in 2022 and 20.9% (
Z
-Score: 7.1) in
2023. Excess death rates rose consecutively in 2020,
2021, 2022 and 2023, with the rises in 2021, 2022
and 2023 showing very high statistical significance
(extreme occurrences), while in 2020 the excess
death rates had lower statistical significance.
For age group 35-44, excess death rates were 3.8%
(
Z
-Score: 3.7) in 2020, 8.3% (
Z
-Score: 8.1) in
2021, 6.5% (
Z
-Score: 6.4) in 2022 and 4.6% (
Z
-
Score: 4.5) in 2023. This age group already showed
a clear signal in excess death rates from 2020, albeit
with a lower percentage change when compared
with the 15-24 age group. As with most causes of
death, death rates from neurological diseases tend to
increase exponentially with age for individuals over
10 years old, leading to larger sample sizes in the
older age groups, and therefore any change in death
rates is more likely to reach statistical significance
compared with younger age groups.
For newborns below the age of 1, the excess death
rates were 8.9% (
Z
-Score: 1.5) in 2020, 21.8% (
Z
-
Score: 3.7) in 2021, 10.8% (
Z
-Score: 1.9) in 2022
and 21.6% (
Z
-Score: 3.7) in 2023. In 2020 the
increase in death rates was not statistically signifi-
cant. However, in 2021 and 2023 excess death rates
exhibited a high degree of statistical significance
while in 2022 excess death rates were somewhat
statistically significant. These signals merit further
investigation in our opinion. In particular, the excess
ResearchGate PrePrint 12

Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
Figure 9. Excess UC death rates from neurological
diseases for 2020, 2021, 2022 and 2023 for different
age groups of both sexes in the US. Top: Relative
deviation from trend, percent. Bottom: Deviation
from trend Z-Score.
deaths signal in 2021 coincided with the vaccination
of pregnant women for COVID-19, which could
have played a role in the effect on newborns, in
addition to other more common factors.
For older age groups from 45 upwards, we see
negative excess deaths from neurological diseases
in 2023, most marked for the 45-64 age groups
and individuals over 85. This may be the first year
that we see the reversal of a previous ‘pull forward’
effect whereby fragile individuals with neurological
diseases were more likely to die during the pande-
mic years due to the added impact of lockdowns,
reduced access to healthcare provision, COVID-19
infection and its sequelae, and vaccination effe-
cts. As some of these individuals have died sooner
than would otherwise have been expected, this
results in a negative excess death rate for the year(s)
they would have died without the impact of the
pandemic.
5.2 Excess MC Deaths from Neurological
Diseases for Different Age Groups
In this section we compute, for all 10-year age
groups, the excess MC death rates from neurologi-
cal diseases in 2020, 2021, 2022 and 2023, shown
in Figure 10. For a detailed view of the results refer
to the appendix.
In Figure 10 (top) we plot the excess MC death
rate (in percent) while Figure 10 (bottom) shows the
respective
Z
-Scores. As mentioned previously, each
data-point on the charts corresponds to the excess
death rate for a given year, which is obtained by per-
forming the analysis described in the methodology
section where the extrapolated 2010-2019 trendline
in death rates is subtracted from the MC death rates
in 2020, 2021, 2022 and 2023, for each of the age
groups. The highlighted region corresponds to the
results for the detailed analysis shown previously
for the 15 to 44 age group.
In Figure 10 we can observe that in general, excess
MC death rates from neurological diseases were
higher than for excess UC death rates in 2020, 2021,
2022 and 2023, for age groups 15-24 and older,
despite the fact that multiple-cause neurological
deaths are multiple times underlying-cause deaths
(as shown in Figure 7 – bottom). However, this
and can be explained by MC neurological death
rates increasing due to the impact of COVID-19 and
the rise in all-cause mortality during the pandemic
years. Consequently, in the next section we analyze
excess MC neurological deaths where COVID-19-
related deaths are excluded.
