Intracerebral Hemorrhage in the Very Old Future Demographic Trends of an Aging Population

Background and Purpose-In most European societies and in the United States, the percentage of patients >= 80 years has been rising over the past century. The present study was conducted to observe this demographic change and its impact on patients with intracerebral hemorrhage (ICH). Methods-We reviewed patients' data with the diagnosis of ICH from January 2007 to December 2009. All data were collected out of a prospective stroke registry covering the entire state of Hesse, Germany. Incidence rates and absolute numbers of patients with ICH for 2009 to 2050 were calculated. Results-Of 3448 patients, 34% had an age >= 80 years. Hospital mortality was 35.9% for patients >= 80 years and 20.0% for patients >= 80 years. Unfavorable outcome (modified Rankin Scale score >2) was more often found in patients >= 80 years compared with patients <80 years (84.9% versus 74.8%). By the year 2050, the proportion of all patients with ICH <80 years will be 2.5-fold higher than in 2009. The total number of ICH cases will increase approximately 35.2% assuming that ICH probability stays the same. The number of patients who die in the hospital will increase approximately 60.2%. The total number of patients with severe disability due to ICH will increase approximately 36.8%. Conclusions-If current treatment strategies according to age remain unchanged, an increase of in-hospital mortality and a higher proportion of patients who need lifelong care after ICH can be expected in the coming decades. (Stroke. 2012;43:1126-1128.)