"Figure 3: In England, dementia and Alzheimers disease remained the leading cause of death in October 2021, while COVID-19 remained the third leading cause ","" "Age-standardised mortality rate for selected leading causes of death, per 100,000 people, England, deaths registered in October 2021 ","" "","" "Notes","1. Age-standardised mortality rates per 100,000 population, standardised to the 2013 European Standard Population. Monthly rates in this bulletin are adjusted to allow for comparisons with annual rates. For more information, see [Section 10: Measuring the data](https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/monthlymortalityanalysisenglandandwales/october2021#measuring-the-data). 2. Figures for 2021 are based on provisional mortality data and projected populations. 3. ""COVID-19"" includes only deaths where COVID-19 was the underlying cause of death. 4. Figures exclude deaths of non-residents. 5. The five-year average has been provided for 2015 to 2019 (rather than 2016 to 2020) because of the impact of the coronavirus (COVID-19) pandemic on deaths registered in 2020. The average for 2015 to 2019 provides a comparison of the number of deaths expected per month in a usual (non-pandemic) year. 6. Leading causes are ranked based on number of deaths, not age-standardised mortality rates. " "Unit","Age-standardised mortality rates " "","" "Leading cause","October 2021","5-year average" "Dementia and Alzheimers disease","101.7","113.5" "Ischaemic heart diseases","90.1","97.2" "COVID-19","50.8",":" "Malignant neoplasm of trachea bronchus and lung","46.1","54.8" "Cerebrovascular diseases","45.2","54.5" "Chronic lower respiratory diseases","44.9","47.1" "Influenza and pneumonia","27.7","39.9" "Symptoms signs and ill-defined conditions","26.8","22.5" "Malignant neoplasm of colon sigmoid rectum and anus","25.0","26.3" "Malignant neoplasms of lymphoid haematopoietic and related tissue","18.9","21.4"