We also notice from Figure 10 that MC excess
death rates from neurological diseases were highest
in 2020 for older age groups (around 15%), from
ages 55 and older, while for younger age groups, the
inverse occurred with the highest death rates occur-
ring in 2021 and 2022. Additionally, MC death rates
are significantly higher values than for equivalent
excess UC death rates, for example for age group
35-44 MC excess death rates were 12.0% (
Z
-Score:
ResearchGate PrePrint 13

Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
7.7) in 2020, 22.3% (
Z
-Score: 14.3) in 2021, 15.1%
(
Z
-Score: 9.7) in 2022 and 7.4% (
Z
-Score: 4.8)
in 2023. Consequently, we would expect that the
larger increase in MC death rates from neurologi-
cal diseases would lead to lower UC death rates
in the following year, due to a pull-forward effect
of fragile individuals suffering from neurological
diseases. The opposite occurs for those aged 44 and
under. However, as previously described, the older
age groups are exhibiting negative excess UC death
rates in 2023, indicating that the pull forward effect
may be ending for these age groups.
Figure 10. Excess MC death rates from neurolo-
gical diseases for 2020, 2021, 2022 and 2023 for
different age groups of both sexes in the US. Top:
Relative deviation from trend, percent. Bottom:
Deviation from trend Z-Score.
5.3
Excess MC* Deaths from Neurological
Diseases for Different Age Groups
Now we compute, for all age groups, the excess
MC* death rates from neurological diseases in 2020,
2021, 2022 and 2023. As a reminder, MC* death
rates refer to MC deaths from neurological diseases
except for those where COVID-19 is also reported
(either as underlying cause or a contributing cause).
In Figure 11 (top) we plot the excess MC* death
rates (in percent) while Figure 11 (bottom) shows
the respective
Z
-Scores. The results show that the
excess MC* death rates exhibit a similar pattern to
UC excess death rates for the different age groups.
After removing deaths related from COVID-19, we
can still observe excess MC death rates in 2021,
2022 and 2023 for the most affected age groups of
15 to 44. This is likely due to the rise in MC* death
rates being driven by the rises in UC death rates.
When looking at the younger 15-24 age group,
excess MC* death rates were 3.5% (
Z
-Score: 1.5)
in 2020, 7.9% (
Z
-Score: 3.4) in 2021, 8.1% (
Z
-
Score: 3.5) in 2022 and 8.7% (
Z
-Score: 3.7) in 2023.
When comparing these values with the equivalent
excess UC death rates which were 6.8% (
Z
-Score:
2.3) in 2020, 14.5% (
Z
-Score: 4.9) in 2021, 16.5%
(
Z
-Score: 5.6) in 2022 and 20.9% (
Z
-Score: 7.1) in
2023, we observe that both follow a similar pattern
where excess death rates rose consecutively in 2020,
2021, 2022 and 2023. Furthermore, in both cases,
excess death rates seem to have impacted mostly
in 2021, 2022 and 2023, exhibiting rises with very
large
Z
-Scores. A similar pattern is found for age
group 25-34 and 35-44.
Older individuals appear, in general, to be less
impacted, particularly in 2021, 2022 and 2023, with
lower
Z
-Scores for the excess MC* death rates, and
negative MC* death rates for the 45-64 and 85+ age
groups, with strong statistical significance for the
negative excess death rates for those between 45
and 64.
For newborns below the age of 1 and age groups
1-4 and 5-14, the excess MC* death rates could
not be computed due to data suppression rules by
the CDC WONDER system which occur in small
sample sizes.
ResearchGate PrePrint 14

Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
Figure 11. Excess MC* death rates from neurologi-
cal diseases (except COVID-19-related deaths) for
2020, 2021, 2022 and 2023 for different age groups
of both sexes in the US. Top: Relative deviation
from trend, percent. Bottom: Deviation from trend
Z-Score.
6 SUMMARY OF FINDINGS AND
COMMENTARY
In this study we investigate trends in death rates
from neurological diseases (ICD-10 codes G00-
G98) for all age groups in the US using data from
the CDC. We also perform a detailed analysis for
younger individuals aged 15 to 44. We investigate
trends in neurological diseases where these appear
on multiple causes (MC) of death, or as the underl-
ying cause (UC), as well as the trends in the ratio of
multiple cause to underlying cause death rates. We
also investigate trends in MC* neurological deaths,
that is, multiple cause neurological deaths except
those that are also COVID-19-related.
Excess neurological disease deaths for all
ages
When investigating different age groups, Figure
9 shows (with more detail in the appendix) that the
excess UC death rates from neurological diseases in
2020, 2021, 2022 and 2023 seem to have impacted
mostly younger individuals aged 15 to 44, and also
newborns below 1 year of age. For age groups 45-54
and older we do not notice significant excess death
rates, similarly for age groups 1-4 and 5-14.
