October 19, 2026
Demographic incidence of mortality related to Alzheimer’s and Amyotrophic Lateral Sclerosis (ALS) in Brazil
Demographic Incidence of Mortality Related to Alzheimer’s and Amyotrophic Lateral Sclerosis (ALS) in Brazil
Simone Aparecida da Cruz Miquelin; Douglas Augusto de Paula
DOI: 10.22167/2675-6528-202603471
Article derived from a Course Conclusion Work (TCC), with content based on the student’s original work and adapted to the editorial format of the E&S Magazine with the support of the ResumeAI tool, an artificial intelligence solution developed by Instituto Pecege for textual synthesis and organization.
Summary
The demographic incidence of mortality related to Alzheimer’s disease and Amyotrophic Lateral Sclerosis (ALS) in Brazil represents a growing challenge for healthcare systems, given the acceleration of population aging. The study aimed to reveal relevant mortality patterns for these diseases, using analytical techniques applied to public databases. For this purpose, secondary mortality data from the Mortality Information System (SIM/DATASUS) and population data from IBGE (SIDRA) for the period 2015 to 2024 were used. The data were processed in Python, and descriptive methods, Poisson regression, and binary logistic regression were applied to analyze the distribution of deaths and their associations with demographic, socioeconomic, and occupational variables. The results indicated a significant increase in mortality from Alzheimer’s disease, predominantly in women over 75 years old and in the Southeast and South regions, and associated with low education levels and agricultural/rural occupations. Mortality from ALS remained relatively stable, with a higher incidence in men, in intermediate age groups (41-80 years), and in occupations with higher cognitive load, such as lawyers, but also in agricultural workers and bricklayers. It was concluded that Alzheimer’s disease shows an upward trend as a cause of neurological death, and ALS, although rare, maintains a relevant impact, highlighting the need for public policies for healthy aging and specialized care, with data science as a useful tool to support such actions.
Keywords: Alzheimer’s; Cognitive; ALS; Neurodegenerative.
1. Introduction
Neurodegenerative diseases, such as Alzheimer’s and Amyotrophic Lateral Sclerosis (ALS), represent a growing challenge for healthcare systems, especially in countries with rapidly aging populations, like Brazil (IBGE, 2023). The analysis of demographic data can reveal important patterns regarding the incidence, geographic distribution, and associated factors of these diseases, such as age, sex, and socioeconomic conditions.
Alzheimer’s is the most common form of dementia, characterized by gradual memory loss, behavioral changes, and decline in cognitive functions. It mainly affects people over 65 years old and is related to genetic, environmental, and lifestyle factors. In Brazil, it is estimated that 8.5% of the population aged 60 and over live with the disease, representing about 1.8 million cases, with a projection of 5.7 million by 2050 (BRASIL; UNIFESP, 2022). This exponential growth reflects not only the increase in life expectancy but also the need for public policies focused on prevention, early diagnosis, and continuous patient follow-up. National studies confirm this trend, pointing to a consistent increase in Alzheimer’s mortality in all regions of Brazil between 2000 and 2019 (PASCHALIDIS et al., 2023).
Amyotrophic Lateral Sclerosis (ALS) is a rare and progressive neurodegenerative disease that affects motor neurons, leading to loss of muscle function and, in advanced stages, respiratory failure. Although there have been advances in the genetic understanding of ALS, many unknown aspects about its origin and evolution remain, making the analysis of population data essential to identify incidence patterns and associated factors. The rarity of the disease makes it difficult to construct specific policies, but epidemiological studies show that ALS, despite being less prevalent, has a significant impact on the quality of life of patients and their families, requiring multidisciplinary support and specialized follow-up.
Although Alzheimer’s and ALS are distinct conditions, previous studies have pointed out relevant correlations between them. International research describes common neuropathological mechanisms, such as protein aggregation and cellular stress, in addition to the presence of similar biomarkers in patients with both diseases (HETZ et al., 2018; JOHNSON et al., 2025). Furthermore, patients with ALS may present cognitive impairment, bringing their clinical picture closer to typical Alzheimer’s manifestations (BORGHEAI et al., 2024). This intersection between the two conditions reinforces the importance of comparative studies that consider not only clinical aspects but also demographic and socioeconomic ones (VRILLON et al., 2021).
