Journal
AGE AND AGEING
Volume 50, Issue 3, Pages 898-905Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ageing/afaa192
Keywords
stroke; epidemiology; older people; outcome
Categories
Funding
- Sante Publique France (French Institute for Public Health Surveillance)
- Institut national de la sante et de la recherche medicale (INSERM)
- University Hospital of Dijon
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The increasing burden of stroke in older people is associated with a greater prevalence of risk factors, severity of initial stroke, and poorer functional outcomes post-stroke among elderly patients. Discharge to home is less common in older stroke survivors, with a higher proportion requiring long-term care institutions, highlighting the need for dedicated care facilities in the future.
Background: the ongoing growing and ageing population is associated with an increase in older patients suffering a stroke. We aimed to assess the current profile of these patients in a population-based setting. Methods: all patients with acute stroke were prospectively identified among residents of Dijon, France, between 2013 and 2017, using a population-based registry. Characteristics and early outcome of patients were compared according to age groups. Results: 1,288 stroke cases were recorded (median age: 81.1 years, interquartile range: 66.1-86.7, 54% women). Patients aged 75-85 years and those >85 years accounted for 27.6 and 33.9% of overall cases. Increasing age was associated with a greater prevalence of vascular risk factors, pre-existing cognitive impairment and handicap, higher initial severity, more frequent cardioembolic ischemic stroke, post-stroke pulmonary infection and delirium. Only 41% of patients aged 75-85 years and 18% of those aged >85 years had a good early recovery. Compared with patients aged <75 years, patients aged 75-85 years [adjusted odds ratio (OR) = 2.61; 95% confidence interval (CI): 1.74-3.93, P < 0.001] and those aged >85 years (adjusted OR = 7.18; 95% CI: 4.58-11.3, P < 0.001) had an increased risk of poor post-stroke functional outcome. Among survivors, the proportion of patients discharged to home was 60% in age group <75 years, compared with 49% in patients aged 75-85 years and 29% in those aged >85 years. Thirty per cent of patients >85 years old required a long-term care institution. Conclusion: the increasing burden of stroke in older people has major implications for future treatment strategies and need for dedicated care facilities.
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