We show statistically significant excess death rates
from neurological diseases for age groups 15-24,
25-34 and 35-44, particularly in 2021, 2022 and
2023. The consistency of excess death rates for the
individual age groups within the broader 15-44 age
group analysis points to the observed signals being a
real effect and not an artifact of changing age-group
proportions. The signal strengths in 2020 were weak
for 15-24 and 25-34 age groups, likely due to small
sample sizes, while for age group 35-44 there was
already a statistically significant increase in death
rates starting in 2020. The largest percentage of
excess deaths were observed in the younger 15-
24 age group, where excess death rates were 6.8%
(
Z
-Score: 2.3) in 2020, 14.5% (
Z
-Score: 4.9) in
2021, 19.9% (
Z
-Score: 6.8) in 2022 and 20.9%
(
Z
-Score: 7.1) in 2023. Excess death rates rose
consecutively in 2020, 2021, 2022 and 2023 with
the rises in 2021, 2022 and 2023 showing very high
statistical significance (extreme occurrences), while
in 2020 the excess death rates had lower statistical
significance.
For newborns below the age of 1, the excess death
rates were 8.9% (
Z
-Score: 1.5) in 2020, 21.8% (
Z
-
Score: 3.7) in 2021, 14.5% (
Z
-Score: 2.5) in 2022
and 21.6% (
Z
-Score: 3.7) in 2023. In 2020 the
increase in death rates was not statistically signi-
ficant. However, in 2021 and 2023 excess death
rates exhibited a high degree of statistical signi-
ficance and in 2022 excess death rates were also
statistically significant, albeit with lower strength.
It should be noted that the excess deaths signal in
2021 coincided with the mass vaccination campaign
for COVID-19 (which included pregnant women),
ResearchGate PrePrint 15

Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
and that might have played a role in the observed
signal, and we believe merits further investigation.
One must also explain why older individuals, who
are subject to more COVID-19 vaccinations do not
appear to be impacted so strongly as younger indi-
viduals in 2021, 2022 and 2023. One explanation
could be that there was a larger pull-forward effect
for older individuals that tracks the all-cause mor-
tality increase caused by the COVID-19 pandemic,
and subsequently lower excess death rates from
neurological diseases (in 2021 and 2022). This is
supported by the negative excess UC deaths from
neurological diseases in older age groups in 2023,
which could indicate the end of the pull-forward
effect.
Excess deaths from neurological diseases
for age group 15 to 44
Our results show that the excess UC death rates
from neurological diseases for individuals aged 15
to 44 age were 4.4% (
Z
-Score 4.9) in 2020, then
rose to 10.0% (
Z
-Score 11.1) in 2021, 11.2% (
Z
-
Score 12.4) in 2022 and 8.1% (
Z
-Score 9.0) in 2023.
In 2020 we already observe a significant deviation
from the 2010-2019 trend in UC death rates, and the
excess UC death rates in 2021, 2022 and 2023 can
be considered extreme occurrences due to their very
high statistical significance. The results show a clear
break from the prior historical trend in death rates
from neurological diseases, pointing to a new pheno-
menon in action, worsening in 2022 and persisting
through 2023.
When analyzing excess MC death rates from neu-
rological diseases we show that these were 11.2% in
2020, which then rose to 20.6% in 2021 before sub-
siding to 14.7% in 2022 and 7.1% in 2023. These
numbers track closely the rises in all-cause morta-
lity which we mentioned in Figure 4, and are closely
associated with COVID-19-related deaths as was
confirmed by the MC* analysis. When analyzing
MC* death rates from neurological diseases (where
COVID-19 deaths are excluded) we show that these
followed a similar pattern to UC deaths rates, sugge-
sting that the rises in excess MC* death rates were
driven by the rises in excess UC death rates.
Of note, the larger rise in MC death rates from neu-
rological diseases when compared with UC death
rates implies that there was a pull forward effect
due to the early deaths of the most fragile indi-
viduals of the 15-44 age group with neurological
diseases. Consequently, we would expect that this
would lead to lower (or even negative) excess UC
death rates from neurological diseases in subsequ-
ent years, which was contrary to what has so far
occurred.
How can we explain the excess UC deaths from
neurological diseases in 2020, 2021, 2022 and
2023?
