Aging and Neurological Diseases

Kowalska, Marta; Owecki, Michał K.; Prendecki, Michał; Wize, Joanna Nowakowska Katarzyna; Kozubski, Wojciech; Lianeri, Margarita; Dorszewska, Jolanta

doi:10.5772/intechopen.69499

Cited by 26 publications

(21 citation statements)

References 175 publications

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“…Stroke is a leading contributor to Disability Adjusted Life Years (DALYs) in low and middle income countries (LMICs), causing 4.85 million deaths and 91.4 million DALYs compared to 1.6 million and 21.5 million deaths and DALYs respectively in high income countries [1]. Stroke incidence increases steeply with age, with a quarter of strokes occurring in individuals below 65 years compared with half occurring in those above 75 years [2]. The population at risk for stroke has increased in LMICs due to improved life expectancy mainly due to the treatment and control of HIV/AIDS [3].…”

Section: Introductionmentioning

confidence: 99%

The burden and outcomes of stroke in young adults at a tertiary hospital in Tanzania: a comparison with older adults

Matuja

Munseri

Khanbhai³

2020

BMC Neurol

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Background: Stroke burden in young adults is growing associated with unique risk factors and devastating outcomes. We aimed to investigate the magnitude, risk factors and outcomes of first ever stroke in young adults ≤45 years compared to older adults > 45 years. Methods: All patients with a World Health Organization clinical definition of stroke at a tertiary hospital in Tanzania were enrolled. The National Institute of Health Stroke Scale and Modified Rankin Scale were used to assess admission stroke severity and outcomes respectively. Kaplan-Meier analysis was used to describe survival and Coxproportional hazards model was used to examine predictors of fatality. Results: We enrolled 369 first ever stroke participants over 8 months. First strokes accounted for one quarter of the medical admissions in both younger and older groups, 123/484 {(25.4%) [95% CI 21.5-29.3%]} and 246/919 {(26.8%) [95% CI 23.9-29.6%]} respectively. Hemorrhagic stroke occurred in 47 (42.3%) vs 62 (27.2%) for the young and old respectively p = 0.005. Factors associated with stroke in the young were: a new diagnosis of hypertension in 33 (26.8%) vs 23 (9.3%) p < 0.001, HIV infection 12 (9.8%) vs 7 (2.8%) p = 0.005, use of hormonal contraception in females 33 (48.5%) vs 13 (9.4%) p < 0.001, elevated serum low density lipoproteins 28 (27.7%) vs 29 (16.4%) p = 0.024, hypercholesteremia 34 (31.2%) vs 40 (20.2%), p = 0.031, sickle cell disease 11 (9.7%) vs 9 (4.2%) p = 0.047 and thrombocytosis 12 (16.9%) vs 8 (5.6%) p = 0.007. The overall 30-day fatality rate was 215 (61.3%); 57 (49.1%) vs 158 (67.2%) in the young and old respectively. Independent predictors of fatality were: severe stroke {HR 10.35 (95% CI: 1.397-76.613)}, leukocytosis {HR 2.23 (95% CI: 1.448-3.419)} and fever {HR 1.79 (95% CI: 1.150-2.776)}. Conclusions: There is a high burden of stroke in young adults that is coupled with a high 30-day fatality rate. Screening and management of hypertension is crucial in the prevention of stroke. More research is needed to identify factors which cause death, allowing the development of sustainable interventions to reduce early post stroke fatality in this group.

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Section: Introductionmentioning

confidence: 99%

The burden and outcomes of stroke in young adults at a tertiary hospital in Tanzania: a comparison with older adults

Matuja

Munseri

Khanbhai³

2020

BMC Neurol

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show abstract

“…Stroke is a leading contributor to Disability Adjusted Life Years (DALYs) in low and middle income countries (LMICs), causing 4.85 million deaths and 91.4 million DALYs compared to 1.6 million and 21.5 million deaths and DALYs respectively in high income countries (1). Stroke incidence increases steeply with age, with a quarter of strokes occurring in individuals below 65 years compared with half occurring in those above 75 years (2). The population at risk for stroke has increased in LMICs due to improved life expectancy mainly due to the control and treatment of HIV/AIDS (3).…”

Section: Introductionmentioning

confidence: 99%

The burden and outcomes of stroke in young adults at a tertiary hospital in Tanzania: A comparison with older adults