In recent years, data science has revolutionized the way large volumes of information are processed, offering predictive models capable of generating clinical insights and supporting personalized medical decisions. This work proposes the use of data analysis techniques to explore demographic and clinical information available in public databases, combining statistics and interactive visualizations.
In addition to contributing to the understanding of mortality from Alzheimer’s and ALS, this approach seeks to demonstrate how data science tools can be applied in public health contexts to transform raw data into useful knowledge. The integration of demographic, socioeconomic, and occupational variables allows not only for the characterization of disease incidence but also for the identification of more vulnerable population groups. This perspective broadens the scope of research, as it is not limited to the clinical description of diseases but incorporates social and economic dimensions that directly influence mortality indicators.
Another relevant aspect is the possibility of using the results to support public policies and health management strategies. By identifying regions with higher incidence or more affected population groups, managers can direct resources more efficiently, promoting awareness campaigns, professional training, and investments in hospital infrastructure. Temporal analysis also allows for observing trends and projecting future scenarios, contributing to long-term planning (PASCHALIDIS et al., 2023).
Therefore, this work is inserted in an interdisciplinary context, uniting knowledge from health, statistics, and data science to offer a comprehensive view of mortality from Alzheimer’s and ALS in Brazil. By revealing patterns and correlations, the aim is not only to broaden the scientific understanding of these diseases but also to provide practical subsidies for public health policies that respond to the challenges imposed by population aging and the complexity of neurodegenerative diseases. The objective of this study is to reveal relevant patterns of mortality from Alzheimer’s and Amyotrophic Lateral Sclerosis in Brazil, using analytical techniques applied to public databases, combining demographic and clinical statistics with interactive visualization tools.
2. Material and Methods
The present study was characterized as a quantitative, descriptive, and analytical research, with a methodological approach based on data science techniques. The objective was to reveal relevant patterns of mortality from Alzheimer’s and Amyotrophic Lateral Sclerosis (ALS) in Brazil, using secondary data from public databases and combining demographic and clinical statistics with interactive visualization tools.
Data collection was carried out from two main sources. Firstly, secondary mortality data from the Mortality Information System (SIM), which is part of the Informatics Department of the Unified Health System (DATASUS), were used. Access to the files was made via file transfer protocol (FTP – File Transfer Protocol) at the official DATASUS address (ftp://ftp.datasus.gov.br/dissemin/publicos/SIM/), covering the period from 2015 to 2024.
The identification of diseases of interest in death records was carried out through the CAUSABAS variable (basic cause of death), using the codes from the International Classification of Diseases – 10th Revision (ICD-10), as established by the World Health Organization (WHO, 1992). For Alzheimer’s, codes G30, G30.0, G30.1, G30.8, and G30.9 were considered. For Amyotrophic Lateral Sclerosis (ALS), code G12.2, corresponding to motor neuron disease, was used.
Additionally, population data by Federation Unit (UF) were obtained from the IBGE Automatic Recovery System (SIDRA), maintained by the Brazilian Institute of Geography and Statistics (IBGE). Specifically, table 1209 was consulted, which provides population estimates by age groups and UF for the year 2022 (IBGE, 2022). This information was crucial for contextualizing and comparing mortality rates.
For the treatment and data cleansing, the original files, which were in DBC (Data Base Compressed) format, were converted to DBF (Data Base File) using the TABWIN software (SUS Data Tabulator), an official tool for reading and converting DATASUS data. After conversion, the data were processed and treated using the Python programming language, in the Anaconda development environment, utilizing the Spyder IDE.
In the processing stage, the DBF files were read and converted into data structures called dataframes. The SIDRA population data were standardized, with the removal of irrelevant rows and the renaming of fields. Auxiliary dataframes were also created from tables provided by DATASUS, including the Brazilian Classification of Occupations (cbo2002-ocupacao.csv), the Municipalities Registry (CADMUN.DBF), the Federation Units Table (TABUF.DBF), and the ICD-10 descriptions (CID10.DBF).
