Younger people are getting strokes at a faster rate, and people under age 55 make up a greater percentage of all strokes, according to a study out Wednesday in the journal Neurology.
The increase is an alarming trend because strokes in younger people translate to "greater lifetime disability," says lead author Brett Kissela, a physician at the University of Cincinnati College of Medicine and a fellow of the American Academy of Neurology. While the study design does not explore reasons for the change, he says the increasing prevalence of obesity and diabetes in younger patients could be leading factors. Better detection through increased use of imaging might also explain the increase, he says.
Stroke is the fourth-leading cause of death in the USA, according to the Centers for Disease Control and Prevention. It can also cause paralysis and speech and emotional difficulties. Lifestyle changes and better management of risk factors with medication have led to overall lower rates.
Researchers looked at strokes in people ages 20 and 54 in the greater Cincinnati/Northern Kentucky area during three separate one-year periods between 1993 and 2005. Only patients' first strokes were included.
They embarked on the study after noticing more young patients coming to hospitals with strokes.
Transient ischemic attacks, or TIAs, with symptoms lasting less than 24 hours were not included in the study's analysis of 923 cases.
Among findings:
Stroke rates in those under 55 increased from 109 per 100,000 people in 1993-1994 to 176 in 2005.
Average age of stroke patients fell from 71 in 1993-94 to 69 in 2005.
The rate among blacks 20-54 increased from 83 per 100,000 people in 1993-94 to 128 in 2005.
The rate among whites increased from 26 in 1993-94 to 48 in 2005.
Experts say findings will change the way doctors think about strokes.
"This is a very disturbing trend and meaningful, strong data," says neurologist Daniel Labovitz of Montefiore Medical Center in New York, who was not associated with the study. "In older people, we're more likely to make the call (diagnosing a stroke). Both patients and doctors tend to think, 'It can't be a stroke because the person is too young.' We all have to be on the lookout now. I will use this study as guidance."
The National Institutes of Health provided funding for the study.
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