Epidemiology of stroke in the elderly in the Nordic countries. Incidence, survival, prevalence and risk factors

Abstract

Objective:To review what is known at present with respect to incidence, survival, risk factors and prevalence among the elderly stroke patients in the Nordic countries. Method: This article is based mainly on literature identified through search engines (Mc Master Plus, Cochrane Library, Medline and PubMed), restricted to first-ever stroke in Nordic population-based studies and having applied to the standard WHO definition, a prospective study design and no upper age limit. Results: Data from the Nordic countries show an incidence rate of 1250 to 1796/100 000 in the age group 75-84, and 1628 to 2234 in those above 85 years. The incidence rates are higher among men, but women are expected to contribute more to incident cases due to their higher life expectancy. If the age-specific incidence of stroke remains stable, the proportion of stroke patients aged 80 years and older may reach 50% in a few decades. The elderly stroke patients have a higher 30-days case fatality, and a higher risk of dependency. Better treatment of stroke patients has improved the survival over the last two decades. The prevalence is expected to increase due to the decrease in lethality, a slower fall in incidence and a higher proportion of elderly. Cardiovascular risk factors increase with age. Hypertension is a major risk factor for stroke mortality in the elderly. Cardioembolic stroke due to atrial fibrillation is the most common stroke subtype in the elderly. Lifestyle risk factors are less prevalent in the older stroke patients. Conclusion:The growing proportion of elderly stroke patients is a major challenge for future stroke care. The elderly stroke patients have a different risk factor profile compared to younger stroke patients. Treatment should focus on regaining independency. The age-specific epidemiology of stroke needs to be studied further in large studies in order to plan for future health care.

Current status of stroke epidemiology in Greece: A panorama

“…Epidemiological studies from Southern Europe have shown that stroke is more common in women than in men, with this predominance ranging from 50.5 to 62.1% for women [29], while data based on Western European surveys show a stroke ratio of 1.41, meaning that stroke episodes were 41% more common among the male population [30]. Although Greece extends over a peninsula located on the South-Eastern side of Europe, Greek studies have found a slight male predominance in stroke incidence, which appears to match the results and findings of studies in Northern Europe [31,32].…”

Hand strengthening exercises in chronic stroke patients: Dose-response evaluation using electromyography

“…1,2 Although mortality rates are decreasing due to a combination of interventions and public health programs, for example, improved control of hypertension, 3 the number of stroke incidents is steadily increasing due to demographic changes in the population. 4,5 Following stroke, up to 74% of patients rely on long-term help to perform activities of daily living (ADL), 6 and about 50% show impaired upper limb and hand function (Santisteban et al, 2016). These numbers are not surprising, as severe motor impairments of both upper and lower limb function following stroke are seen in many patients, 2,7 as a consequence of ischemic or hemorrhagic injury to areas associated with motor function.…”

Ischemic stroke in patients older and younger than 80 years

“…Old patients constitute a large part of patients with acute cerebral infarction. The age group above 80 years is expected to grow rapidly in the next decades in Nordic countries . Previous studies have shown that old patients differ from younger patients with ischemic stroke as to cause of ischemic stroke, severity of stroke, and outcome.…”