Increase in strokes in young

Recent research has found the incidence of strokes in under 64s has increased by 25%.

Strokes in the 20–64 age group now make up nearly a third of the total number of strokes compared with a quarter in 1990. Resulting in strokes no longer being a “disease of old age”. Related disability, illness and premature death caused by stroke is also projected to more than double by 2030.

There was some good news, death rates from stroke have decreased worldwide in the past two decades, but they didn’t mention the number of strokes that led to long-term disability.

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Where you live may also play a large part, with strokes becoming more widespread in the poorer countries. They also found that the UK falls behind both Germany and France in terms of mortality rates from stroke, measured against incidence, prompting calls for improvements in acute care.

The study made the news but with some reports using the word “epidemic”, which is perhaps a little strong as it may imply that strokes are spreading from one person to another…The media also related the findings to the “young” but the research focused more on the middle-aged.

The research used a validated analytical technique to calculate an estimate of percentage stroke incidence that would affect the general population and mortality. They also looked at disability-adjusted life years (DALYs) lost to stroke. DALYs are a measure of the number of years lost due to ill health, disability or early death, in this case from stroke.

Results

  • From 1990 to 2010, the incidence of stroke decreased by 12% (95% confidence interval (CI) 6–17) in high-income countries, and increased by 12% (-3 to 22) in low-income and middle-income countries. This last increase was not statistically significant.
  • Mortality rates decreased by 37% in high-income (95% CI 31–41) countries and by 20% in low-income and middle-income countries (95% CI 15–30).
  • In 2010, worldwide, there were 16.9 million people who had a first stroke (incident strokes), 33 million stroke survivors (prevalent strokes), 5.9 million stroke-related deaths and 102 million disability adjusted life years (DALYs) lost. These numbers had significantly increased since 1990 (by 68%, 84%, 26% and 12%, respectively).
  • Most of the stroke burden (68.6% incident strokes, 52.2% prevalent strokes, 70.9% stroke deaths and 77.7% DALYs lost) occurred in low-income and middle-income countries.
  • In 2010, 5.2 million (31%) strokes were in children (defined as less than 20 years old) and young and middle-aged adults (20–64 years).
  • 89% of strokes in children and 78% of strokes in young and middle aged adults occurred in low-income and middle-income countries.
  • There were significant differences in overall stroke burden between different regions and countries.
  • More than 62% of new strokes, 69.8% of prevalent strokes, 45.5% of deaths from stroke and 71.7% of DALYs lost because of stroke were in people younger than 75 years.

stroke

The researchers say that although mortality rates from stroke have decreased worldwide in the past two decades, the absolute number of people who have a stroke every year, the number of stroke survivors, related deaths and the overall global burden of stroke (DALYs lost) are “great and increasing”.

Despite an overall reduction in stroke, the findings on younger people are worrying.

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