The dataframes were integrated through merge operations, allowing the association of information such as municipality, capitals, codes and acronyms of the Federative Units, in addition to the description of diagnoses and occupations. The date variables (DTOBITO and DTNASC) were converted to the standard format, enabling the calculation of individuals’ age at the time of death. For fields with missing values, specific treatments were applied: assignment of zero for numerical variables (age, schooling, race/color, marital status) and filling with “n/a” for categorical variables (occupation and municipality).
The statistical analysis was conducted in Python, using libraries such as pandas, numpy, statsmodels, and scikit-learn. Descriptive methods and statistical models were applied to evaluate the distribution of deaths by Alzheimer’s and ALS and their associations with demographic variables. Individuals were grouped into age intervals (0-20, 21-40, 41-60, 61-80, 80+ years). The distribution by sex and region was obtained through tables of absolute and relative frequency.
The incidence rate was calculated per federative unit (UF), considering the resident population according to IBGE (2022). The measure was expressed as the number of deaths per 100,000 inhabitants, allowing for the comparison of the relative occurrence of diseases among different states, adjusted for population size.
For statistical modeling, Poisson regression was used, a model suitable for analyzing count data, such as the number of deaths in epidemiology (COLOSIMO, 2011). The dependent variable corresponded to the number of deaths from Alzheimer’s and ALS, adjusted by the resident population. The model allowed for the incorporation of explanatory variables such as schooling and occupation, evaluating their influence on mortality. The interpretation of the results was carried out using the Incidence Rate Ratio (IRR), where an IRR equal to one indicated a risk equivalent to the reference group, an IRR greater than one indicated increased risk, and an IRR less than one indicated reduced risk.
Additionally, binary logistic regression was applied to estimate the probability of an event occurring as a function of explanatory variables. This model classified mortality incidence into two binary categories: high incidence (rate above the median) and low incidence (rate below the median). The dependent variable was constructed from aggregated information by UF and year, based on the mortality incidence rate per 100,000 inhabitants.
The independent variables used in the binary logistic regression included schooling (ESC), occupation (OCUPACAO), age (IDADE), and sex (SEXO). Occupations with more than one hundred deaths were transformed into dummy variables. These variables were selected because they represent socioeconomic factors that may be associated with mortality from neurodegenerative diseases. The quality of the model was evaluated by accuracy, which corresponded to the proportion of correct classifications, and by the confusion matrix, which detailed the distribution between true positives, true negatives, false positives, and false negatives.
3. Results and Discussion
The analysis of mortality data for Alzheimer’s disease and Amyotrophic Lateral Sclerosis (ALS) in Brazil, from 2015 to 2024, revealed distinct and relevant demographic and socioeconomic patterns. A progressive increase in the incidence of both diseases was observed over the last decade, with Alzheimer’s showing a more significant upward trend. These findings are crucial for understanding the impact of population aging and the improvement of diagnostic processes and death registration in the country, as previously indicated by earlier studies (PASCHALIDIS et al., 2023). The use of analytical techniques applied to public databases allowed for the unveiling of these dynamics, contributing to the objective of revealing relevant mortality patterns.
The geographical distribution of deaths indicated that the South and Southeast regions concentrate the highest incidence rates for both diseases. This concentration can be attributed to demographic factors, such as the larger proportion of elderly population in these regions, according to data from the 2022 Demographic Census (IBGE, 2022). The temporal analysis, in turn, demonstrated continuous growth in mortality incidence, especially for Alzheimer’s, throughout the studied period. This trend reinforces the need for public policies aimed at healthy aging and specialized care, considering the regional particularities of Brazil.