In 2020, this could be explained by deaths from
health effects related to the pandemic management
measures such lockdowns and lack of medical care,
or other related factors such as stress, less exe-
rcise, worse food habits, or from under-diagnosed
COVID-19 itself, or related side effects.
The acceleration in excess death rates from neu-
rological diseases in 2021, 2022 and 2023 is more
difficult to explain due to COVID-19 on its own.
Given the case studies of neurological adverse
events following COVID-19 vaccination cited in the
literature, one possible factor could be adverse effe-
cts of the COVID-19 vaccines. Furthermore, one
must also account for the possibility of continuous
COVID-19 infections or Long COVID (Jangnin,
et al., 2024)[
10
] or “Long COVID-19 vaccines”
(Asadi-Pooya, et al., 2023)[
11
] being contributors
towards an increased incidence or severity of neuro-
logical conditions, leading to increased neurological
disease death rates.
Limitations of the study
The main limitations of this study are data-related:
One of the limitations of our analysis is that the
2022 and 2023 data from the CDC for the different
causes of death is provisional, at the date of the data
download (5th April, 2024), which signifies that
it might be subject to change, particularly in the
classification of underlying cause or when adding
secondary causes of disease. This might lead to
some discrepancies when the final data is released.
ResearchGate PrePrint 16

Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
Furthermore, the CDC population denominator,
used to compute the death rates, is also provisional
in 2023, as the population values for 2023 are the
same as 2022, for each of the age groups. This
might lead to changes in the death rate calculations
once final values for both MC death classification
and the population denominator are released.
The second limitation is the data suppression that
the CDC WONDER system imposes on deaths with
fewer than 10 individuals. This suppression means
that it is not possible to perform a more granular
analysis, such as analyzing deaths that are conditio-
nal on several distinct causes (disaggregating MC
deaths), and in particular for younger age groups.
Future work
Given the literature showing the emergence of
neurological diseases following COVID-19 vacci-
nation cited above, future studies should focus
on COVID-19 vaccinated and un-vaccinated indi-
viduals and whether the vaccination rollout or
COVID-19-related conditions such as Long COVID
are contributing factors to the ongoing rise in
neurological-related deaths (Tindle, 2024)[12]
Future research should be aimed at disentan-
gling the effects of each factor separately or in
combination, stratified by age group, to better
inform public health decisions in the future and lead
towards effective therapeutic strategies for related
conditions.
CONFLICT OF INTEREST STATEMENT
None that the authors are aware of.
ACKNOWLEDGMENTS
The authors would like to acknowledge Elizabeth
Walsh and Bess Dalby for their comments and
suggestions towards the writing of the paper.
FUNDING SOURCES
There was no funding source associated with this
research. The research was a product of independent
work by the authors.
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Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
APPENDIX
Summary tables with MC, MC* and UC excess death rates from neurological diseases in
2020, 2021, 2022 and 2023, for all age groups.
MC* - Refers to Multiple Cause Deaths with the exception of those with COVID-19 ICD-10 code U07.1
n.a. - Data not possible to calculate due to data suppression rules for CDC WONDER
2020 UC Excess Death Rate MC Excess Death Rate MC* Excess Death Rate Ratio MC/UC
Age Group Deviation,% Z-Score Deviation,% Z-Score Deviation,% Z-Score
18.9 1.5 3.5 1.0 n.a. n.a. 2.45
1-4 -10.5 -2.0 -2.8 -0.7 n.a. n.a. 2.74
5-14 -5.5 -1.0 -10.0 -.6 -11.6 -4.2 2.12
15-24 6.8 2.3 7.3 3.2 3.5 1.5 2.12
25-34 2.0 1.0 9.6 5.4 4.9 2.8 2.65
35-44 3.8 3.7 12.0 7.7 5.8 3.7 3.01
45-54 0.0 0.0 11.6 14.7 3.1 3.9 3.12
55-64 1.1 0.8 11.9 9.2 3.1 2.4 2.78
65-74 7.0 2.7 15.4 6.4 4.9 2.0 2.07
75-84 6.9 1.9 15.3 5.0 4.7 1.5 1.59
85+ 5.3 1.0 13.6 3.1 4.0 0.9 1.40
Table 1. UC, MC and MC* excess death rates from neurological diseases for different age groups in 2020.
