Stroke in the Very Elderly: Characteristics and Outcome in Patients Aged ≥85 Years with a First-Ever Ischemic Stroke
Neuroepidemiology , 07/17/2012
Gur AY et al. - There is an increasing proportion of very elderly subjects, mostly women, among first-ever ischemic stroke patients. Current information on age-specific aspects of stroke in the very elderly is crucial to set up successful prevention pathways and implementing well-organized stroke care for this population.Methods
- The NASIS registry is a nationwide prospective hospital-based study performed triennially (2004, 2007, 2010).
- Patients with ischemic stroke aged ≥85 years were compared with those 65–84 years old regarding their baseline characteristics, stroke severity, etiology of stroke and stroke outcomes.
- Logistic regression analyses were used to adjust for potential confounders.
- Stroke severity was determined according to the National Institute of Health Stroke Scale (NIHSS) score.
- The proportion of very elderly (≥85 years) patients among the NASIS population increased from 18.3% in 2004 to 19.9% in 2007 and 24.5% in 2010 (p for trend = 0.005).
- The percentage of women was higher in patients aged ≥85 years (p < 0.0001).
- Atrial fibrillation, congestive heart disease and prior disability were significantly more common, while diabetes, current smoking and dyslipidemia were less frequent in the very elderly.
- The very elderly presented with more severe strokes: 36.3% of the ≥85-year-old patients had an NIHSS score ≥11 compared with 22.0% in the younger age group (p < 0.05).