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BackgroundAlzheimer's disease (AD) among patients with metabolic syndrome-related conditions is a global threat, contributing significantly to escalating mortality and economic burden. They demonstrate analogous pathophysiologies and risk determinants, highlighting the necessity for addressing this critical issue.ObjectiveThis study analyzed demographic trends and disparities of AD with metabolic syndrome-related conditions among patients aged 75 and above from 1999 to 2020.MethodsThis study examined the death certificates sourced from the CDC-WONDER database from 1999 to 2020, to analyze age-adjusted mortality rates (AAMRs) per 100,000 population. The Joinpoint regression model was used to assess trends in overall demographics, geographic, and place-of-death variables.ResultsThere were 2,355,233 deaths documented with AD listed as the underlying cause of death among older adults (aged ≥75), out of which 444,488 deaths were related to metabolic syndrome-related conditions from 1999 to 2020. The AAMR rose substantially from 36.48 in 1999 to 157.93 in 2020. Women consistently had higher AAMRs than males (females: 107.79, males: 79.02). Non-Hispanic African Americans (121.65) showed the highest mortality rates among all racial groups. However, from 1999 to the early to mid-2000s, all races highlighted a sharp peak in mortality rates. Striking geographical disparities were noted, with Mississippi in the top 90^th percentile and Massachusetts in the lower 10^th percentile.ConclusionsThis study reveals the demographic and geographic variations in mortality rates, highlighting the modalities of interventions and the need for equitable healthcare access.