Stroke among younger adults is becoming increasingly common, with rates nearly doubling among people ages 20 to 54 over nearly three decades, research has revealed.
Most of the increase involved ischaemic strokes, caused by blocked blood flow to the brain. Survival rates also improved over the study period.
Researchers identified 2,076 adults who experienced their first stroke during the period. Overall rates rose from 33.9 to 62.2 cases per 100,000 person-years, a measure accounting for population size and observation time.
Emily R. Fisher, study author at the University of Cincinnati, said: “While stroke has traditionally been considered a disease of older adults, our findings show that stroke is becoming increasingly common in younger adults.
“At the same time, more people are surviving these strokes, which means more younger adults may be living with the long-term effects of stroke.”
The study, involving researchers at the University of Cincinnati, examined nearly three decades of data on stroke incidence, risk factors and mortality among younger adults.
Ischaemic stroke rates almost doubled, rising from 23.8 cases per 100,000 person-years in 1993-94 to 47.3 in 2020.
This type of stroke occurs when a blocked blood vessel prevents oxygen and nutrients from reaching part of the brain.
No comparable increases were found in intracerebral haemorrhage, which involves bleeding within the brain, or subarachnoid haemorrhage, which involves bleeding in the space surrounding the brain.
The researchers also examined changes in health conditions and behaviours among younger stroke patients.
High blood pressure, diabetes, atrial fibrillation and substance use became more common over the study period.
Atrial fibrillation is an irregular heart rhythm that can allow blood clots to form in the heart. These can cause an ischaemic stroke if they travel to the brain.
One of the largest changes was in documented substance use, which rose from 4.6 per cent of younger stroke patients in 1993-94 to 40.2 per cent in 2020.
Much of the increase was associated with marijuana use.
However, the study could not establish whether these changes contributed to the rise in stroke rates.
Researchers lacked comparable health information from people who had not experienced a stroke, making it impossible to determine how much the observed risk factor trends contributed to the increase.
Despite the rise in cases, younger adults were somewhat more likely to survive a stroke than nearly three decades earlier.
After adjusting for age, race and sex, the proportion of patients who died within 30 days fell from 11.7 per cent in 1993-94 to 9.4 per cent in 2020.
The improvement was most noticeable among patients who experienced intracerebral or subarachnoid haemorrhage.
Better survival, however, does not necessarily mean a full recovery.
Depending on the location and severity of the brain injury, survivors can experience lasting difficulties with movement, speech, memory and other functions.
The researchers suggested that rising stroke rates, combined with improved survival, could mean more younger adults living with neurological complications for decades.
Fisher said: “Our findings highlight the importance of identifying and managing stroke risk factors early in adulthood. Additional research is needed to better understand what is driving these trends and how they can be reversed.”
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