Mortality From Alzheimer's Disease, Parkinson's Disease, and Dementias in France and Italy A Comparison Using the Multiple Cause-of-Death Approach

Objective: We perform an in-depth analysis of all death certificates collected in France and Italy with an entry of Parkinson's disease (PD), Alzheimer's disease (AD), or another dementia. Method: Data are for 2008. We measure how frequently these conditions are the underlying cause of death. We then examine what other causes are reported on the certificates. Results: In both countries, AD is the underlying cause for about 6 in 10 certificates with an AD entry. The proportion is lower for PD and dementia, but higher in France than in Italy. Many contributing causes reflect the circumstances surrounding the end of life in AD, PD, and dementia, often characterized by bed confinement and frailty. Discussion: Our research highlights several consequences of the conditions under study that could be targeted by public health policy. It also speaks to the existence of differences in diagnosis/certification practices that may explain differences in mortality levels.