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This analysis uses the Multiple-Cause-of-Death file, created by Statistics Canada. All causes entered on a death certificate are routinely coded, and those codes produce raw multiple-cause data.Note 1 To produce multiple-cause-of-death data, computing software (the Automated Classification of Medical Entities) assigns the underlying cause of death based on World Health Organization rules for selection and modification and causal relationships among diseases. Another system (TRANSAX) converts death codes to a form amenable to person-based analysis of multiple causes. This software eliminates redundant causes in death certificates and combines pairs of codes into a third code.Note 1

Multiple-cause-of-death data for 2000 through 2011 were obtained from all provinces and territories—a total of 2,712,681 records. For earlier years, the data of certain provinces or territories were incomplete. To have complete information for all provinces and territories, this study used data for 2004 through 2011.

To produce multiple-cause-of death data at the national level for all provinces and territories, the multiple-cause information was merged with the Canadian Vital Statistics Death database maintained by Statistics Canada. The merge was based on the death registration number, province/territory, and year of occurrence. Because of mismatches between the two datasets, 0.6% of all deaths (0.4% of Alzheimer’s disease-related deaths) were excluded from analysis.

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