Cerebrovascular disease incidence in central Spain (NEDICES): a population-based prospective study

Stroke is one of the most disabling and burdensome health conditions worldwide, but no prospective population-based study has been conducted in Spain. Our aim was to assess age- and gender incidence rates of cerebrovascular disease, including stroke and transient ischemic attack, in three populations in central Spain using data from the NEDICES (Neurological Diseases in Central Spain), a population-based survey of elderly participants.

Individuals were evaluated at baseline (1994-1995) and at follow-up (a median of 3.2 years later in 1997-1998). The evaluation included a screening questionnaire for stroke and a neurological assessment (when possible).

Of 5278 participants evaluated at baseline, there were 257 prevalent stroke cases. Seventy-five incident patients with cerebrovascular disease (57 stroke cases and 18 transient ischemic attacks cases) were identified among 3914 individuals assessed at follow-up. Average annual incidence rate (per 1000 person-years) in the population aged 65 to 85 and over years, adjusted to the standard European population, was 5.1 (95% CI, 3.7 to 6.6) for all types of cerebrovascular disease. Age-specific incidence rates of cerebrovascular disease increased with advancing age. Age and diabetes mellitus were independent risk factors for cerebrovascular disease. Number of vascular risk factors present at baseline showed an independent positive and graded association with incident cerebrovascular disease.

In the NEDICES study, incidence of cerebrovascular disease increased with age beyond age 85. Our incidence rates provide new estimates for projection of future burden of disease in Spain.