McLean, VA (written by Janice Lloyd/USA Today) -- 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 today 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 in Ohio and a fellow of the American Academy of Neurology. While he adds that the study design does not explore reasons for the change, he thinks the increasing prevalence of obesity and diabetes could be leading factors. National studies have shown those risk factors are increasing among younger patients. Better detection through increased use of imaging might also explain the rise, 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 occurrences of strokes in people between the ages 20 and 54 in the Greater Cincinnati/Northern Kentucky area during three separate, one-year-long periods between July 1993 and June 1994, and the calendar years of 1999 and 2005. Only patients' first strokes were included in the analysis. Data analysis from 2010 is underway.
They embarked on the study after noticing more young patients coming to hospitals with strokes. To qualify as a case in the study, a patient must have met the criteria for one of these stroke categories: cerebral ischemia, intracerebral hemorrhage, subarachnoid hemorrhage or stroke of uncertain cause. Transient ischemic attacks (TIAs) with symptoms lasting less than 24 hours were not included.
Among findings on the 923 stroke cases analyzed:
-- Stroke rates in those under age 55 increased from 109 (per 100,000 population) in 1993-1994 to 176 in 2005.
-- The average age of stroke patients fell from 71 years old in 1993-1994 to 69 in 2005.
-- The rate among African Americans ages 20-54 increased from 83 per 100,000 population in 1993-94 to 128 in 2005.
-- The rate among Caucasians ages 20-54 increased from 26 per 100,000 in 1993-94 to 48 in 2005.
Experts say the findings will change the way doctors think about strokes.
"This is a very disturbing trend and meaningful, strong data,'' said neurologist Daniel Labovitz of the Montefiore Medical Center in New York, who was not associated with the study.
"In older people, we're more likely to make the call (of 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."
About 80% of all strokes are preventable, according to the American Stroke Association. Among older black and white patients in the study, the rates have been dropping, as other studies also have shown. The National Institutes of Health provided funding for the study.
"The good news is that some of the possible contributing factors to these strokes can be modified with lifestyle changes, such as diet and exercise," said Kissela. "However, given the increase in stroke among those younger than 55, younger adults should see a doctor regularly to monitor their overall health and risk for stroke and heart disease."