Stroke, long considered a disease of older age, is becoming far more common among younger adults, according to a new study published in Neurology, the medical journal of the American Academy of Neurology.
Researchers analysed nearly three decades of data from the Greater Cincinnati and Northern Kentucky region in the United States, covering 2,076 adults aged 20 to 54 who had their first stroke between 1993 and 2020. The stroke rate rose from 33.9 cases per 100,000 person-years in 1993-94 to 62.2 in 2020, an increase of about 83 per cent.
Most of the rise was driven by ischaemic strokes, which occur when a blood vessel supplying the brain is blocked. Their rate climbed from 23.8 to 47.3 per 100,000 person-years over the same period. Bleeding strokes did not show a comparable increase.
The study also tracked health conditions among younger patients who suffered strokes. High blood pressure, diabetes, atrial fibrillation (an irregular heartbeat that can lead to clots) and substance use all became more common over time. Documented substance use among these patients rose from 4.6 per cent to 40.2 per cent, with much of the increase linked to marijuana.
There was some good news. The share of patients who died within 30 days of a stroke fell from 11.7 per cent to 9.4 per cent, with the biggest improvement among those who had bleeding strokes. But survival does not always mean full recovery, and survivors may live for decades with difficulties in movement, speech or memory.
“More younger adults may be living with the long-term effects of stroke,” said study author Dr Emily R. Fisher of the University of Cincinnati. She stressed the need to identify and manage risk factors early in adulthood.
The researchers cautioned that the study could not prove these risk factors caused the rise because it lacked comparison data from people who did not have strokes. It was also limited to one region, so the findings may not apply everywhere.