Excess death rates refer to deviations from 2010-2019 trend. The ratio MC/UC is the ratio of MC deaths to
UC deaths from neurological diseases.
2021 UC Excess Death Rate MC Excess Death Rate MC* Excess Death Rate Ratio MC/UC
Age Group Deviation,% Z-Score Deviation,% Z-Score Deviation,% Z-Score
121.8 3.7 15.3 4.4 n.a. n.a. 2.52
1-4 3.5 0.6 3.1 0.8 1.1 0.3 2.52
5-14 -1.5 -0.3 -7.4 -2.7 -10.4 -3.8 2.16
15-24 14.5 4.9 16.3 7.1 7.9 3.4 2.16
25-34 6.9 3.3 16.0 9.0 6.0 3.4 2.69
35-44 8.3 8.1 22.3 14.3 8.6 5.5 3.18
45-54 -2.2 -1.3 14. 18.7 0.0 0.0 3.30
55-64 -1.0 -0.7 12.9 10.0 0.9 0.7 2.87
65-74 2.3 0.9 12.5 5.1 2.1 0.9 1.59
75-84 2.5 0.7 11.3 3.7 2.7 0.9 1.59
85+ 4.3 0.9 11.7 2.7 4.54 1.0 1.38
Table 2. UC, MC and MC* excess death rates from neurological diseases for different age groups in 2021.
Excess death rates refer to deviations from 2010-2019 trend. The ratio MC/UC is the ratio of MC deaths to
UC deaths from neurological diseases.
ResearchGate PrePrint 19

Trends in death rates from Neurological diseases in the US for all ages and detailed analysis for 15-44
2022 UC Excess Death Rate MC Excess Death Rate MC* Excess Death Rate Ratio MC/UC
Age Group Deviation,% Z-Score Deviation,% Z-Score Deviation,% Z-Score
110.8 1.9 16.7 4.8 14.6 4.1 2.89
1-4 14.8 2.8 19.1 4.7 14.0 3.5 2.65
5-14 3.9 0.7 5.5 2.0 0.1 0.0 2.29
15-24 16.5 5.6 14.0 6.1 8.1 3.5 2.10
25-34 8.9 4.3 11.9 6.7 5.4 3.1 2.55
35-44 6.5 6.4 15.1 9.7 7.5 4.8 3.07
45-54 -0.5 -0.3 10.0 12.8 1.9 2.4 3.14
55-64 -2.0 -1.4 7.4 5.7 -0.4 -0.3 2.77
65-74 2.4 0.9 10.1 4.2 2.7 1.1 2.05
75-84 0.0 0.0 7.2 2.4 0.4 0.1 1.56
85+ -3.6 -0.7 2.5 0.6 -3.4 -0.8 1.36
Table 3. UC, MC and MC* excess death rates from neurological diseases for different age groups in 2022.
Excess death rates refer to deviations from 2010-2019 trend. The ratio MC/UC is the ratio of MC deaths to
UC deaths from neurological diseases.
2023 UC Excess Death Rate MC Excess Death Rate MC* Excess Death Rate Ratio MC/UC
Age Group Deviation,% Z-Score Deviation,% Z-Score Deviation,% Z-Score
121.6 3.7 17.3 4.9 n.a. n.a. 2.75
1-4 10.9 2.0 20.9 5.2 18.7 4.6 2.81
5-14 5.9 1.0 5.7 2.1 4.1 1.5 2.27
15-24 20.9 7.1 10.4 4.5 8.7 3.7 1.97
25-34 3.6 1.7 2.5 1.4 0.5 0.3 2.47
35-44 4.6 4.5 7.4 4.8 5.5 3.5 2.94
45-54 -6.5 -4.0 -2.2 -2.8 -3.9 -5.0 3.00
55-64 -7.6 -5.3 -3.8 -3.0 -5.9 -4.5 2.64
65-74 0.0 0.0 3.2 1.3 0.6 0.3 1.96
75-84 -0.7 -0.2 4.8 1.6 1.9 0.6 1.53
85+ -8.6 -1.7 -4.2 -1.0 -6.8 -1.6 1.34
Table 4. UC, MC and MC* excess death rates from neurological diseases for different age groups in 2023.
Excess death rates refer to deviations from 2010-2019 trend. The ratio MC/UC is the ratio of MC deaths to
UC deaths from neurological diseases.
ResearchGate PrePrint 20