CINCINNATI—Stroke is declining in the elderly but increasing at younger ages, new research from the University of Cincinnati (UC) indicates.
The research, based on data from Greater Cincinnati and Northern Kentucky, is being presented Wednesday, Feb. 24, at the American Stroke Association’s International Stroke Conference 2010 in San Antonio.
In 1993-94, the average age of first stroke in the region was 71.3 years. That number dropped to 70.9 in 1999 and 68.4 by 2005.
Meanwhile, the proportion of all strokes under age 45 was up to 7.3 percent in 2005 from 4.5 percent in 1993-94 and 5.5 percent in 1999.
"This is scary and very concerning,” says Brett Kissela, MD, the study’s lead author, an associate professor and vice chair of the neurology department at the UC College of Medicine and member of the UC Neuroscience Institute at University Hospital. "It shows that stroke is not just a disease of the elderly.
"What was shocking was the proportion of patients under age 45,” adds Kissela, noting that younger strokes carry the potential for greater lifetime burden of disability. "The proportion is up, and the incidence rate is up.”
The region included in the study has a population of about 1.3 million people. Kissela says the trend noted is likely occurring throughout the United States because the higher prevalence of risk factors such as obesity and diabetes in younger patients seen in Greater Cincinnati and Northern Kentucky is also seen in younger patients throughout the country.
Researchers also found racial differences in stroke incidence. For African-Americans, the incidence of strokes among those over age 85 dropped significantly by 2005. For whites, the incidence decreased significantly starting at age 65 by 2005.
In both races, the incidence rates for strokes in 20- to 45-year-olds increased, although the increase was only statistically significant among whites, doubling from 12 to 25 per 100,000 people.
Kissela says he became interested in studying the issue after observing an increase in young stroke patients admitted to UC Health University Hospital in Cincinnati. He says it’s hard to know with certainty what’s driving the trend toward strokes in younger people, but he speculates that the increased prevalence of diabetes, hypertension and obesity is a major contributor.
"As physicians, we need to look for these potent risk factors even in young people,” he says. "Stroke is a life-changing, devastating disease. It can affect young people, and we hope these data will serve as a wake-up call.”
Co-authors of the study, all affiliated with the UC College of Medicine, are: Kathleen Alwell; Jane Khoury, PhD; Charles Moomaw, PhD; Daniel Woo, MD; Opeolu Adeoye, MD; Matthew Flaherty, MD; Pooja Khatri, MD; Simona Ferioli, MD; Joseph Broderick, MD; and Dawn Kleindorfer, MD.