Age at stroke Temporal trends in stroke incidence in a large, biracial population
ABSTRACT We describe temporal trends in stroke incidence stratified by age from our population-based stroke epidemiology study. We hypothesized that stroke incidence in younger adults (age 20-54) increased over time, most notably between 1999 and 2005.
The Greater Cincinnati/Northern Kentucky region includes an estimated population of 1.3 million. Strokes were ascertained in the population between July 1, 1993, and June 30, 1994, and in calendar years 1999 and 2005. Age-, race-, and gender-specific incidence rates with 95 confidence intervals were calculated assuming a Poisson distribution. We tested for differences in age trends over time using a mixed-model approach, with appropriate link functions.
The mean age at stroke significantly decreased from 71.2 years in 1993/1994 to 69.2 years in 2005 (p < 0.0001). The proportion of all strokes under age 55 increased from 12.9% in 1993/1994 to 18.6% in 2005. Regression modeling showed a significant change over time (p = 0.002), characterized as a shift to younger strokes in 2005 compared with earlier study periods. Stroke incidence rates in those 20-54 years of age were significantly increased in both black and white patients in 2005 compared to earlier periods.
We found trends toward increasing stroke incidence at younger ages. This is of great public health significance because strokes in younger patients carry the potential for greater lifetime burden of disability and because some potential contributors identified for this trend are modifiable.
Article: Stroke in young adults: On the rise?[Show abstract] [Hide abstract]
ABSTRACT: Stroke has traditionally been considered a disease of the elderly, its incidence doubling with each decade after age 50. Given the aging of the population of the developed world, prevalent stroke is projected to increase by 24.9% over the next 20 years.(1) In this light, decreasing overall stroke incidence rates in the 21st century are welcome news. The Framingham Heart Study reported a decline in age-adjusted stroke incidence per 1,000 person-years from 1950 to 2004 of 7.6 to 5.3 in men and 6.2 to 5.1 in women.(2).Neurology 10/2012; 79(17):1752-3. DOI:10.1212/WNL.0b013e31827040d6 · 8.30 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: BACKGROUND AND PURPOSE: Approximately 5% of strokes occur in adults aged 18 to 44 years. Substance abuse is a prevalent risk factor for stroke in young adults. We sought to identify trends in substance abuse detection among stroke patients. METHODS: Using a population-based design, we sought to identify all patients aged 18 to 54 years experiencing a stroke (ischemic or hemorrhagic) in the Greater Cincinnati and Northern Kentucky Study region during 1993 to 1994, 1999, and 2005. Demographic and clinical characteristics and substance use data were obtained retrospectively from chart review and adjudicated by physicians. RESULTS: The number of young patients identified with a stroke increased from 1993 to 1994 (297) to 2005 (501). Blacks (61% vs 51%; P<0.02) and men (61% vs 47%; P<0.002) reported substance abuse (current smoking, alcohol, or illegal drug use) more frequently than did whites and women. Overall use of substances increased across study periods, 45% in 1993 versus 62% in 2005 (P=0.003). The trend was significant for illegal drug use (3.8% in 1993 vs 19.8% in 2005) and ever smoking (49% in 1993 vs 66% in 2005). Documentation of both cocaine and marijuana use increased over time. In 2005, half of young adults with a stroke were current smokers, and 1 in 5 abused illegal drugs. CONCLUSIONS: Substance abuse is common in young adults experiencing a stroke. The observed increase in substance abuse is contributing to the increased incidence of stroke in young adults. Patients aged younger than 55 years who experience a stroke should be routinely screened and counseled regarding substance abuse.Stroke 11/2012; 43(12). DOI:10.1161/STROKEAHA.112.667808 · 6.02 Impact Factor
Article: Stroke: advances in thrombolysisThe Lancet Neurology 01/2013; 12(1):2-4. DOI:10.1016/S1474-4422(12)70273-9 · 21.82 Impact Factor