Matuja

Munseri

Khanbhai³

2020

Preprint

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Background: Stroke burden in young adults is growing associated with unique risk factors and devastating outcomes. We aimed to investigate the magnitude, risk factors and outcomes of first ever stroke in young adults ≤45 years compared to older adults >45 years.Methods: All patients with a World Health Organization clinical definition of stroke at a tertiary hospital in Tanzania were enrolled. The National Institute of Health Stroke Scale and Modified Rankin Scale were used to assess admission stroke severity and outcomes respectively. Kaplan-Meier analysis was used to describe survival and Cox-proportional hazards model was used to examine predictors of fatality.Results: We enrolled 369 first ever stroke participants over 8 months. First strokes accounted for one quarter of medical admissions in both younger and older groups, 123/484 {(25.4%) [95% CI 21.5% - 29.3%]} and 246/919 {(26.8%) [95% CI 23.9% - 29.6%]} respectively. Hemorrhagic stroke occurred in 47 (42.3%) vs 62 (27.2%) for the young and old respectively p=0.005. Factors associated with stroke in the young were: a new diagnosis of hypertension in 33 (26.8%) vs 23 (9.3%) p<0.001, HIV infection 12 (9.8%) vs 7 (2.8%) p=0.005, use of hormonal contraception in females 33 (48.5%) vs 13 (9.4%) p<0.001, elevated serum low density lipoproteins 28 (27.7%) vs 29 (16.4%) p=0.024, hypercholesteremia 34 (31.2%) vs 40 (20.2%), p=0.031, sickle cell disease 11 (9.7%) vs 9 (4.2%) p=0.047 and thrombocytosis 12 (16.9%) vs 8 (5.6%) p=0.007. The overall 30-day fatality rate was 215 (61.3%); 57 (49.1%) vs 158 (67.2%) in the young and old respectively. Independent predictors of fatality were: severe stroke {HR 10.35 (95% CI: 1.397–76.613)}, leukocytosis {HR 2.23 (95% CI: 1.448–3.419)} and fever {HR 1.79 (95% CI: 1.150–2.776)}.Conclusions: There is a high burden of stroke in young adults that is coupled with a high 30-day fatality rate. Screening and management of hypertension is crucial in the prevention of stroke. More research is needed to identify factors which cause death, allowing the development of sustainable interventions to reduce early post stroke fatality in this group.

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“…These changes include accumulation of mutations, telomere attrition, and epigenetic alterations, resulting in genomic instability and thus priming for neuronal damage and loss, reduced neurotransmitter levels, enhanced neuroinflammation, increased susceptibility to cerebral ROS, and decreased cerebral vascular compliance. All of these adverse processes are associated with increased risk of age-related neurological diseases, such as stroke, epilepsy, Parkinson’s disease, and dementia/cognitive decline [ 58 ]. Immunosenescence and inflammaging, as the most recognized effects of aging [ 59 ], might promote neuroinflammatory processes along with cerebral oxidative stress, via altered microglia activation (immune cells of the brain), which are central to neurotoxicity through the release of neurotoxic cytokines, such as TNFα, IL-1β, and INF-γ, as well as different ROS such as ONOO − and O 2 •− [ 60 , 61 ].…”

Section: Impact Of Aging On Inflammation Adverse Redox Signalingmentioning

confidence: 99%

Accelerated Aging and Age-Related Diseases (CVD and Neurological) Due to Air Pollution and Traffic Noise Exposure

Hahad

Frenis

Kuntic

et al. 2021

IJMS

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The World Health Organization estimates that only approximately 25% of diversity in longevity is explained by genetic factors, while the other 75% is largely determined by interactions with the physical and social environments. Indeed, aging is a multifactorial process that is influenced by a range of environmental, sociodemographic, and biopsychosocial factors, all of which might act in concert to determine the process of aging. The global average life expectancy increased fundamentally over the past century, toward an aging population, correlating with the development and onset of age-related diseases, mainly from cardiovascular and neurological nature. Therefore, the identification of determinants of healthy and unhealthy aging is a major goal to lower the burden and socioeconomic costs of age-related diseases. The role of environmental factors (such as air pollution and noise exposure) as crucial determinants of the aging process are being increasingly recognized. Here, we critically review recent findings concerning the pathomechanisms underlying the aging process and their correlates in cardiovascular and neurological disease, centered on oxidative stress and inflammation, as well as the influence of prominent environmental pollutants, namely air pollution and traffic noise exposure, which is suggested to accelerate the aging process. Insight into these types of relationships and appropriate preventive strategies are urgently needed to promote healthy aging.

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Aging and Neurological Diseases

Cited by 26 publications

References 175 publications

The burden and outcomes of stroke in young adults at a tertiary hospital in Tanzania: a comparison with older adults

The burden and outcomes of stroke in young adults at a tertiary hospital in Tanzania: a comparison with older adults

The burden and outcomes of stroke in young adults at a tertiary hospital in Tanzania: A comparison with older adults

Accelerated Aging and Age-Related Diseases (CVD and Neurological) Due to Air Pollution and Traffic Noise Exposure

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