Distribution by age group, sex, and region
Regarding the age distribution, Alzheimer’s disease demonstrated a strong association with advanced aging. The highest concentration of deaths occurred in individuals over 61 years old, with a marked predominance in the age group over 80 years, which registered 174,939 deaths. In contrast, younger age groups showed significantly lower numbers, with only 1 death between 1 and 20 years old, 23 deaths between 21 and 40 years old, and 1,312 deaths between 41 and 60 years old. This pattern reinforces the disease’s character as a condition strongly linked to old age, aligning with literature that highlights aging as the main risk factor for dementia (PASCHALIDIS et al., 2023).
Amyotrophic Lateral Sclerosis (ALS), although also related to aging, exhibited a distinct mortality profile regarding age group. The highest incidence of deaths from ALS was observed between 41 and 80 years of age, with a peak in the 61 to 80 year range, which accounted for 8,499 deaths. The 41 to 60 year range recorded 4,912 deaths, while the range above 80 years presented 1,187 deaths. In the younger age groups, there were 128 deaths between 1 and 20 years and 488 deaths between 21 and 40 years. These data suggest that the lethal manifestation of ALS tends to occur at earlier stages of the life cycle compared to Alzheimer’s, implying differentiated challenges for health policies, especially regarding early diagnosis and palliative care.
Temporal evolution by sex
The analysis of the temporal evolution of deaths by sex between 2015 and 2024 revealed important patterns. For Alzheimer’s, a continuous growth in the number of deaths was observed throughout the decade, with a clear predominance in the female sex category. The female category accounted for the majority of deaths in all years analyzed, followed by the male category. This pattern of unequal distribution by sex indicates a greater vulnerability of women to mortality from Alzheimer’s, a finding that corroborates evidence from the literature associating the female sex with an increased risk of dementia (BRASIL; UNIFESP, 2022).
Regarding ALS, a gradual increase in deaths was observed in the same period, although on a smaller scale when compared to Alzheimer’s. Unlike Alzheimer’s, the higher incidence of mortality from ALS occurred in the male sex category, followed by the female category. The category of unidentified deaths showed residual values in both cases, indicating that most records contained information about the sex of the individuals. The temporal progression of ALS, even if less pronounced, maintains a growing impact on mortality, especially in intermediate and advanced age groups, reinforcing the need for continuous attention to this rare disease.
Education
The research results indicated that schooling is a factor that is distinctly associated with mortality from Alzheimer’s and ALS. For Alzheimer’s, the highest concentration of deaths was observed in individuals with low schooling. The Fundamental II (2) category registered 60,562 deaths, followed by the Ensino Médio (3) category with 51,281 deaths and Fundamental I (1) with 44,294 deaths. People without schooling (0) or with unidentified schooling (9) also showed significant numbers, with 11,071 and 26,948 deaths, respectively. Individuals with complete higher education (5) and incomplete higher education (4) showed lower incidence, with 30,472 and 14,373 deaths, respectively. This pattern suggests a direct relationship between lower educational level and greater vulnerability to mortality from Alzheimer’s, reinforcing the importance of socioeconomic factors in the progression of the disease.
In contrast, ALS presented a more balanced distribution of deaths in relation to schooling, without the same direct correlation with lower levels of education observed in Alzheimer’s. The highest incidence of deaths from ALS was identified in individuals with Complete Higher Education (5), with 3,900 deaths, and High School (3), with 3,196 deaths. The Middle School category (2) registered 2,577 deaths, while Elementary School (1) had 874 deaths. People with no schooling (0) and with unidentified schooling (9) presented 748 and 1,450 deaths, respectively. This data indicates that ALS may not have the same relationship with schooling as Alzheimer’s, suggesting that other factors may be more influential in its incidence.
Occupation
The application of the Poisson regression model to correlate occupation and deaths, considering 87 occupations with more than 100 deaths, revealed striking differences between the two neurodegenerative diseases. For Alzheimer’s, occupations related to agricultural and rural work showed extremely high risk ratios (RR). Flying agricultural workers registered an RR of 21,019.00, and agricultural workers in general presented an RR of 17,378.00. Other occupations with high risk included general service domestic employees (RR of 7,601.00) and retail merchants (RR of 8,346.00). Professions requiring higher education, such as lawyers (RR of 2,956.00) and university professors (RR of 2,503.00), showed a relatively low risk compared to agricultural occupations, although they still represent significant numbers of deaths.
Regarding ALS, the occupation with the highest risk was lawyer, with a risk ratio of 6.09. This finding is particularly noteworthy, as it suggests an association with occupational conditions involving mental stress and high cognitive load. Next, agricultural workers (RR of 3.242 for agricultural itinerant workers and 3.069 for agricultural workers in general) and bricklayers (RR of 2.314) also presented elevated risks. Professions linked to the service and commerce sector, such as retail merchants (RR of 2.531) and self-employed commercial representatives (RR of 1.976), also indicated an increased risk. This distinction suggests that ALS may be associated not only with social factors such as low education, but also with cognitive demands and occupational stress, a point that finds support in international literature (RHODES et al., 2024; BORGHEAI et al., 2024; VRILLON et al., 2021).
Binary logistic regression
The binary logistic regression models applied to classify the incidence of mortality as high and low for Alzheimer’s and ALS presented moderate accuracy, with 65% for Alzheimer’s and 63% for ALS. This reasonable ability to distinguish between incidence contexts reinforces the utility of the approach. The analysis demonstrated that variables such as schooling, occupation, age, and sex exert a significant influence on mortality, contributing to the identification of vulnerability patterns in the Brazilian population. The confusion matrix, which compares predicted and observed values, corroborated the model’s performance, indicating a balance in class classification.
Despite the relevance of these explanatory variables, the models also showed that these factors are not sufficient to capture the full complexity of neurodegenerative diseases. This suggests the need to incorporate additional variables, such as clinical conditions and individual health history, in future studies to enhance the predictive power of the models. However, logistic regression proved to be a valuable tool for highlighting population groups more exposed to risk, providing important subsidies for the development of effective public policies aimed at reducing mortality from Alzheimer’s and ALS and promoting healthy aging with specialized support.
In summary, the research revealed that mortality from Alzheimer’s and ALS in Brazil presents distinct, yet equally challenging, demographic and socioeconomic patterns. Alzheimer’s shows a strong association with advanced age, the female sex, and low education levels, in addition to a high incidence in agricultural occupations. ALS, in turn, although rarer, impacts intermediate age groups, the male sex, and is associated with occupations of high cognitive load, such as lawyers, but also with agricultural workers. These findings reinforce the need for differentiated public policies and the application of data science as an essential tool to support effective and targeted public health actions.
4. Conclusion
The present study aimed to reveal relevant patterns of mortality from Alzheimer’s and Amyotrophic Lateral Sclerosis (ALS) in Brazil, using analytical techniques applied to public databases. An expressive increase in Alzheimer’s mortality was observed in the period from 2015 to 2024, predominantly in women over 75 years old and in the Southeast and South regions of the country. An association was observed with low schooling and occupations related to agricultural and rural work. In contrast, mortality from ALS, although with gradual growth on a smaller scale, predominantly affected men, in intermediate age groups (41-80 years), and in occupations with higher cognitive load, such as lawyers, but also in agricultural workers and bricklayers. These findings demonstrate the capacity of data science to transform raw information into useful knowledge, identifying vulnerable population groups and providing subsidies for the direction of public policies and health management strategies, aiming for healthy aging and specialized care.
Despite the relevance of the identified patterns, the applied binary logistic regression models showed moderate accuracy, indicating that demographic, socioeconomic, and occupational variables, although significant, do not capture the full complexity of these neurodegenerative diseases. This limitation suggests the need for future studies that incorporate additional variables, such as clinical conditions and individual health history, to enhance predictive power and understanding of the phenomena. However, the analytical approach employed reinforces the role of data science as an essential tool to support effective and targeted public health actions, contributing to long-term planning and mitigation of the challenges posed by population aging and the growing incidence of neurodegenerative diseases in Brazil.
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Article originating from the Final Course Project of the Specialization in Data Science and Analytics of the MBA USP/Esalq
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